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目的:探讨甘草泻心汤联合人免疫球蛋白治疗手足口病(Hand-foot-and-mouth disease,HFMD)患儿对超敏C-反应蛋白(hs-CRP)及心肌酶谱的影响。方法:选取2012年1月—2014年8月住院治疗的手足口病患儿104例,随机分为实验组和对照组,每组52例。对照组给予常规抗炎和抗病毒治疗,实验组在对照组基础上,加用甘草泻心汤联合人免疫球蛋白治疗。比较两组患儿治疗前和治疗7 d后的中医症候评分、hs-CRP和心肌酶谱水平以及治疗7 d后的临床疗效。结果:治疗7 d后两组患儿发热、出疹、咽痛、纳差和便秘症状评分较治疗前显著降低,且实验组较对照组显著降低,差异具有统计学意义(P<0.05);治疗7 d后两组患儿的hs-CRP、CK、CK-MB、AST、LDH、LDH-1和α-HBDH较治疗前显著降低,且实验组较对照组显著降低,差异具有统计学意义(P<0.05);治疗7 d后实验组患儿的临床总有效率显著高于对照组,差异具有统计学意义(χ2=5.225 1,P=0.022 3<0.05)。结论:甘草泻心汤联合人免疫球蛋白可有效改善HFMD患儿的临床症状,修复心肌损伤,改善炎症反应,具有较好的疗效。
Objective: To investigate the effects of Gancao Xiexin Decoction combined with human immunoglobulin on hs-CRP and myocardial enzymes in children with Hand-foot-and-mouth disease (HFMD). Methods: A total of 104 children with hand-foot-mouth disease admitted to hospital from January 2012 to August 2014 were randomly divided into experimental group and control group, with 52 cases in each group. The control group was given routine anti-inflammatory and antiviral therapy. The experimental group was treated with Gancaoxiexin Decoction combined with human immunoglobulin on the basis of the control group. The TCM symptom scores, hs-CRP and myocardial zymogram scores before and 7 days after treatment were compared between two groups and the clinical efficacy after 7 days of treatment. Results: After 7 days of treatment, fever, rash, sore throat, anorexia and constipation symptoms in both groups were significantly lower than those before treatment, and the experimental group was significantly lower than the control group (P <0.05). The levels of hs-CRP, CK, CK-MB, AST, LDH, LDH-1 and α-HBDH in the two groups after treatment were significantly lower than those before treatment, and the experimental group was significantly lower than the control group (P <0.05). After 7 days of treatment, the clinical total effective rate of the experimental group was significantly higher than that of the control group (χ2 = 5.2251, P = 0.022 3 <0.05). Conclusion: Gancaoxiexin Decoction combined with human immunoglobulin can effectively improve the clinical symptoms of children with HFMD, repair myocardial injury, improve the inflammatory response, and has good curative effect.