喜炎平联合丙种球蛋白治疗重症手足口病研究

Clinical efficacy of Xiyanping combined with gamma globulin in the treatment of patients with severe hand, foot and mouth disease

目的探讨喜炎平联合丙种球蛋白在重症手足口病患者中的临床应用效果及对T淋巴细胞表达的影响。方法选择2017年5月至2018年7月台州市中心医院治疗的重症手足口病患者78例,根据治疗方法分为观察组和对照组,每组39例。两组均给予常规方法治疗,对照组给予喜炎平注射液治疗,观察组在对照组基础上联合丙种球蛋白治疗,两组均进行10 d治疗,比较两组症状消失时间、T淋巴细胞水平及药物安全性。结果治疗后,观察组精神恢复、退热、四肢抖动缓解、疱疹消退、神经受累时间均短于对照组,差异有统计学意义(t=5.692、7.835、9.195、6.391、8.316,P=0.000)。治疗后,观察组T淋巴细胞水平中CD3+、CD4+及CD4+/CD8+水平,均高于对照组,差异有统计学意义(t=6.015、4.295、7.556,P=0.000);CD8+水平低于对照组,差异有统计学意义(t=5.981,P=0.000)。两组治疗期间皮肤风闭、胃肠道反应、咳嗽发热、荨麻疹及肝肾异常发生率差异均无统计学意义(P>0.05)。结论喜炎平联合丙种球蛋白用于重症手足口病患者能缩短症状消失时间,改善患者T淋巴细胞水平,未增加不良反应发生率。

Objective To observe the therapeutic effect of Xiyanping combined with gamma globulin in severe hand,foot and mouth disease(HFMD).Methods A total of 78 patients with severe HFMD treated in Taizhou Central Hospital from May 2017 to July 2018 were enrolled.Subjects were randomly assigned to control group receiving Xiyanping injection only and observation group receiving Xiyanping and gamma globulin treatment for a period of 10 days.The clinical symptoms,T lymphocyte and safety of drugs were compared between the two groups.Results After treatment,patients in the observation group spent less days to clear the manifestations as fever,mental disturbance,limb exudation,rash/blister and neurological complication compared to the control group,the differences were significant(t=5.692,7.835,9.195,6.391,8.316,P=0.000).The CD3^+and CD4^+T cell counts and CD4^+/CD8^+ratio were higher in the observation group than those in the control group(t=6.015,4.295,7.556,P=0.000),while the CD8^+T cell count was lower(t=5.981,P=0.000).There were no significant differences in the occurrence of drug side effects as gastrointestinal reactions,cough,fever,urticaria,liver and kidney dysfunction(P>0.05).Conclusions Administration of Xiyanping along with gamma globulin in severe cases of HFMD can shorten the duration of symptom clearance,increase the number of T lymphocytes,and is safe to use.