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目的探讨曲美他嗪联合灯盏花素注射液治疗急性病毒性心肌炎的临床疗效及可能的作用机制。方法将124例急性病毒性心肌炎患者随机分为观察组和对照组各62例。2组均给予常规对症、营养支持治疗,并给予曲美他嗪口服,观察组在对照组基础上给予灯盏花素注射液静滴,治疗4周后比较2组疗效,检测治疗前后心肌酶谱(CK、CK-MB、c Tn I、LDH)及炎症细胞因子相关指标(TNF-α、IL-6、CRP)水平,记录患者临床症状及体征改善时间。结果观察组临床总有效率显著高于对照组(P<0.05);治疗4周后,2组心肌酶谱指标及炎症细胞因子水平均较治疗前、同期对照组明显下降(P均<0.05);且观察组心脏扩大、胸闷、心悸、ST-T及心律失常改善时间明显短于对照组(P均<0.05)。结论曲美他嗪联合灯盏花素注射液治疗急性病毒性心肌炎疗效较好,可通过减轻炎症反应而减轻心肌损伤,值得推广应用。
Objective To investigate the clinical efficacy and possible mechanism of trimetazidine combined with breviscapine injection in the treatment of acute viral myocarditis. Methods 124 patients with acute viral myocarditis were randomly divided into observation group and control group, 62 cases each. 2 groups were given conventional symptomatic and nutritional support treatment, and oral administration of trimetazidine, the observation group was given Breviscapine Injection intravenously on the basis of the control group, after 4 weeks of treatment, the efficacy of two groups were compared, before and after treatment to detect myocardial enzymes (CK, CK-MB, cTn I, LDH) and inflammatory cytokines (TNF-α, IL-6, CRP) were measured and the clinical symptoms and signs of patients were recorded. Results The total effective rate in observation group was significantly higher than that in control group (P <0.05). After 4 weeks of treatment, the levels of myocardial enzymes and inflammatory cytokines in two groups were significantly lower than those in the control group (P <0.05) In the observation group, heart enlargement, chest tightness, palpitation, ST-T and arrhythmia were significantly shorter than those in the control group (all P <0.05). Conclusion Trimetazidine combined with breviscapine injection is effective in the treatment of acute viral myocarditis. It can relieve myocardial injury by reducing inflammation and is worth popularizing and applying.