热毒宁联合人血免疫球蛋白治疗小儿手足口病92例

Treating 92 Children with Hand-foot-and-mouth Disease by ReDuNing Combined with Human Serum Immunoglobulin

目的:观察热毒宁联合人血免疫球蛋白治疗小儿手足口病的临床疗效及对机体炎性水平、心肌功能的影响。方法:将184例患儿随机均分为观察组、对照组各92例。2组均给予隔离、维持水电解质,酸碱平衡、退热等常规治疗。对照组在此基础上给予糖皮质激素抗炎及利巴韦林抗病毒治疗,5天为1个疗程。观察组在对照组的基础上给予热毒宁联用人血免疫球蛋白治疗。比较2组临床疗效及心肌酶、炎症因子水平。结果:总有效率观察组为93.48%(86/92),对照组为79.35%(73/92),2组比较差异有统计学意义;退热时间、皮疹消失时间、溃疡消失时间、神经系统受累症状改善时间观察组均短于对照组,2组比较差异有统计学意义(P<0.05);血清降钙素原(PCT)、肿瘤坏死因子(TNF-α)、白介素6(IL-6)以及C反应蛋白(CRP)、α-羟丁酸脱氢酶(α-HBDH)、肌酸激酶同工酶(CK-MB)和磷酸肌酸激酶(CK)水平治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后组间比较差异也有统计学意义(P<0.05)。结论:热毒宁联合人血免疫球蛋白治疗小儿手足口病,临床疗效显著,可有效控制全身炎症反应,积极修复心肌损伤,减轻脑水肿,能有效减少手足口病患儿的并发症和后遗症,减少残疾儿发病率。

Objective:To investigate clinical effects of ReDuNing combined with human serum immunoglobulin in treating children with hand-foot-and-mouth disease,and its influence on inflammatory factors and myocardial function of human body.Methods:All184children were randomized into the observation group and the control group,92cases each group.Both groups accepted routine treatment such as insulation,maintaining the balances of water-electrolyte and acid-base,abatement of fever and others,the control group were given glucocorticoid and ribavirin,five days were one course of the treatment.The observation group were treated with ReDuNing combined with human serum immunoglobulin on the foundation of the therapy the control group accepted.Clinical effects of both groups and the levels of myocardial enzyme and inflammatory factors were compared.Results:Total effective rate of the observation group was93.48%(86/92),higher than79.35%(73/92)of the control group,and the difference showed statistical meaning;the observation group was lower than the control group in the time of abatement of fever,the time of rash disappearing,the time of ulcer disappearing,and the time of nervous system involvement symptom improvement,and the difference had statistical meaning(P<0.05);the difference presented statistical meaning in the comparisons of the levels of PCT,TNF-琢,IL-6,CRP,琢-HBDH,CK-MB and CK between before and after treating within both groups(P<0.05);the difference presented statistical meaning in the comparisons between both groups after treating(P<0.05).Conclusion:ReDuNing combined with human serum immunoglobulin is effective in treating children with hand-foot-and-mouth disease,it could effectively control inflammatory response of the whole human body,positively repair myocardial injury and relieve cerebral edema,which could effectivelyrelieve the complications and the sequela of the children suffering hand-foot-and-mouth disease,and lower the morbidity of the handicapped children.