中西医结合治疗对重症手足口病患儿血清TNF-α与IL-6的影响  

Influence of traditional Chinese medicine combined with western medicine on serum TNF-α and IL-6 of children with server hand,foot and mouth disease

作　　者：单鸣凤[1] 周凯[1] 胡静[1] 田野[1] 石小华 陈鸿健[1] 梅小丽[1] SHAN Ming-feng;ZHOU Kai;HU Jing;TIAN Ye;SHI Xiao-hua;CHEN Hong-jian;MEI Xiao-li(Children＇s Hospital of Nanjing Medical University,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京医科大学附属儿童医院感染科,江苏南京210008

出　　处：《中华医院感染学杂志》2018年第20期3132-3135,共4页Chinese Journal of Nosocomiology

基　　金：江苏省中医药局科技基金资助项目(LZ13117)

摘　　要：目的探讨中西医结合治疗重症手足口病患儿的疗效及对血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)等水平的影响。方法选择2015年3月-2016年5月住院重症手足口病患儿60例为研究对象,随机分为试验组与对照组,各30例。对照组在常规治疗基础上采用利巴韦林注射液静滴,试验组在对照组基础上加用热毒宁静滴、安宫牛黄丸口服;观察两组患儿治疗后疗效及TNF-α、IL-6水平。结果试验组患儿痊愈6例,显效8例,有效15例,对照组痊愈1例,显效10例,有效13例,试验组疗效优于对照组(P=0.048);治疗前,两组患儿血清TNF-α、IL-6差异无统计学意义;治疗后两组患儿的血清TNF-α、IL-6水平均下降(P<0.001),且试验组患儿TNF-α、IL-6分别为(221.69±7.19)pg/ml、(17.93±1.25)pg/ml,低于对照组(P<0.001);试验组患儿症状体征均消失时间为(6.52±1.57)天短于对照组(7.13±0.94)天(P<0.001)。在治疗过程中两组患儿均未观察到严重不良反应。结论中西医结合治疗重症手足口病在改善临床症状方面优于单纯西医治疗组,可有效降低血清炎症细胞因子TNF-α、IL-6,具有一定的临床价值。OBJECTIVE To explore the effect of traditional Chinese medicine combined with western medicine on treatment of children with severe hand,foot and mouth disease（HFMD）and observe the influence on the levels of serum tumor necrosis factor-α（TNF-α）and interleukin-6（IL-6）.METHODS A total of 60 children with severe HFMD who were hospitalized from Mar 2015 to May 2016 were recruited as the study objects and randomly divided into the experimental group and the control group,with 30 cases in each group.The control group was treated with intravenous drip of ribavirin injection on basis of conventional treatment,while the experimental group was given intravenous drip of Reduning and oral administration of Angong Niuhuang bolus on basis of the treatment of the control group.The curative effects and levels of TNF-α and IL-6 were observed and compared between the two groups of children.RESULTSIn the experimental group,6 children were cured,8 were improved,and 15 were effective.In the control group,1 child was cured,10 were improved,and 13 were effective;the therapeutic effects of the experimental group were significantly better than those of the control group（P=0.048）.There were no significant differences in the levels of serum TNF-α and IL-6 between the two groups of children before the treatment.The levels of serum TNF-α and IL-6 of the two groups of patients were significantly reduced after the treatment（P〈0.001）.The levels of TNF-α and IL-6 of the experimental group were respectively（221.69±7.19）pg/ml and（17.93±1.25）pg/ml,significantly lower than those of the control group（P〈0.001）.The time of disappearance of symptoms and sings was（6.52±1.57）days in the experimental group,significantly shorter than（7.13±0.94）days in the control group（P〈0.001）.No severe adverse reactions were observed in the two groups of children during the treatment.CONCLUSION Traditional Chinese medicine combined with western medicine is superior to single western medicine in improvement of the

关 键 词：手足口病 肿瘤坏死因子-Α 白细胞介素-6 中西医结合疗法 

分 类 号：R446.62[医药卫生—诊断学]