清热解毒疏风祛湿法（抗毒合剂）治疗手足口病的临床研究

发布时间：2018-04-15 10:26

本文选题：手足口病/儿童 + 临床研究　；参考：《湖北中医药大学》2012年硕士论文

【摘要】：目的：观察清热解毒疏风祛湿法(抗毒合剂)治疗手足口病的临床疗效,并探讨抗毒合剂的安全性,为手足口病的临床治疗提供新的思路方法,改变目前西医治疗手足口病无特异性方法方药的现状,并为降低重症手足口病的发生率提供有效安全的药物打下基础。方法：选取符合手足口病诊断标准的患儿61例,随机分成治疗组和对照组。治疗组31例,其中男17例,女14例,年龄6月-5岁,平均年龄为1.826±0.965岁,病程为1-5天。对照组30例,其中男16例,女14例,年龄6月-5岁,平均年龄为1.717±0.749岁,病程为1-5天。两组患儿性别、年龄及病程经统计学处理,无显著性差异,具有可比性。对照组治疗按2010年卫生部颁布的手足口病诊疗指南执行；治疗组在此基础上加用抗毒合剂口服或保留灌肠(6月-1岁：10ml/次,日三次；1-3岁：15ml/次,日三次；3-6岁：20ml/次,日三次)。两组疗程均为7天。观察两组病例治疗前后症状、体征及实验室指标等的变化,并进行临床综合评价。统计分析采用SPSS13.0统计软件,分类资料用x2检验,计量资料用t检验,等级资料用Ridit分析法。结果： 1、两组总疗效比较治疗组痊愈率为90.32%,总有效率为96.77%；对照组痊愈率为70%,总有效率为86.67%,两组差异经统计学比较有显著性意义(P0.05),说明治疗组疗效优于对照组。 2、两组症状比较治疗组平均退热时间为2.731±1.069天,平均皮疹消退时间为3.778±1.609天,对照组平均退热时间为3.828±1.860天,平均皮疹消退时间为6.052±1.551天；两组差异经比较有显著性意义(P均0.05),说明治疗组退热时间及皮疹消退时间较对照组时间均明显缩短；两组出现咳嗽症状共计44例,其中治疗组21例,平均痊愈时间为2.397±0.518天,对照组23例,平均痊愈时间为4.729±1.021天；出现呕吐症状共计41例,其中治疗组20例,平均痊愈时间为1.636±1.210天,对照组21例,平均时间为2.532±1.228天；出现大便干结症状共计56例,其中治疗组29例,恢复正常平均时间为3.008±1.209天,对照组27例,平均时间为4.347±1.761天；两组在咳嗽、呕吐及大便干结痊愈时间上差异统计比较有意义(P值均0.05),说明治疗组在大便干结、咳嗽、呕吐痊愈时间方面短于对照组。 3、两组重症病例发生率的比较治疗组有1例发展为重症病例,重症病例占3.23%,对照组有4例发展为重症病例,重症病例占13.33%,两组通过统计比较有显著意义(P0.05),表明治疗组在减少重症病例发生方面优于对照组。 4、两组治疗后血清EV71抗体转阴时间比较经治疗后治疗组血清EV71抗体转阴30例,平均转阴时间为4.398±0.751天,对照组转阴25例,平均转阴时间5.163±0.906天；两组统计比较有显著性差异(P0.01),说明治疗组在血清EV71抗体转阴时间上优于对照组。结论：清热解毒疏风祛湿法(抗毒合剂)治疗手足口病,总有效率为96.77%、总治愈率为90.32%,疗效优于西医常规治疗组；主症方面,平均退热时间为2.731±1.069天,平均皮疹消退时间为3.778±1.609天,能明显缩短手足口病热程及皮疹消退时间；次症咳嗽平均痊愈时间为2.397±0.518天,呕吐平均痊愈时间为1.636±1.210天,大便干结平均痊愈时间为3.008±1.209天,缩短次要症状(大便干结、咳嗽、呕吐)痊愈时间上明显优于西医常规治疗组；仅有1例发展为重症病例,重症病例占3.23%,减少重症病例发生方面优于西医常规组；治疗后血清EV71抗体转阴30例,平均转阴时间为4.398±0.751天,缩短血清EV71抗体转阴时间上优于对照组。通过以上临床研究表明：抗毒合剂具有清热解毒、疏风祛湿的功效,能明显缩短手足口病热程及皮疹消退时间,及早改善大便干结、咳嗽、呕吐等症状,减少重症病例数,缩短血清EV71抗体转阴时间,是临床上治疗手足口病的有效药物,且未发现与治疗有关的毒副反应；清热解毒疏风祛湿法是手足口病的主要治疗大法,值得进一步深入研究。
[Abstract]:Objective:
Observation of Qingrejiedu dispelling wind and dampness (Kangdu mixture) clinical curative effect of the treatment of hand foot and mouth disease, and to investigate the safety of Kangdu mixture, to provide new ideas for clinical treatment of HFMD, change the current status of Western medicine in the treatment of HFMD has no specific method of prescription, and to reduce the severe hand foot mouth disease there lay the foundation to provide effective rate of drug safety.
Method:
Selected according to the diagnostic criteria of HFMD patients 61 cases were randomly divided into treatment group and control group. The treatment group of 31 cases, male 17 cases, female 14 cases, age -5 years old in June, the average age was 1.826 + 0.965 years, duration of 1-5 days. The control group of 30 cases, 16 cases were male, 14 female in June, age -5 years old, the average age was 1.717 + 0.749 years, duration of 1-5 days. The two groups of gender, age and duration after statistical treatment, no significant difference, comparable.
The control group was treated by the Ministry of health in 2010 promulgated the guidelines for diagnosis and treatment of hand foot and mouth disease; the treatment group based on the use of Kangdu mixture of oral or enema (June -1 years: 10ml/ times, three times a day; 1-3: 15ml/ times, three times a day; 3-6: 20ml/ times, three times a day). The two groups the course of treatment was 7 days. The two groups were observed before and after treatment, symptoms, signs and laboratory indicators of change, and a comprehensive clinical evaluation. Statistical analysis using statistical software SPSS13.0, using x2 classification test, measurement data using t test, ranked data Ridit analysis method.
Result:
1, the total curative effect of two groups was compared, the cure rate of the treatment group was 90.32%, the total effective rate was 96.77%, the cure rate of the control group was 70%, the total effective rate was 86.67%, and the difference between the two groups was statistically significant (P0.05), indicating that the curative effect of the treatment group is better than that of the control group.
2, compared with two groups of symptoms group average cooling time was 2.731 + 1.069 days, the average time is 3.778 + rash subsided 1.609 days, the control group average cooling time was 3.828 + 1.860 days, the average time is 6.052 + rash subsided 1.551 days; the difference between the two groups by comparison were significant (P 0.05), that the pyretolysis time and deflorescence time were significantly shorter than the control group; two groups of cough in 44 cases, including 21 cases of treatment group, the average healing time was 2.397 + 0.518 days, 23 cases in the control group, the average healing time was 4.729 + 1.021 days; a total of 41 cases of vomiting, 20 of them patients in the treatment group, the average healing time was 1.636 + 1.210 days, 21 cases in the control group, the average time is 2.532 + 1.228 days; symptoms appear dry stool a total of 56 cases, including 29 cases of treatment group returned to normal, the average time is 3.008 + 1.209 days, 27 cases in the control group, the average time was 4 .347 + 1.761 days; the two group in cough, vomiting and dry stool recovery time compared with statistical significance (P < 0.05), indicating that the treatment group in cough, dry stool, vomiting recovery time is shorter than the control group.
3, the two groups the incidence of severe cases of the treatment group 1 patients developed severe cases, severe cases accounted for 3.23%, 4 cases in the control group for the development of severe cases, severe cases accounted for 13.33%, two groups by statistical comparison was significant (P0.05), showed that the treatment group in reducing severe disease cases than the control group.
4, the two groups after treatment of serum EV71 antibody negative time after treatment, serum EV71 antibody negative in 30 cases, the average clearance time was 4.398 + 0.751 days, 25 cases of the control group, the average clearance time 5.163 + 0.906 days; two groups had significant difference (P0.01), the treatment group was better than that of in the time of serum EV71 antibody negative control group.
Conclusion:
Qingrejiedu dispelling wind and dampness (Kangdu mixture) in treatment of HFMD, the total effective rate was 96.77%, the total cure rate was 90.32%, the curative effect is better than routine western medicine treatment group; main symptoms, the average cooling time was 2.731 + 1.069 days, the average time is 3.778 + rash subsided 1.609 days, can significantly shorten the course and rash foot and mouth disease pyretolysis time; secondary symptoms of cough the average recovery time was 2.397 + 0.518 days, vomiting the average recovery time was 1.636 + 1.210 days, dry stool, the average recovery time was 3.008 + 1.209 days, shorten the secondary symptoms (cough, dry stool, vomiting) healing time was better than conventional western medicine treatment group; only 1 with the development of severe cases, severe cases accounted for 3.23%, reduce the occurrence of severe cases was superior to conventional western medicine group; 30 cases of serum EV71 antibody negative after treatment, the average clearance time was 4.398 + 0.751 days, shorten the time of serum EV71 antibody negative. In the control group. The clinical study showed that: Kangdu mixture with heat clearing and detoxicating, dispelling wind and dampness effect, can significantly shorten the process and a rash of hand foot and mouth disease pyretolysis time, as soon as possible to improve the dry stool, coughing, vomiting and other symptoms, reduce the number of severe cases, shorten the time of serum EV71 antibody negative, is an effective drug for clinical treatment foot and mouth disease, and found no adverse reactions and treatment related; Qingrejiedu dispelling wind and dampness is the main treatment method of hand foot and mouth disease, which is worthy of further research.

【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272

【参考文献】