安宫牛黄丸治疗重症手足口病31例

Clinical Efficacy of Angong Niuhuang Pill in Treatment of Severe Hand,Foot,and Mouth Disease:A Report of 31 Cases

目的观察安宫牛黄丸治疗重症手足口病的临床疗效,并初步探讨其作用机制。方法将62例重症手足口病患儿随机分为对照组及观察组,每组各31例。对照组给予抗病毒、降颅压、丙种球蛋白等治疗,观察组在对照组基础上加用安宫牛黄丸治疗。治疗7d后,比较两组临床疗效,观察两组患儿治疗前后血清神经细胞特异性烯醇化酶(neuron specific enolase,NSE)、S-100β以及肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)、白细胞介素-6(interleukin 6,IL-6)水平的变化。结果观察组临床疗效明显优于对照组(P<0.05)。与对照组比较,观察组退热时间、皮疹消退时间及住院时间均明显缩短(P<0.05)。治疗7d后,两组患儿血清NSE、S-100β、TNF-α和IL-6水平较治疗前均明显下降(P<0.05),观察组患儿治疗后血浆NSE、S-100β、TNF-α、IL-6降低值明显大于对照组(P<0.05)。结论在常规治疗基础上加用安宫牛黄丸能有效减轻重症手足口病患儿炎性反应,提高临床疗效。

Objective To observe the clinical efficacy of Angong Niuhuang Pill in the treatment of severe hand,foot,and mouth disease（HFMD）,and to preliminarily investigate its mechanism of action.Methods A total of 62 children with severe HFMD were randomly and equally divided into control group and observation group.The control group received antiviral treatment,intracranial pressure-reducing medication,and gamma globulin,while the observation group received Angong Niuhuang Pill in addition to the treatment for the control group.Treatment was carried out for 7days in both groups.The therapeutic effect was assessed based on serum levels of neuron specific enolase（NSE）,S-100β,tumor necrosis factor-α（TNF-α）,and interleukin-6（IL-6）before and after treatment.Results The observation group had a significantly better clinical outcome than the control group（P〈0.05）.The observation group had significantly shorter fever clearance time,time to disappearance of rash,and length of hospital stay than the control group（P〈0.05）.After 7days of treatment,both groups showed significant decreases in serum levels of NSE,S-100β,TNF-α,and IL-6（P〈0.05）,but the treatment group had significantly greater decreases than the control group（P〈0.05）.Conclusion For children with severe HFMD,Angong Niuhuang Pill combined with conventional treatment can effectively reduce inflammatory response and improve clinical outcome.