甘露消毒丹加减灌肠、苦黄散外洗联合干扰素治疗湿热蕴毒型手足口病的疗效及对肝功能、心肌酶谱、炎症因子、免疫球蛋白的影响
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摘要
目的:观察甘露消毒丹加减灌肠、苦黄散外洗联合干扰素治疗湿热蕴毒型手足口病的疗效及对肝功能、心肌酶谱、炎症因子、免疫球蛋白的影响。方法:选取本院诊断为湿热蕴毒型手足口病患儿74例,随机分为观察组(38例)和对照组(36例)。对照组给予常规的西医对症治疗,同时采用IFN-α雾化吸入或IFN-α2b喷雾剂喷于口腔患处。观察组在对照组的基础上给予甘露消毒丹加减灌肠,苦黄散外洗。7d为1个疗程。观察两组患儿体温复常时间、皮疹消退时间及患儿疗效,比较两组治疗前后肝功能、心肌酶谱、炎症因子、免疫球蛋白的变化。结果:观察组疗效高于对照组,差异有统计学意义(P<0.05)。观察组体温复常所需时间低于对照组,皮疹消退所需时间低于对照组,差异有统计学意义(P<0.01);治疗后观察组ALT、AST、CK-MB、IL-4、IL-6水平低于对照组,血清IgA、IgM水平高于对照组,差异有统计学意义(P<0.05)。结论:甘露消毒丹加减灌肠苦黄散外洗联合干扰素治疗湿热蕴毒型手足口病有较好的疗效,能改善肝功能、保护心肌细胞、降低患儿炎症因子,调节免疫功能。
Objective:To observe the curative effect of Modified Ganlu Xiaodu Dan and Kuhuangsan combined with interferon on the treatment of HFMD of damp-heat accumulation toxin syndrome and its effects on liver function,myocardial enzymes,inflammatory factors and immunoglobulin.Merhods:From June 2018 to November 2018,74 children with damp-heat accumulation toxin syndrome who were diagnosed with hand,foot and mouth disease were randomly divided into observation group (38 cases)and control group (36 cases).The control group was given conventional Western medicine symptomatic treatment,and sprayed on the oral cavity with IFN-αatomized inhalation or IFN-α2 bspray.On the basis of the control group,the observation group was given Modified Ganlu Xiaodu Dan,and Kuhuangsan was washed outside.7 days is a course of treatment.The recurrence time of the two groups,the time of rash regression and the efficacy of the children were observed.The changes of liver function,myocardial zymogram,inflammatory factors and immunoglobulin were compared before and after treatment.Results:The efficacy of the observation group was 92.1% higher than that of the control group (83.3%),and the difference was statistically significant (P<0.05).The time required for the body temperature of the observation group (2.64±0.57)d was lower than that of the control group (3.12±0.62)d,and the time required for the rash to resolve was (4.18±0.69)d,which was lower than that of the control group (5.25±0.73)d.Statistically significant,P<0.01.The levels of ALT,AST,CK-MB,IL-4 and IL-6 in the observation group were lower than those in the control group after treatment,the difference was statistically significant (P<0.05).The serum IgA and IgM levels in the observation group were higher than those in the control group after treatment,P<0.05.Conclusion:Modified Ganlu Xiaodu Dan and Kuhuangsan combined with interferon for the treatment of HFMD of damp-heat accumulation toxin syndrome have better curative effect and it can improve liver function,protect cardiomyocytes,reduce inflammatory factors,and regulate immune function in chidren.
Objective:To observe the curative effect of Modified Ganlu Xiaodu Dan and Kuhuangsan combined with interferon on the treatment of HFMD of damp-heat accumulation toxin syndrome and its effects on liver function,myocardial enzymes,inflammatory factors and immunoglobulin.Merhods:From June 2018 to November 2018,74 children with damp-heat accumulation toxin syndrome who were diagnosed with hand,foot and mouth disease were randomly divided into observation group (38 cases)and control group (36 cases).The control group was given conventional Western medicine symptomatic treatment,and sprayed on the oral cavity with IFN-αatomized inhalation or IFN-α2 bspray.On the basis of the control group,the observation group was given Modified Ganlu Xiaodu Dan,and Kuhuangsan was washed outside.7 days is a course of treatment.The recurrence time of the two groups,the time of rash regression and the efficacy of the children were observed.The changes of liver function,myocardial zymogram,inflammatory factors and immunoglobulin were compared before and after treatment.Results:The efficacy of the observation group was 92.1% higher than that of the control group (83.3%),and the difference was statistically significant (P<0.05).The time required for the body temperature of the observation group (2.64±0.57)d was lower than that of the control group (3.12±0.62)d,and the time required for the rash to resolve was (4.18±0.69)d,which was lower than that of the control group (5.25±0.73)d.Statistically significant,P<0.01.The levels of ALT,AST,CK-MB,IL-4 and IL-6 in the observation group were lower than those in the control group after treatment,the difference was statistically significant (P<0.05).The serum IgA and IgM levels in the observation group were higher than those in the control group after treatment,P<0.05.Conclusion:Modified Ganlu Xiaodu Dan and Kuhuangsan combined with interferon for the treatment of HFMD of damp-heat accumulation toxin syndrome have better curative effect and it can improve liver function,protect cardiomyocytes,reduce inflammatory factors,and regulate immune function in chidren.
引文
1 Li Y,Chang Z,Wu P,et al.Emerging enteroviruses causing hand,foot and mouth disease,China,2010-2016[J].Emerg Infect Dis,2018,24(10):1902-1906.
2 Jones E,Pillay TD,Liu F,et al.Outcomes following severe hand foot and mouth disease:A systematic review and meta-analysis[J].Eur J Paediatr Neurol,2018,22(5):763-773.
3 Tan CW,Lai JK,Sam IC,et al.Recent developments in antiviral agents against enterovirus 71infection[J].JBiomed Sci,2014,21:14.
4国家卫生健康委员会.手足口病诊疗指南(2018年版)[J/OL].中国病毒病杂志,2018,(5):1-5.
5孙传兴.临床疾病诊断依据好转标准[S].第2版.北京:人民军医出版社.
6张红梅,刘凯凯,张国梁,等.基于现代文献分析普通型手足口病证候、证素分布特点及常见证候与症状对应关系[J].北京中医药大学学报,2016,39(10):869-874.
7韩云,邹俊驹,贺又舜.甘露消毒丹的来源与现代应用概况[J].湖南中医杂志,2017,33(5):181-183.
8贺又舜,赵国荣,黄开颜.甘露消毒丹对柯萨奇病毒体外抑制作用的实验研究[J].中国中西医结合杂志,1998,18(12):737-740.
9艾碧琛,贺又舜,赵国荣,等.甘露消毒丹及其拆方体外抗肠道病毒71型作用[J].中医杂志,2014,55(8):695-698.
10陈青,岑杨成,钟斌,等.苦黄散治疗普通型手足口病肺脾湿热证临床研究[J].蛇志,2016,28(4):407-409.
11陈永英.重症手足口病患儿的营养状况评估及其与靶器官功能损伤、免疫应答的相关性研究[J].海南医学院学报,2016,22(23):2886-2889.
12 Zheng G,Cao J,Yu J,et al.Risk factors for death in children with critical and severe hand-foot-and-mouth disease in Chongqing,China:An observational study[J].Medicine(Baltimore),2017,96(49):e8934.
13周冠寅.不同程度手足口病患儿血清细胞因子及免疫球蛋白水平变化探讨[J].国际检验医学杂志,2017,38(6):799-800,804.
2 Jones E,Pillay TD,Liu F,et al.Outcomes following severe hand foot and mouth disease:A systematic review and meta-analysis[J].Eur J Paediatr Neurol,2018,22(5):763-773.
3 Tan CW,Lai JK,Sam IC,et al.Recent developments in antiviral agents against enterovirus 71infection[J].JBiomed Sci,2014,21:14.
4国家卫生健康委员会.手足口病诊疗指南(2018年版)[J/OL].中国病毒病杂志,2018,(5):1-5.
5孙传兴.临床疾病诊断依据好转标准[S].第2版.北京:人民军医出版社.
6张红梅,刘凯凯,张国梁,等.基于现代文献分析普通型手足口病证候、证素分布特点及常见证候与症状对应关系[J].北京中医药大学学报,2016,39(10):869-874.
7韩云,邹俊驹,贺又舜.甘露消毒丹的来源与现代应用概况[J].湖南中医杂志,2017,33(5):181-183.
8贺又舜,赵国荣,黄开颜.甘露消毒丹对柯萨奇病毒体外抑制作用的实验研究[J].中国中西医结合杂志,1998,18(12):737-740.
9艾碧琛,贺又舜,赵国荣,等.甘露消毒丹及其拆方体外抗肠道病毒71型作用[J].中医杂志,2014,55(8):695-698.
10陈青,岑杨成,钟斌,等.苦黄散治疗普通型手足口病肺脾湿热证临床研究[J].蛇志,2016,28(4):407-409.
11陈永英.重症手足口病患儿的营养状况评估及其与靶器官功能损伤、免疫应答的相关性研究[J].海南医学院学报,2016,22(23):2886-2889.
12 Zheng G,Cao J,Yu J,et al.Risk factors for death in children with critical and severe hand-foot-and-mouth disease in Chongqing,China:An observational study[J].Medicine(Baltimore),2017,96(49):e8934.
13周冠寅.不同程度手足口病患儿血清细胞因子及免疫球蛋白水平变化探讨[J].国际检验医学杂志,2017,38(6):799-800,804.