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Objective: To explore the clinical curative effect of trimetazidine or Shengmai decoction combined with astragalus injection in the treatment of acute viral myocarditis(AVMC). Methods: A total of 140 patients with AVMC, who were treated in Sichuan Provincial People’s Hospital from April 2013 to April 2016, were selected and randomly divided into control group(n=45), Qu Huang group(n=46) and Sheng Huang group(n=49). The control group received routine drug treatment.On the basis of the control group’s therapy, the Qu Huang group received trimetazidine combined with astragalus injection and the Sheng Huang group received Shengmai decoction combined with astragalus injection. The serum creatine kinase-MB(CK-MB), cardiac troponin I(cTnI), electrocardiogram indexs, clinical total effective rate, improvement of clinical symptoms and adverse reaction were compared among the three groups.Results: After treatment, the total effective rate in the Qu Huang group and Sheng Huang group was significantly higher than that in the control group,and the total effective rate in the Qu Huang group was higher than that in the Sheng Huang group(P<0.05). The incidence of heart palpitations and chest pain in the Qu Huang group and the Sheng Huang group were lower than that in the control group,the differences were statistically significant(P<0.05). The levels of serum CK-MB and cTnI in the Qu Huang group and the Sheng Huang group were lower than those in the control group, and the levels of above indexes in the Qu Huang group was lower than that in the Sheng Huang group(P<0.05). The incidence of atrioventricular heart-block, ST-T change,premature ventricular contractions in the Qu Huang group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05). Conclusion: In the treatment of patients with AVCM. The total effective rate of trimetazidine combined with astragalus injection is higher than that of Shengmai decoction combined with astragalus injection. It can reduce the degree of myocardial injury and improve clinical symptoms,without serious adverse reactions, which is worthy of clinical application. [ABSTRACT FROM AUTHOR]