【摘要】 目的:探讨清热解毒开窍醒神法治疗重症手足口病(HFMD)的临床疗效及对脑、心、肺等重要脏器的保护作用。方法:90例重型HFMD患儿随机按数字法分为观察组和对照组各45例。对照组参照"手足口病诊疗指南(2010年版)"进行常规对症、支持治疗。观察组在此基础上,采用清热解毒开窍醒神法,分别给予热毒宁注射液静脉滴注,中药内服,中药灌肠治疗。观察患儿体温恢复正常时间,皮疹、疱疹消退时间,口腔溃疡愈合时间及住院时间。检测第0、3天血氧饱和度(SPO2)、氧分压(PaO2);检测第0、5天血清门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)及肌酸激酶同功酶(CK-MB)水平,脑脊液神经元特异性烯醇酶(NSE)。结果:观察组体温恢复正常时间,皮疹、疱疹消退时间,口腔溃疡愈合时间、住院时间均明显低于对照组(P<0.05);治疗后第3天观察组SPO2,PaO2高于对照组(P<0.01);治疗后第5天观察组血清CK和CK-MB水平低于对照组(P<0.05,P<0.01);治疗后第5天观察组脑脊液NSE水平低于对照组(P<0.01)。结论:采用清热解毒,开窍醒神法治疗重症HFMD能缩短病程,该法对患儿的脑、心、肺等重要脏器具有较好的保护作用。更多还原

【Abstract】 Objective:To discuss the clinical efficacy of heat-clearing and detoxifying resuscitation method on patients with severe hand-foot-and-mouth disease(HFMD) and the protection effect on brain,heart,lungs.Method:ninety patients with HFMD were randomly divided into observation group(n = 45) and control group(n = 45).Control group was given conventional therapy according to ‘Hand-foot-mouth disease treatment guidelines(2010 Edition) ’.Reduning injection and traditional Chinese medicine were added to observation group by using heat-clearing and detoxifying resuscitation method.Body temperature returned to normal time,Rash,bleb subsidise time,the healing time of oral ulcer and hospital stay of patients were observed.The SPO2 and PaO2 of the 0 day and 3th day were tested;the Aspartate aminotransferase(AST),Lactate dehydrogenase(LDH),Creatine kinase(CK),Isoenzymes of creatine kinase(CK-MB) and Neuron specific enolase(NSE) of 0 day and 5th day were tested.Result:The body temperature returned to normal time,Rash,bleb subsidise time,the healing time of oral ulcer and hospital stay of patients in observation group were lower than control group(P < 0.05).The SPO2 and PaO2 level of the 3th day in observation group were higher than control group(P < 0.01);the CK and CK-MB level of the 5th day in observation group were lower than control group(P < 0.05,P < 0.01);the NSE level of the 5th day in observation group were lower than control group(P < 0.01).Conclusion:Heat-clearing and detoxifying resuscitation method can Shorten the course of HFMD disease,and it can protect brain,heart,lungs of patients.It is worthy of clinical application.更多还原