大蒜素治療病毒性心肌炎療效分析

【摘要】 目的 探討大蒜素治療病毒性心肌炎(VMC)的療效及其機制。方法 選擇符合診斷標準的96例VMC患者，隨機分為三組。A組32例，予常規西藥治療，B組32例在A組基礎上加用黃芪注射液治療，C組在A組基礎上加用大蒜素注射液治療，三組療程均為30 d，觀察治療前后患者心律失常率、STT改變率及心臟肌鈣蛋白T(cTnT)、肌酸激酶同工酶（CKMB）和白細胞介素18（IL18）檢測水平的變化情況。結果 三組患者治療后其心律失常率、STT改變率、cTnT和CKMB均顯著下降（P＜0.01），A、B、C三組各觀察指標有逐級改善趨勢，C組改善幅度最大（P＜0.01）。C組患者治療7、15、30 d后其血清 IL18水平均顯著下降（P＜0.01），A、B組患者治療15、30 d后其血清IL18水平均顯著下降（P＜0.05或0.01），A、B、C三組患者治療15、30 d后其血清 IL18水平有逐級下降趨勢（P＜0.01），C組下降幅度最大（P＜0.01）。結論 大蒜素對VMC患者有良好的治療效果，可能與其抑制病毒復制，恢復被病毒破壞的細胞免疫系統功能，減輕患者的免疫反應對其心肌的損傷，從而改善患者臨床癥狀和心功能有關。

【關鍵詞】 病毒性心肌炎；大蒜素；細胞因子；白細胞介素18

文章編號：1003-1383(2010)02-0120-02 中圖分類號：R 542.2+2 文獻標識碼：A

doi:10.3969/j.issn.1003-1383.2010.02.002

Analysis on the effect of garlicin for treating viral myocarditis

PAN Xingshou，LAN Jingsheng，LI Tianzi，HUANG Zhaohe， LIU Yan， LIANGYue，LAI Tengfang

(Cardiovascular Prevention Institute of Youjiang Medical University for Nationality，Cardiovascular

Department of Affiliated Hospitalof Youjiang Medical University for Nationality，Baise Guangxi 533000)

【Abstract】 Objective To explore the curative effect of garlicin on the treatment of viral myocarditis (VMC)and its mechanism.

Methods 96 patients with VMC were randomly divided into three groups.group A of 32 patients were given western conventional medicine，group B of 32 patients were given astragalus injection besides the conventional therapy，while group C were given garlic injection.The course in three groups were 30 days.The incidence of the arrhythmia，stt segment changes and the level of cTnT，CKMB，IL18 in patients were observed before and after thetreatment.ResultsThe incidence of the arrhythmia，stt segment changes and the level of cTnT，CKMB，IL18 decreased significantly in all the patients After treatment（P＜0.01）.and the observation indexes improved at the same time，especially the group C（P＜0.01）.the level of serum IL18 decreased significantly in the 7th，15th and the 30th day after treatment in group C (P＜0.01)，while the level decreased significantly in the15thand the 30th day after treatment in group A and B (P＜0.05 or 0.01 ).descent range of group C was the largest amongst these three groups (P＜0.01).Conclusion There is good curative effect of garlicin on the treatment for VMC.This may related to the inhibition of virus replication，recovery of the cellular immunity and reduction of the injury of cardia musle by immunological reaction，and this improve the patient's clinlcal symptom and heart function.

【Key words】 viral myocarditis；garlicin；Cytokines；IL18

病毒性心肌炎(viral mayocarditis，VMC)是一種以心肌灶性壞死、纖維化、大量單核細胞浸潤為特征的心肌炎性疾病，柯薩奇B組病毒(CVB)感染是主要病原，其發病機理還不十分清楚，常規西藥療法效果欠佳。研究結果表明免疫系統和炎癥細胞釋放的細胞因子在疾病的進展和調控上起著重要作用，白細胞介素18（IL18）是主要的炎性介質，是細胞因子網絡中的重要成員［1］，為了解中藥對本病的療效及其機制，筆者用大蒜素治療VMC患者，觀察其治療前后的臨床癥狀和IL18水平的變化情況。……