安宫牛黄丸治疗重型手足口病疗效观察

Therapeutic effect of Angong Niuhuang pills on severe hand-foot-mouth disease

目的观察安宫牛黄丸治疗重型手足口病的疗效及不良反应。方法 80例符合纳入标准并自愿参加的重型手足口病患儿进入试验,随机分为观察组及对照组各40例。对照组采用病毒唑、人血免疫球蛋白、降颅压及降温等常规治疗,观察组在常规治疗的基础上加用安宫牛黄丸(北京同仁堂生产),疗程5d。本研究对两组病例在总有效率、退热时间、嗜睡消失时间、肌阵挛消失时间及危重症转化率五项指标进行分析。结果观察组总有效率90.0%(36/40)高于对照组72.5%(29/40),差异有统计学意义(P<0.05)。观察组退热时间(44.23±10.57)h短于对照组(56.38±15.83)h,差异有统计学意义(P<0.05);观察组嗜睡消失时间(51.70±7.01)h短于对照组(60.63±15.11)h,差异有统计学意义(P<0.05);观察组肌阵挛消失时间(43.43±8.07)h短于对照组(50.85±11.90)h,差异有统计学意义(P<0.05)。结论安宫牛黄丸对手足口病重型病例能显著缩短退热时间、嗜睡消失时间、肌阵挛消失时间及降低危重症转化率,无明显不良反应及毒副反应,疗效确切,值得推广。

Objective To observe the effect and side effects of Angong Niuhuang pills on severe handfoot-mouth disease（HFMD）. Methods Eighty severe HMFD patients who met the inclusion criterion and volunteered to attend the trial were divided into the observation group and the control group randomly, 40 patients in each group. The patients in control group were treated with ribavirin,immunoglobulin and symp- tomatic treatments such as intracranial pressure lowering treatment and defervescence; Angong Niuhuang pills was given for 5 days on the basis of above treatments to the patients in the observation group. The total effective rate,the defervescence time of body temperature, the time needed for sleepiness and myoclonus to disappear and the conversion rate of critically ill patients were compared and analysed. Results The total effective rate of observation group was significantly higher than that of control group（90.0% vs 72.5% ,P〈 0.05） ;the defervescence time of body temperature in the observation group was（44.23 ±10.57）h, which was shorter than that in the control group（56.38±15.83）h, the difference being statistically significant（P〈 0.05）. The time needed for sleepiness to disappear in the observation group was（51.70±7.01） h, which was shorter than that in the control group （60.63 ±15.11）h, the difference being statistically significant （P 0.05）. The time needed for myoclonus to disappear in the observation group was（43.43±8. 07）h,which was shorter than that in the control group （50.85 ±11.90）h, the difference being statistically significant （P〈 0.05）. The conversion rate of critically ill patients in the observation group（0%） was lower in observation group than that in the control group（5%）. Conclusion Treatments with Angong Niuhuang pills in severe HFMD can shorten the defervescence time of body temperature and the time needed for sleepiness and myoclonus to disappear, and reduce the conversion rate of critically ill patients, and it has no intolerable side effects and can be applied to clinical work safely.