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Objective: To investigate the effect of astragaloside (Astr), one of the active components of the Chinese medical herb Astragulus membranaceus, on cardiac fibrosis in chronic myocarditis and its relevant mechanisms., Methods: Eighty mice were randomized into 3 groups, the control group (n=20), the model group (n=30) and the Astr group (n=30). Mice in the model group and the Astr group were monthly intraperitoneally inoculated with CVB3, but to the control group equal amount of culture fluid was given instead. Mice in the control and the model group were fed with drinking water while those in the Astr group with drinking water containing Astr-sodium carboxymethycellulose at a concentration of 300 mg/L. All the survived mice were sacrificed 3 months later. Heart tissue of mice was stained by picrosirius red for calculating collagen volume fraction (CVF) with an automatic image analysis system. Expressions of transforming growth factor beta1 (TGF-beta1), platelet derived growth factor (PDGF), matrix metalloproteinase 1 (MMP-1), tissue inhibitor of metalloproteinase 1 (TIMP-1), MMP-13 and MMP-14 in heart tissue were detected by Western blot analysis., Results: As compared with the model group, in the Astr group, the mortality and CVF were significantly lower (53.3% vs. 23.3%, chi2 = 4.23, P < 0.05), and (17.4 +/- 1.2% vs. 8.6 +/- 0.9%, chi2 = 5.38, P < 0.05), respectively. As compared with the control group, Western blot analysis showed that expression of TGF-beta1 was decreased, MMP-1 and TIMP-1 were down-regulated, while expressions of MMP-13 and MMP-14 were up-regulated after Astr treatment., Conclusion: Astr could lower the mortality and alleviate the myocardial fibrosis of mice with chronic myocarditis. Its antifibrotic effect might be realized by way of inhibiting TGF-beta1 expression and up-regulating the expressions of MMP-13 and MMP-14 in the heart tissues.

Objective: To investigate the effects of Yiqi Jiangzhuo Decoction (YJD) on transforming growth factor-beta1(TGF-beta1) mRNA expression in treating ventricular remodeling in viral myocarditis., Methods: After being established into chronic viral myocarditis model by 4 times repetitively infecting with gradient multiplicative CVB3m, 160 male mice were divided into the blank group, the model group, the TCM treated group and the Western medicine treated group. On the 10th, 30th and 60th day after the last time of infection, mice were killed to observe their pathological changes of myocardium with HE staining and to detect TGF-beta1 mRNA expression in myocardial tissue with semi-quantitative RT-PCR method., Results: Pathological changes of myocardium alleviated, and TGF-beta1 mRNA expression distribution area reduced significantly in the two treated groups, as compared with those in the model group (all P < 0.05)., Conclusion: YJD could inhibit the hyperplasia and reconstruction of ECM by down-regulating TGF-beta1 mRNA expression to improve cardiac pathological changes in myocarditis, so as to prevent the occurrence of ventricular remodeling and the conversion of disease to dilative cardiomyopathy.

Objective: To observe the therapeutic effect and mechanism of the treatment according to Syndrome Differentiation of TCM combined with captopril (CAP) on severe viral myocarditis (SVM) complicated heart failure (CHF)., Methods: One hundred and nine patients of SVM complicated CHF were randomly divided into the treated group (n = 72) and the control group (n = 37), the former was treated with TCM combined with CAP, while the latter was treated with dexamethasone and interferon. The TCM prescriptions were made depending on types of diseases by Syndrome Differentiation, i.e. Heart-Spleen deficiency type, Qi-Yin deficiency type and Spleen-Kidney Yang deficiency type. The efficacy of treatment was evaluated by the criteria including NYHA classification, myocardial enzymology, electrocardiogram, cardiac function and motorial toleration measured before and after treatment., Results: The therapeutic effect of the treated group according to NYHA classification was obviously better than that of the control group; the creatine phosphokinase isoenzyme (CPK-MB), aspartate transaminase (AST), lactate dehydrogenase (LDH) content lowered in both groups, but more significantly lowered in the treated group than in the control group (P < 0.05, P < 0.01); the improvement of S-T segment of ECG in the treated group was better than that in the control (P < 0.01); also some parameters of heart function and motorial toleration were bettered in the treated group more significantly (P < 0.01)., Conclusion: TCM treatment according to Syndrome Differentiation combined with CAP in treating SVM complicated CHF could elevate the clinical efficacy.

Objective: To study the therapeutic effect of Xinkang Oral Liquid (XKOL) in treating acute Coxsackie B3 viral myocarditis in mice., Methods: Viral myocarditis model was established by intraperitoneal inoculation with Coxsackie B3 virus. Mice were randomly divided into 4 groups randomly, the model group, the positive control group (treated with Ribavilin), the XKOL group and the normal control group. Body weight of mice was weighed at the 5th, 10th and 20th day. Weight, macro- and histopathologic changes of heart were observed by microscope and measured by morphometric quantification, and the data were treated statistically., Results: In the XKOL group, the body weight of mice increased, the degree of myocardial necrosis mild and small in size, which has been repaired more completely, the antiviral effect was found in XKOL group., Conclusion: XKOL has definite therapeutic effect on viral myocarditis, its effect is better than Ribavilin in protecting myocardium and anti-virus.

Objective: To observe the effect of Yixin Yidu Decoction (YXYDD, self-formulated according to the TCM therapeutic principle of supplementing Qi and Yin, clearing away evil Heat and toxic substances) in treating acute viral myocarditis (AVM)., Methods: Seventy-six patients of AVM were randomly divided into 2 groups, the 40 patients in the treated group were treated with YXYDD and the 36 patients in the control group treated with Qidong Yixin Oral Liquid (QDYX), the therapeutic course for both groups was 4 weeks., Results: YXYDD was more effective than QDYX in improving clinical symptoms, adjusting the abnormal ECG, lowering the serum level of myocardial enzymes, improving the cardiac function of left ventricle and regulating the T-cell immunity (elevation of CD3, CD4 and CD4/CD8 ratio)., Conclusion: YXYDD is an effective medicine in treating AVM.

Objective: To observe the clinical effect of Xinyikang Oral Liquid (XYK) in treating viral myocarditis patients of Qi-Yin Deficiency and Evil-Toxin Encroaching Heart Type., Methods: Randomized controlled method was adopted, the 92 cases in the XYK group received XYK and 30 cases in the control group received Qidong Yixin oral liquid treatment for 4 weeks as a therapeutic course. Their symptoms, signs, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), lactate, aspartate aminotransferase (AST) dehydrogenase (LDH), creatine phosphokinase (CPK), creatine phosphokinase isoenzyme (CPK-MB), electrocardiogram (ECG) and dynamic ECG changes before and after treatment were observed., Results: The improvement on chest stuffiness, short breath, fatigue and spontaneous perspiration in the treatment group was better than those in the control group (P < 0.05) and XYK showed obvious improving effect on ESR, AST, LDH, CPK and CPK-MB (P < 0.01 or 0.05). There was no adverse reaction or side-toxic effects revealed in using XYK., Conclusion: XYK has significant therapeutic effect in treating viral myocarditis.

Objective: To observe the clinical effect of the treatment of infantile viral myocarditis with puerarin., Methods: Puerarin was administered intravenously together with conventional treatment in the treated group, while that of conventional treatment solely was given in the control group. Creatine kinase isoenzyme, lactate dehydrogenase isoenzyme, cardiac function and clinical manifestations before and after treatment were observed., Results: Puerarin could significantly relieve the symptoms of patients of infantile viral myocarditis, enhance the metabolism of myocardium and improve the cardiac function. The total effective rate of the treated group was 87.04%, significantly higher than that of the control group, the difference between them was significant (P < 0.05)., Conclusion: Puerarin can be used to treat patients with infantile viral myocarditis with a satisfactory result.

Objective: To study the effect of Huodan Tablet in treating pediatric viral myocarditis., Methods: Clinical manifestations and physical signs as well as laboratory examinations have been observed., Results: The markedly effective rate was 68%, the total effective rate was 91.67% in therapeutic group, while in control group, the markedly effective rate was 30.83% and the total effective rate 70.84%. According to Ridit analysis, significant difference was shown between the two groups. r-therapeutic group = 0.5000, r-control group = 0.295 + 2 x 0.025, respectively., Conclusion: Huodan Tablet has no toxic and side-effect and can be taken safely and conveniently, it complies with the demands of WHO on new drug for prevention and cure of myocarditis.

Objective: To study immune function of children viral myocarditis and to evaluate the clinical effect of Shuanghuanglian Powder (SHLP)., Methods: The authors determined serum COXB-IgM and the numbers of lymphocyte subsets CD3+, CD4+, CD8+, CD4+/CD8+ with viral myocarditis patients by ELISA and indirect immunofluorescent assay. Sixty-two cases were divided randomly into two groups. Thirty-two cases treated by conventional therapy with SHLP and the other 30 cases treated with conventional therapy alone were taken as control group., Results: COXB-IgM was positive in 39 of 62 patients, which were significantly different with those of normal controls (P < 0.001). In addition, the level of CD4+ cells and the ratio of CD4+/CD8+ were decreased while CD8+ increased. After treatment with SHLP, the recovery of symptoms, signs and immune function in patients were better than that of controls. These changes were significantly different (P < 0.01)., Conclusions: There were disturbance of immune regulatory function with children viral myocarditis patients and SHLP is an effective drug in treating children viral myocarditis.

Objective: To clarify the effects of Astragalus Membranaceus (AM) combined with taurine and/or coenzyme Q10(CoQ10) on coxsackievirus B3 (CVB3) murine myocarditis., Methods: Viral myocarditis model was created by intraperitoneal inoculation with CVB3 solution and were treated by saline, AM, taurine, CoQ10, AM + taurine, AM + CoQ10, AM + taurine + CoQ10, respectively. The mortality, ECG, CVB3-RNA in myocardium and myocardial histopathologic changes were observed., Results: AM combined with taurine and CoQ10 could significantly reduce the mortality of the mice and the incidence of abnormal ECG at acute stage. CVB3-RNA was significantly reduced in AM treated group, especially in AM + taurine group. No anti-virus effect was found in CoQ10 group. All drugs could lighten myocardial histopathologic changes and the effect could be enhanced by combined treatment., Conclusions: AM, taurine and CoQ10 have some curative effects on CVB3 murine myocarditis, AM combined with taurine and CoQ10 is the best.

Objective: To assess the efficacy of Kangke Injection in treating viral myocarditis., Methods: Kangke Injection is the effective ingredient extracted from Radix Sophora flavescens (RSF). Seventy-six cases of virus myocarditis suffering from the continuous positive Coxsackie B virus ribose nucleic acid-polymerase chain reaction (CBVRNA-PCR) in blood, their peak value in blood was determined by high performance liquid chromatography (HPLC) and compared with 50 cases treated by glucose-insulin-potassium chloride (GIK)., Results: The clearance rate of CBVRNA-PCR and RSF was dose-dependent. The effective rate of RSF on palpitation, chest distress, dispnea was 96.02%, and that of arrhythmia was 100%, all of them were better than those of control. After RSF therapy, the parameters of heart function of ejection fraction (EF), stroke volume (SV), cardiac output (CO), and cardiac index (CI) elevated significantly (P < 0.01), left ventricular mass (LVM) and left ventricular mass index (LVMI) were decreased statistically significantly, while after 5 month therapy, the anti-Coxsackie group B virus neutralizing antibodies of RSF group was returned to normal titer, natural killer (NK) cell activity elevated, P < 0.01., Conclusion: RSF was an effective substance for regressing the "Pathologic status" of viral myocarditis.

Unlabelled: To investigate the combination therapy of Western and traditional Chinese medicine on treatment of acute viral myocarditis, 48 patients were randomly divided into 2 groups. The 1st group consisted of 30 patients, receiving the combination therapy of Western and traditional Chinese medicine, including Astragalus membranaceus, taurine, coenzyme Q10 and antiarrhythmics, while the 2nd group consisted of 18 patients, receiving the conventional therapy, including glucose-insulin-potassium (GIK), coenzyme Q10 and also antiarrhythmics., Results: The efficacy of combination therapy of western and traditional Chinese medicine was better than that of conventional therapy in improving the clinical manifestation, negative converting positive EVsRNA in peripheral leukocytes and controlling the premature beats., Conclusion: The combination therapy of western and traditional Chinese medicine was an effective method in treating acute viral myocarditis.

The effect of Shengmaisan (SMS) on 62 acute viral myocarditis patients and its peroxidation damage was studied. The results revealed that the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in blood were decreased and the content of malondialdehyde (MDA) in plasma was increased in acute viral myocarditis patients in comparison with the healthy controls (P < 0.001). 62 acute viral myocarditis patients were divided into two groups: SMS group and placebo group. After treatment, both SOD and GSH-Px activities were increased and the level of MDA decreased (P < 0.001) in SMS group, while those in placebo group were not changed (P < 0.05). The results suggested that the myocardial damage of viral myocarditis is closely related with lipid peroxidation SMS acts as an effective free radical scavenger and anti-lipid peroxidation drug. SMS could prevent the damage of myocardia and might be taken as one of the effective therapeutic methods in treatment of acute viral myocarditis.

The efficacy of Astragalus membranaceus (AM) oral liquor combined with routine therapy and routine therapy alone on T-lymphocyte subsets of peripheral blood in viral myocarditis patients have been studied. The results showed that the T-lymphocyte subsets profile and OKT4/OKT8 ratio of peripheral blood were significantly lower in viral myocarditis patients than that in healthy control (P < 0.05, 0.01). Routine therapy combined with AM could significantly enhance OKT3, OKT4 and OKT4/OKT8 ratio in the above-mentioned patients (P < 0.05, 0.01). The possible pharmacodynamic mechanism of improved cell immunity in viral myocarditis patients by combining routine therapy with AM was discussed.

In order to study the effect of the Fu-Fang Si-Shen Yin (FFSSY) on cellular immunity, the natural killer (NK) cell activity of 60 patients with viral myocarditis, while the lymphocyte subsets consisted of OKT3, OKT4, OKT8, OKT4/OKT8 of other 20 patients were determined. The pretreatmental results were 25.25 +/- 0.46%, 59.11 +/- 8.72%, 30.72 +/- 6.94%, 29.72 +/- 5.35% and 1.04 +/- 0.24 respectively, which were significantly lower than that of the normal value (P < 0.01) except OKT8 However, after the treatment with FFSSY, NK cell activity and OKT3, OKT4, OKT4/OKT8 were elevated to 30.96 +/- 10.13% (P < 0.05), 62.33 +/- 7.78% (P < 0.05), 33.67 +/- 5.50% (P < 0.05) and 1.14 +/- 0.20 (P < 0.01) respectively. The Syndrome Differentiation of TCM indicated that NK cell activity decreased obviously in the Qi-Yin-Deficiency group, while T lymphocyte subsets changed significantly in the Qi-Deficiency group. There existed negative correlation between NK cell activity and OKT4/OKT8 (r = -0.60, P < 0.05). The patients with high NK cell activity in the early stage could have a favourable prognosis, while unfavourable with low NK cell activity.

A murine model for observing the effect of Astragalus membranaceus (AM) on electrophysiological activity of the right ventricular myocardium was developed in 4 week-old male BALB/c mice infected with Coxsackie B3 virus (CB3V). The conventional microelectrode technique and real-time microcomputer data processor system was used. The survival rate in infected-AM treated mice was significantly higher and the percentage of abnormal action potential was much lower than those in control mice (P < 0.05 and < 0.01 respectively). Some abnormal electrophysiological parameters, such as APA, OS and Vmax in infected myocardium were found to be improved by AM treatment. Single dose of AM did not show beneficial effect in murine myocardium infected with CB3V. The results suggested that AM might be valuable in the prevention and treatment of acute myocarditis involving Coxsackie B3 virus.

A prospective study of 65 infantile acute viral myocarditis was done, they were divided into two groups, the first group mainly treated with Tong-Mai oral liquid, a TCM drug, the second group used general therapy with Mixture ATP as its main drug. The results showed that the effective rate of the 1st and 2nd group was 93.02% and 72.73% respectively; their symptoms and signs such as suffocation, fatigue, chest pain, improved in reducing the size of enlarged heart, the effective rate of EKG, particularly ST-T and various blocks, as well as in improving the function of left ventricular and abnormal systolic time interval (STI), the 1st group was better than that of 2nd one in all above-mentioned five aspects (P < 0.05-0.01). Therefore, it was assumed that therapy of activating the blood circulation to relieve stasis, the Tong-Mai oral liquid might be a good approach in treating infantile acute viral myocarditis.

Control observation of infantile acute toxic myocarditis treated by Salvia miltiorrhizae (SM) showed that 36 cases were clinically cured through SM treatment. The total effects have obvious advantages over Western Medicine control group, P < 0.01. The period of hospitalization and ECG normalization, of control group was significantly longer than that of SM treated group, P < 0.001 respectively.

33 patients divided into 2 groups for treatment. Group A (18 cases) early use of adrenal cortico-steroid treatment in combination with traditional Chinese medicine; group B (15 cases): early use of adrenal cortico-steroid treatment is combination with interferon, then compared the therapeutic effects of these 2 groups. The results showed that, in these 2 groups, the sinus-atrial block, atrial ventricular block, ventricular tachycardia, acute pump failure as well as the EKG changes were relieved and improved to the same degree. In group A, after therapy, the parameters of OKT3 (%) was elevated from 51 +/- 15.22 to 55.23 +/- 8.53; OKT4(%) was elevated from 30.06 +/- 11.47 to 47.32 +/- 10.87; ratio of OKT4/OKT8 was elevated from 1.11 to 1.53; all of their P values were < 0.01. NK cell activity was elevated from 8.36 +/- 3.75 to 13.08 +/- 5.77, P value < 0.05. In group B, the parameters of OKT3 (%) was elevated from 50.91 +/- 8.12 to 56.75 +/- 8.29; OKT4 (%) was elevated from 32. 55 +/- 6.78 to 45.13 +/- 10.85; ratio of OKT4/OKT8 was elevated from 1.00 +/- 0.21 to 1.37 +/- 0.16; P value < 0.05, < 0.05 and < 0.01 respectively. NK cell activity (%) was elevated from 8.20 +/- 3.08 to 14. 0.3 +/- 4.89, P value also < 0.01. Hence, not only in group A but also in group B, after therapy, the parameters of OKT3,4,8, OKT4/OKT8 and NK cell activity (%) were all improved. But there was no significant statistical difference between group A and B.(ABSTRACT TRUNCATED AT 250 WORDS)

In Order to evaluate the effect of Salvia miltiorrhizae (SM) on the acute viral myocarditis (AVM), 60 children with AVM were studied. The patients were divided in random into two groups, group 1 treated with vit. C, ATP, CoA (n = 30), group II with SM plus vit. C, ATP, CoA (n = 30). The levels of plasma lipid peroxide (LPO), erythrocyte membrane microviscosity (EMMV), LDH, CPK, GOT and ECG in each patient were determined before and after one course of treatments respectively. The results revealed that before treatment the levels of plasma LPO and EMMV in both groups increased significantly compared with those of normal controls (n = 30, P < 0.01) respectively. There was a close correlation between LPO and EMMV (r = 0.6774, P < 0.01) and a close correlation between LPO and LDH (r = 0.5703, P < 0.01). After one course, the levels of plasma LPO and EMMV in both groups decreased significantly (compared with those before treatment, P < 0.01, respectively). But the LPO level and EMMV in group I were much higher than those in normal controls yet (P < 0.05, respectively). And LDH, GOT and ECG in nearly half of the patients in group I did not recover after one course while most patients in group II recovered. The results suggested that free radical plays an important role in the pathogenesis of AVM. SM as a good antioxidant, could protect myocardium from repairing membrane damage and clearing away free radical. This provided a new approach to treatment of viral myocarditis.