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目的探讨黄芪注射液联合1,6-二磷酸果糖治疗儿童病毒性心肌炎(viral myocarditis,VMC)的临床效果。方法选取2011年9月—2012年11月收治的VMC患儿63例,随机分为对照组31例和治疗组32例,对照组给予吸氧、维生素C、辅酶、抗病毒及其他基础治疗。治疗组在对照组的基础上给予1,6-二磷酸果糖100~250 mg.kg-1.d-1加入5%葡萄糖注射液100~250 ml静脉滴注,1次/d;黄芪注射液10~20 ml加入10%葡萄糖注射液100~250 ml静脉滴注,1次/d。两组均连续治疗10 d为1个疗程,治疗2~3个疗程后比较心肌酶谱、疗效和不良反应。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果心肌酶谱改善对照组占74.2%,治疗组占96.9%,两组比较差异有统计学意义(χ2=5.55,P<0.05);总有效率对照组71.0%,治疗组90.6%,比较差异有统计学意义(χ2=4.71,P<0.05);除个别患儿出现注射部位疼痛外,两组患儿均未出现胃肠道反应和过敏反应,也无肝肾损害等不良反应发生。结论黄芪注射液联合1,6-二磷酸果糖治疗儿童VMC疗效好,恢复快,无明显不良反应,值得推广。
Objective To investigate the clinical effect of Astragalus injection combined with fructose-1,6-diphosphate in the treatment of viral myocarditis (VMC) in children. Methods Sixty-three children with VMC who were admitted from September 2011 to November 2012 were randomly divided into control group (n = 31) and treatment group (n = 32). The control group was given oxygen, vitamin C, coenzyme, antiviral and other basic treatment. The treatment group was given 100 ~ 250 mg.kg-1.d-1 fructose-1,6-diphosphate on the basis of the control group by intravenous infusion of 100-250 ml 5% dextrose injection once / d, Astragalus injection 10 ~ 20 ml 10% glucose injection 100 ~ 250 ml intravenous infusion, 1 time / d. Both groups were treated for 10 consecutive days as a course of treatment, after treatment of 2 to 3 courses of myocardial enzymes, efficacy and adverse reactions. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The myocardial enzyme spectrum improved 74.2% in the control group and 96.9% in the treatment group, with significant difference between the two groups (χ2 = 5.55, P <0.05); the total effective rate was 71.0% in the control group and 90.6% in the treatment group (Χ2 = 4.71, P <0.05). Except for some patients with pain in the injection site, no gastrointestinal reactions and allergic reactions occurred in both groups, and no adverse reactions such as liver and kidney damage occurred. Conclusion Astragalus injection and fructose-1,6-diphosphate treatment of children with VMC good curative effect, rapid recovery, no obvious adverse reactions, it is worth promoting.