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关键词：心肌炎；心律失常；干预性研究
【摘要】 目的 全国十二家大型医院协作观察中西医结合治疗急性病毒性心肌炎疗效。方法 对1028例临床诊断为急性病毒性心肌炎患者随机各分两组，治疗组602例，用中西医结合(黄芪、牛磺酸、泛葵利酮、抗心律失常药等)治疗；对照组426例，用常规(极化液、抗心律失常药等)治疗。结果 中西医结合治疗组临床症状改善、外周血肠道病毒阴转、心电图ST-T改变及房室传导阻滞、阵发性心房颤动、窦房传导阻滞等恢复均优于对照组(P<0.01、0.05)；对早搏及心功能改善两组间无统计学差异(P<0.05)。结论 在目前对急性病毒性心肌炎无特效药物治疗的情况下，采用中西医结合治疗可作为一种治疗手段。
Study of drug therapy in acuteviral myocarditis
Collaborative Group of “Key National Medical Projects for the Ninth-Five YearPlan-Research” (Correspondence: YANG Yingzhen, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital,Shanghai Medical University,Shanghai 200032)
【 Abstract】 Objective To observe the efficacy of combination therapy of westernand traditional Chinese medicine on the treatment of acute viral myocarditis (VM) by 12hospitals in China.Methods One thousand and twenty eight patients with acute viral myocarditiswere randomly divided into 2 groups. The VM subject group consisted of 602 patients,receiving the combination therapy of western and traditional Chinese medicine (WTCM),including Astragalus membranaceus, taurine, coenzyme Q10 and antiarrhythmics,while theother 426 patients served as controls, receiving the conventional therapy,includingglucose-insulin -potassium (GIK), coenzyme Q10 and also antiarrhythmics.Results The efficacy of combinationtherapy of WTCM was better than that of conventional therapy in improving the clinicalmanifestation (P<0.001), ST-T changes (P<0.01), sinus atrial block (P<0.05),paroxysmal atrial fibrillation (P<0.05), etc, and converting EVs RNA negative inperipheral leukocytes in acute viral myocarditis patients; even though the premature beatsand fraction showed no statistical differences between the 2 groups after treatment.Conclusion Sincethere is no specific drugs for the treatment of acute viral myocarditis, the combinationtherapy of western and traditional Chinese medicine can be considered as one of theeffective methods to treat viral myocarditis.
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