目的 探討應(yīng)用參麥注射液聯(lián)合地塞米松治療病毒性心肌炎的臨床效果。方法 選取湖北省中西醫(yī)結(jié)合醫(yī)院2015年3月-2017年9月收治的病毒性心肌炎患者98例，隨機(jī)分為對(duì)照組（49例）和治療組（49例）。對(duì)照組靜脈滴注地塞米松磷酸鈉注射液，0.5 mg加入5%葡萄糖注射液250 mL，1次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注參麥注射液，60 mL加入5%葡萄糖注射液250mL，1次/d。兩組患者均連續(xù)治療30 d。評(píng)價(jià)兩組患者臨床療效，同時(shí)比較治療前后兩組患者心肌酶譜指標(biāo)、血清指標(biāo)和T淋巴細(xì)胞亞群水平。結(jié)果 治療后，對(duì)照組和治療組臨床有效率分別為79.6%和93.9%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血清肌酸激酶同工酶（CK-MB）、谷草轉(zhuǎn)氨酶（AST）、乳酸脫氫酶（LDH）、磷酸肌酸激酶（CK）濃度均顯著減少（P<0.01）；且治療組上述心肌酶譜指標(biāo)明顯低于對(duì)照組（P<0.01）。治療后，兩組患者血清腫瘤壞死因子（TNF）-α、白細(xì)胞介素（IL）-18、丙二醛（MDA水平較治療前顯著降低，超氧化物歧化酶（SOD）水平顯著上升，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.01）；且治療組患者血清指標(biāo)治療后水平明顯好于對(duì)照組（P<0.01）。治療后，兩組患者外周血CD4⁺和CD4⁺/CD8⁺比值較治療前均顯著升高（P<0.01），CD8⁺值顯著降低（P<0.01）；且治療后治療組患者T淋巴細(xì)胞亞群水平顯著優(yōu)于對(duì)照組（P<0.01）。結(jié)論 應(yīng)用參麥注射液聯(lián)合地塞米松治療病毒性心肌炎可迅速緩解患者癥狀，有效抑制機(jī)體炎癥反應(yīng)，緩解氧化應(yīng)激，維持細(xì)胞免疫平衡。

Objective To investigate the clinical effect of Shenmai Injection combined with dexamethasone in treatment of viral myocarditis. Methods Patients (98 cases) with viral myocarditis in Hubei Hospital of Integrated Traditional Chinese and Western Medicine from March 2015 to September 2017 were randomly divided into control (49 cases) and treatment (49 cases) groups. Patients in the control group were iv administered with Dexamethasone Sodium Phosphate Injection, 0.5 mg added into 5% glucose injection 250 mL, once daily. Patients in the treatment group were iv administered with Shenmai Injection on the basis of the control group, 60 mL added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacy was evaluated, and the myocardial enzymes, serum TNF-α, IL-18, SOD, MDA, and T lymphocyte subsets levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 79.6% and 93.9% respectively, and there were differences between two groups (P<0.05). After treatment, the CK-MB, AST, LDH and CK levels in two groups were significantly decreased (P<0.01). And the myocardial enzymes indexes levels in the treatment group after treatment were significantly lower than those in the control group (P<0.01). After treatment, the TNF-α, IL-18 and MDA levels in two groups were significantly decreased, but SOD level was significantly increased, and the difference was statistically significant in the same group (P<0.01). And these serum indexes levels in the treatment group after treatment were significantly better than those in the control group (P<0.01). After treatment, the CD4⁺ and CD4⁺/CD8⁺ levels in two groups were significantly increased (P<0.01), CD8⁺ was significantly decreased (P<0.01). And the T lymphocyte subsets levels in the treatment group after treatment were significantly better than those in the control group (P<0.01). Conclusion Shenmai Injection combined with dexamethasone in treatment of viral myocarditis can rapidly relieve clinical symptoms, inhibit inflammatory response, relieve oxidative stress, and maintain cellular immune balance.