中医辨证施治联合卡托普利治疗急性重症病毒性心肌炎并心力衰竭的临床研究

Clinical Study on Therapeutic Effects of Treatment according to Syndrome Differentiation of Traditional Chinese Medicine Combined with Captopril on Severe Viral Myocarditis Complicated Heart Failure

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中文关键词: 急性重症病毒性心肌炎心力衰竭中医辨证施治卡托普利心肌酶学心功能

英文关键词:severe viral myocarditis heart failure TCM treatment according to Syndrome Differentiation captopril myocardial enzymology cardiac function

基金项目:

作者	单位
孔庆福	山东省枣庄卫校
宋树芝	山东省枣庄市立医院
谢学英	山东省枣庄卫校
张兴华	山东省立医院
岳革界	山东省枣庄市立医院
陈照立	山东省枣庄卫校

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中文摘要:

目的 :观察中医辨证施治联合卡托普利 (CAP)治疗急性重症病毒性心肌炎 (VMC)并心力衰竭 (CHF)的疗效及机制。方法 :10 9例患者随机分为两组 ,治疗组 ( 72例 )中医辨证以心脾两虚、气阴两虚、脾肾阳虚分别处方 ,均伍用CAP治疗 ,对照组 ( 3 7例 )用地塞米松加干扰素治疗。采用NYHA分级、心肌酶学、心电图、心功能、运动耐量试验测定进行评价。结果 :治疗后NYHA分级治疗组明显优于对照组 (P <0 0 1) ;心肌酶学 3项指标测定值两组均显著降低 (P <0 0 1) ,且治疗组优于对照组 (P <0 0 5) ;心电图S T段改善治疗组优于对照组 (P <0 0 1) ;心功能、运动耐量试验中部分指标疗效治疗组均也优于对照组 (P <0 0 1)。结论 :中医辨证施治联合CAP治疗急性重症VMC并CHF能明显提高临床疗效

英文摘要:

To observe the therapeutic effect and mechanism of the treatment according to Syndrome Differentiation of TCM combined with captopril (CAP) on severe viral myocarditis (SVM) complicated heart failure (CHF). Methods: One hundred and nine patients of SVM complicated CHF were randomly divided into the treated group (n=72) and the control group (n=37), the former was treated with TCM combined with CAP, while the latter was treated with dexamethasone and interferon. The TCM prescriptions were made depending on types of diseases by Syndrome Differentiation, i.e. Heart Spleen deficiency type, Qi Yin deficiency type and Spleen Kidney Yang deficiency type. The efficacy of treatment was evaluated by the criteria including NYHA classification, myocardial enzymology, electrocardiogram, cardiac function and motorial toleration measured before and after treatment. Results: The therapeutic effect of the treated group according to NYHA classification was obviously better than that of the control group; the creatine phosphokinase isoenzyme (CPK MB), aspartate transaminase (AST), lactate dehydrogenase (LDH) content lowered in both groups, but more significantly lowered in the treated group than in the control group (P<0 05, P<0 01); the improvement of S T segment of ECG in the treated group was better than that in the control (P<0 01);also some parameters of heart function and motorial toleration were bettered in the treated group more significantly (P<0 01). Conclusion: TCM treatment according to Syndrome Differentiation combined with CAP in treating SVM complicated CHF could elevate the clinical efficacy.

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