目的 探讨应用参麦注射液联合地塞米松治疗病毒性心肌炎的临床效果。方法 选取湖北省中西医结合医院2015年3月-2017年9月收治的病毒性心肌炎患者98例，随机分为对照组（49例）和治疗组（49例）。对照组静脉滴注地塞米松磷酸钠注射液，0.5 mg加入5%葡萄糖注射液250 mL，1次/d。治疗组在对照组基础上静脉滴注参麦注射液，60 mL加入5%葡萄糖注射液250mL，1次/d。两组患者均连续治疗30 d。评价两组患者临床疗效，同时比较治疗前后两组患者心肌酶谱指标、血清指标和T淋巴细胞亚群水平。结果 治疗后，对照组和治疗组临床有效率分别为79.6%和93.9%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清肌酸激酶同工酶（CK-MB）、谷草转氨酶（AST）、乳酸脱氢酶（LDH）、磷酸肌酸激酶（CK）浓度均显著减少（P<0.01）；且治疗组上述心肌酶谱指标明显低于对照组（P<0.01）。治疗后，两组患者血清肿瘤坏死因子（TNF）-α、白细胞介素（IL）-18、丙二醛（MDA水平较治疗前显著降低，超氧化物歧化酶（SOD）水平显著上升，同组比较差异具有统计学意义（P<0.01）；且治疗组患者血清指标治疗后水平明显好于对照组（P<0.01）。治疗后，两组患者外周血CD4⁺和CD4⁺/CD8⁺比值较治疗前均显著升高（P<0.01），CD8⁺值显著降低（P<0.01）；且治疗后治疗组患者T淋巴细胞亚群水平显著优于对照组（P<0.01）。结论 应用参麦注射液联合地塞米松治疗病毒性心肌炎可迅速缓解患者症状，有效抑制机体炎症反应，缓解氧化应激，维持细胞免疫平衡。

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.