传染性单核细胞增多症患儿联合应用热毒宁和阿昔洛韦的疗效

Analysis on curative effect of the combined therapy of Re Du Ning injection and acyclovir on children with infectious mononucleosis

目的观察传染性单核细胞增多症患儿应用热毒宁联合阿昔洛韦的治疗效果。方法选取2012年10月至2015年7月南京医科大学附属儿童医院急诊病房确诊为传染性单核细胞增多症167例患儿为研究对象,采用单纯阿昔洛韦治疗患儿95例为常规治疗组,热毒宁联合阿昔洛韦注射液治疗的患儿72例为观察组,比较两组患儿一般临床症状,临床表现和血常规,肝、肾功能,心肌酶谱,体温恢复正常时间,淋巴结缩小、肝功能恢复和住院时间。结果两组患儿一般临床病程和发热、咽颊炎、淋巴结肿大、肝脾肿大、皮疹和眼睑浮肿构成比之间差异没有统计学意义(P<0.05)。治疗前后血常规和血生化肝肾功能、心肌酶谱指标两组间患儿比较差异均没有统计学意义(P<0.05)。观察组(热毒宁+阿昔洛韦)和常规治疗组(阿昔洛韦)治疗前后组内比较,白细胞、谷丙转氨酶(ALT)、乳酸脱氢酶(LDH)均有明显的降低,差异有统计学意义(P<0.05)。但两组患儿LDH出院前仍有不同程度增高,分别(355.63±116.89)U/L和(347.79±106.74)U/L。其中,观察组退热时间为(2.97±2.56)d,淋巴结缩小时间(9.08±1.54)d,肝功能恢复时间为(8.67±2.35)d,白细胞恢复时间(6.76±2.96)d,住院时间(11.10±3.00)d,较常规治疗组能明显缩短,分别为(4.38±2.70)d,(10.48±3.62)d,(11.50±3.71)d,(9.15±3.24)d,住院时间(12.32±3.62)d,差异有统计学意义(均P<0.05)。结论两组治疗后发热、淋巴结肿大、白细胞增多、肝功能损害指标和乳酸脱氢酶等均有不同程度的缓解和降低。热毒宁联合阿昔洛韦治疗患儿有较好临床疗效,可缩短患儿发热、淋巴结缩小时间和白细胞恢复时间,特别是伴有肝功能损害患儿能缩短其恢复时间,临床应用安全,可作为儿童传染性单核细胞增多症有效治疗措施之一。

Objective To evaluate the efficacy of the combined therapy of ReDuNing injection and acyclo- vir on children with infectious mononueleosis （IM）. Methods From October 2012 to July 2015 in the emergency ward of Children＇s Hospital of Nanjing Medical University, 167 cases diagnosised with infectious mononucleosis were enrolled in this study. Ninety-five cases received acyclovir treatment were recruited in the conventional treat- ment group, 72 cases received the combined thrapy of ReDuNing injection and acyclovir of children were recruited in the observation group. The clinical symptoms, clinical manifestation and blood routine, liver and kidney func- tion, myocardial enzymes, temperature recovery time, reduce lymph node, liver function recovery time and hospi- talization time of patients were recorded and compared between the two groups. Results No significant differences were observed in the clinical course and general fever, pharyngitis, lymphadenopathy, hepatosplenomegaly, rash and eyelid edema in children of the observation group （ReDuNing ＋ Acyclovir ） and routine treatment group （Acyclovir）. No significant differences were found in blood routine, blood biochemical indexes of liver, kidney function and myocardial enzymes in patients of the two groups before and after treatment. The white blood cells, ALT and LDH were significantly reduced in patients of the two groups after treatment （P 〈 0.05 ）. However, LDH was still high in patients of the two groups before discharge, with the level of （355.63 ±116.89） U/L and （347.79± 106.74） U/L, respectively. The pyretolysis time （2.97±2.56） d, lymph node reduced time （9.08±1.54） d,liver function recovery time （8.67 ± 2.35） d, white blood cell recovery time （6.76 ± 2.96） d, hospitalization time （11.10 ± 3） d in the observation group were significantly shortened than those in the conventional treatment group （（4.38 ± 2.70） d, （10.48 ± 3.62） d, （11.50 ± 3.71） d, （9.15 ± 3.24） d, 12.32 ± 3.62） d, respectively） （P 〈 0.05, respectively）. Conclusions The fever, lymphadenopathy, leukoeytosis, liver damage and LDH were relieved and reduced at different degrees in patients of both the observation group and the routine treatment group after treat- ments. Reduning combined with acyclovir treatments lead to better clinical efficacy in children, with shortening the duration of fever, Lymph node reduction time, and white blood cell recovery time. In particularly, the combined therapy can shorten the recovery time of patients with liver function damage, which is a safe clinical application and can be used as one of the effective treatment measures for children with infectious mononucleosis.