抗病毒口服液联合利巴韦林气雾剂治疗手足口病的临床研究

Therapeutic effect of Kangbingdu oral liquid in combination with ribavirin aerosol for hand, foot, and mouth disease

目的：观察抗病毒口服液联合利巴韦林雾剂治疗手足口病的临床疗效。方法收集2012年5月至2014年1月河北省临西县人民医院儿内科手足口病患儿135例，按随机数字表法将患儿随机分为两组，对照组67例采用利巴韦林气雾剂治疗，治疗组68例在对照组治疗基础上配合口服抗病毒口服液治疗，治疗7d 后观察两组患儿临床症状的改善情况，并进行病毒检测。结果治疗组体温恢复时间[（2.51±0.42）d比（3.92±0.61）d；t＝15.621，P＜0.01]以及口腔溃疡[（3.01±0.32）d比（4.52±1.21）d；t＝9.880， P＜0.01]、皮疹消退[（4.22±1.34）d 比（6.33±1.41）d；t＝8.914，P＜0.01]时间均显著性短于对照组。治疗组痊愈率显著性高于对照组（88.2%比44.8%；χ^226.761，P＜0.01），但总有效率与对照组无显著性差异（94.1%比83.6%；χ^22.801，P＝0.094）。治疗组通用型肠道病毒（90.9%比52.6%；χ^213.331，P＜0.01）和肠道病毒71型（83.3%比52.4%；χ^24.307，P＝0.038）转阴率显著性高于对照组，但柯萨奇病毒A16型转阴率与对照组无显著性差异（93.3%比81.8%；χ^20.082，P＝0.774）。结论利巴韦林气雾剂联合抗病毒口服液治疗可提高手足口病患儿的肠道病毒转阴率，缩短口腔溃疡和皮疹消退时间。

Objective To evaluate the therapeutic effect of Kangbingdu oral liquid in combination with ribavirin aerosol for hand, foot, and mouth disease （HFMD）. Methods A total of 135 HFMD children were enrolled and assigned to receive ribavirin aerosol alone （ontrol group, 67 patients） or ribavirin aerosol plus Kangbingdu oral liquid group （treatment group, 68 patients） for 7 days. Therapeutic effect was evaluated as the time to fever resolution, subsidence of skin rash and oral ulcers. All throat swab samples were tested using a fluorescence quantitative RT-PCR assay for panenteroviruses, enterovirus 71（EV71）and Coxsackievirus A16 （CA16）. Results The time to fever resolution（2.51±0.42 d vs. 3.92±0.61 d;t=15.621, P＆lt;0.01）, subsidence of skin rash（4.22±1.34 d vs. 6.33±1.41 d;t=8.914, P＆lt;0.01）and oral ulcers（3.01±0.32 d vs. 4.52±1.21 d;t=9.880, P＆lt;0.01）in the treatment group were significantly shorter than those in the control group. The healing rate in the treatment group were significantly higher than that in the control group（88.2%vs. 44.8%;χ^226.761, P＆lt;0.01）, and total effective rate was no different in treatment and control groups（94.1%vs. 83.6%;χ^22.801, P=0.094）. The rates of conversion from positive to negative for panenteroviruses（90.9% vs. 52.6%;χ^213.331, P＆lt;0.01）and EV71（83.3%vs. 52.4%;χ^24.307, P=0.038）in the treatment group were significantly higher than those in the control group, and the rate of conversion from positive to negative for CA16 was no different in treatment and control groups（93.3%vs. 81.8%;χ^20.082, P=0.774）. Conclusion Kangbingdu oral liquid in combination with ribavirin aerosol may improve the rate of conversion from positive to negative for enteroviruses, reduced the time to fever resolution, subsidence of skin rash and oral ulcers in HFMD children.