抗柯注射液治疗柯萨奇B病毒性心肌炎及其机理研究

作者	单位
陈曙霞	上海第二医科大学仁济医院
梅尚文	上海第二医科大学仁济医院
王平全	上海第二医科大学仁济医院
陈美芳	上海第二医科大学仁济医院
钱富荣	上海第二医科大学仁济医院
谢龙山	上海第二医科大学仁济医院

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中文摘要:

目的：探讨抗柯注射液治疗柯萨奇Ｂ病毒性心肌炎作用机理。方法：以苦参中抗柯萨奇病毒的有效成分制成纯度为９９．４３％的抗柯注射液（下称ＲＳＦ）治疗７６例血中柯萨奇Ｂ病毒核酸（ＣＢＶ－ＲＮＡ）持续阳性的病毒性心肌炎患者（Ａ组），并与用葡萄糖加胰岛素加氯化钾治疗的５０例患者（Ｂ组）进行对照。结果：ＲＳＦ对血中ＣＢＶ－ＲＮＡ的清除率与所用药物剂量及血中药物浓度有相关性；患者心悸、胸闷气短的总有效率（９６．０％）、抗。Ｃ律失常的总有效率（１００．０％，４０／４０例）明显优于Ｂ组（６２．５％，２５／４０例）。ＲＳＦ能使射血分数、心脏每搏输出量、心排血量以及心脏指数等心功能指标明显上升（Ｐ＜０．０１），左室重量及重量指数较治疗前明显下降（Ｐ＜０．０５）；ＲＳＦ治疗（５例）５个月后中和抗体恢复正常，ＮＫ细胞活性上升（Ｐ＜０．０１）。结论：ＲＳＦ对逆转病毒性心肌炎的病理状态效果明显。

英文摘要:

To assess the efficacy of Kangke Injection in treating viral myocarditis. Methods:Kangke Injection is the effective ingredient extracted from Radix Sophora flavescens (RSF). Seventy-six Cases of virus myocarditis suffering from the continuous positive Coxsackie B virus ribose nucleic acid-polymerase chain reaction (CBVRNA-PCR) in blood, their peak value in blood was determined by high performance liquid chromatography (HPLC) and compared with 50 cases treated byglucose-insulin-potasium chloride (GIK ). Results: The clearance rate of CBVRNA - PCR and RSFwas dose-dependent. The effective rate of RSF on palpitation, chest distress, dispnea was 96. 02 %,and that of arrhythmia was 100%,all of them were better than those of control. After RSF therapy,the peramewrs of heart function of ejection fraction (EF), stroke volume (SV), cardiac output (CO), and cardiac index (CI) elevated significantly (P<0.01), left ventricular mass (LVM) and left ventricular mass index (LVMI) were decreased statistically significantly, while after 5 monththerapy, the anti-Coxsackie group B virus neutralizing antibodies of RSF group was returned to normal titer, naied killer (NK) cell activity elevated, P<0. 01. Conclusion: RSF was an effectivesubstance for regressing the "Pathologic status" of viral myocarditis.

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