真武汤联合西药治疗儿童重症手足口病随机平行对照研究

Randomized Controlled Trial of Zhenwu Decoction(真武汤) combined with Western Medicine in the Treatment of Children with Severe HFMD

[目的]观察真武汤联合西药治疗儿童重症手足口病疗效。[方法]使用随机平行对照方法,将24例住院患者按病志号抽签方法简单随机分为两组;卧床休息,加强营养补液,布洛芬,口腔护理。对照组12例更昔洛韦5mg/kg+5%葡萄糖100mL,2次/d,静滴;感染加头孢他啶100mg/kg+5%葡萄糖100mL,2次/d,静点,最大剂量<6g/d。治疗组12例真武汤(附子泡、煎各1h35g,白芍、生白术、生姜各10g,茯苓15g,肉桂3g,生地15g;上焦热明显,舌尖红,脉滑数有力加竹叶、通草、生甘草各5g;厌食,舌淡红,苔白厚腻,去生白术,加砂仁5g,苍术、蔻仁、神曲各10g;高热脉沉弱,加乌梅15g,干姜10g),水煎200mL,1剂/d,分5次服。治疗5d为1疗程。观测临床症状、皮疹、精神状态、肢体抖动、发热恢复时间、不良反应。治疗1疗程(5d),判定疗效。[结果]治疗组痊愈9例,好转3例,无效0例,总有效率100.00%;对照组痊愈7例,好转5例,无效0例,总有效率100.00%,治疗组疗与对照组具有等效性(P>0.05)。皮疹、肢体抖动、体温恢复正常时间治疗组短于对照组(P<0.01),精神状态恢复时间两组间无明显差异(P>0.05)。[结论]真武汤联合西药治疗儿童重症手足口病,与西药治疗具有等效性,无严重不良反应,值得深入研究。

[Objective] To observe the curative effect of Zhenwu decoction combined with western medicine in the treatment of children with severe HFMD. [Methods] 24 patients were randomly divided into two groups according to the random parallel control method, and the bed rest, strengthening nutrition fluid infusion, ibuprofen, oral care. The control group of 12 cases of ganciclovir 5 mg/kg＋5% 100 mL glucose, 2/d, intravenous drip; infection with ceftazidime 100 mg/kg＋5% glucose 100mL, 2/d, IV, the maximum dose is less than 6g/d. The treatment group of 12 cases of Zhenwu Decoction （monkshood decoction, global 1 h 35 g, Baishao, Shengbaizhu, Shengjiang, 10 g, Fuling 15 g, Rougui 3 g,Shengdi 15 g; the heat obviously, red tongue, slippery pulse number and strong leaves, pith, licorice root each 5g; anorexia, pale tongue, thick white greasy fur. To add 5 g Atractylodes, Amomum, Atractylodes, Kou Ren, the Divine Comedy 10 g; fever pulse weak, and 15g 10g）, black plum, dried ginger decoction 200 mL, 1 doses of/d, taking 5 times. Treatment of 5 d for 1 courses. Observation of clinical symptoms, skin rash, mental state, limb jitter, fever recovery time, adverse reactions. Treatment of 1 courses of treatment （5 d）, determine the efficacy. [Results] The treatment group 9 cases were cured, 3 cases improved, 0 cases ineffective, the total efficiency of 100%; control group 7 cases were cured, 5 cases improved, 0 cases ineffective, the total efficiency of 100%, with the equivalent treatment the treatment group and the control group （P〉0.05）. Skin rash, limb shaking, body temperature recovery time in the treatment group was shorter than the control group （P〈0.01）, and no significant difference in the recovery time between the two groups （P〉0.05）. [Conclusion] Zhenwu decoction combined with western medicine in the treatment of children with severe HFMD, is equivalent with the western medicine treatment, no serious adverse reactions, worthy of further study.