李军红，殷小成（.衡阳市妇幼保健院儿科重症监护室，湖南400；.南华大学附属第一医院，湖南衡阳400）

·论著·

黄芪注射液对病毒性心肌炎患儿Th1/Th2平衡的影响

李军红1，殷小成2
（1.衡阳市妇幼保健院儿科重症监护室，湖南421001；2.南华大学附属第一医院，湖南衡阳421001）

目的探讨黄芪注射液对病毒性心肌炎（VMC）患儿Th1/Th2平衡的影响。方法选取2014年1月至2015年12月在衡阳市妇幼保健院及南华大学附属第一医院儿科住院的VMC患儿68例，随机分为常规组和黄芪组，各34例。常规组给予常规治疗，黄芪组在常规治疗基础上加用黄芪注射液，治疗14 d后，评价两组患儿临床疗效，收集治疗前后血清，通过酶联免疫吸附法（ELISA）测定Th1型细胞因子干扰素-γ（IFN-γ）及Th2型细胞因子白介素4（IL-4）浓度，并计算IFN-γ/IL-4比值，另取同期30例健康儿童作为正常对照组。结果黄芪组总有效率高于常规组，差异有统计学意义（P＜0.05）。与正常对照组比较，常规组与黄芪组血清IFN-γ浓度、IFN-γ/IL-4比值均明显增加，差异均有统计学意义（P＜0.01）；而血清IL-4浓度明显减少，差异有统计学意义（P＜0.01）；两组治疗后血清IFN-γ浓度、IFN-γ/IL-4比值较治疗前均下降，差异均有统计学意义（P＜0.01）；血清IL-4浓度较治疗前升高，差异有统计学意义（P＜0.01）；相对于常规组治疗后，黄芪组治疗后血清IFN-γ浓度、IFN-γ/IL-4比值均降低，差异均无统计学意义（P＞0.05），但血清IL-4浓度升高，差异有统计学意义（P＜0.05）。结论黄芪注射液对VMC患儿有良好的治疗作用，可引起Th1/Th2平衡向Th2偏移，促进受损心肌的恢复。

黄芪；心肌炎；病毒性疾病；干扰素Ⅱ型；白介素4

【Abstract】Objective To explore the effects of Radix Astragali Injection on the Th1/Th2 balance in child patients with viralmyocarditis（VMC）.M ethods Sixty-eightcases of VMC in our hospitals from January 2014 to December 2015 were random ly divided into the conventional group and Astragali Radix group，34 cases in each group.The conventional group was treated with the conventional therapy.Based on this，the Radix Astragali group was added with Radix Astragali Injection.After14 d treatment，the clinical curative effects were evaluated.Serum was collected before and after treat ment.ELISA was used to detect the concentrations of Th1 cytokine interferon-γ（IFN-γ）and Th2 cytokine interleukin-4（IL-4），and then the ratio of IFN-γto IL-4was calculated.In addition，30 healthy children served as normal control group in the same period.Results The total effective rate in Radix Astragali group was significantly higher than thatin the conventional group with statistically significant difference（P＜0.05）. In the comparison with the normal control group，serum IFN-γconcentration and the ratio of IFN-γto IL-4 in the conventional group and Radix Astragali group were significantly increased，while serum IL-4 concentration was significantly decreased，the differences were statistically significant（P＜0.01）.The serum IFN-γconcentration and the ratio of IFN-γto IL-4 after treatment in both Radix Astragali group and conventional group were decreased compared with before treatment，butserum IL-4 concentration was increased，the differences were statistically significant（P＜0.01）.Moreover，in the comparison with the conventional group after treatment，serum IFN-γconcentration and the ratio of IFN-γto IL-4 after treatment in the Radix Astragali group were decreased，while serum IL-4 concentration was increased（P＜0.01）.Comparing with the conventional group after treatment，the serum IFN-γ concentration and the radioof IFN-γto IL-4both decreased in the Astragali group after treatment with out statistically significant difference（P＞0.05），while theserum IL-4 concentration increased with statistically significant difference（P＜0.05）.Conclusion Radix Astragali Injection has a better curative effect in the treatment of VMC children patients，can cause the shift of Th1/Th2 balance to Th2，thereby promotes the recovery of impaired myocardium.

【Key words】Astragalus membranaceus；Myocarditis；Virus diseases；Interferon TypeⅡ；Interleukin-4

病毒性心肌炎（viralmyocarditis，VMC）属于儿科常见病，其发病机制主要与病毒的直接损伤作用和机体的免疫反应紊乱有关［1］。……