本文選題：手足口病/兒童 + 臨床研究　； 參考：《湖北中醫(yī)藥大學》2012年碩士論文

【摘要】：目的： 觀察清熱解毒疏風祛濕法(抗毒合劑)治療手足口病的臨床療效,并探討抗毒合劑的安全性,為手足口病的臨床治療提供新的思路方法,改變目前西醫(yī)治療手足口病無特異性方法方藥的現(xiàn)狀,并為降低重癥手足口病的發(fā)生率提供有效安全的藥物打下基礎。 方法： 選取符合手足口病診斷標準的患兒61例,隨機分成治療組和對照組。治療組31例,其中男17例,女14例,年齡6月-5歲,平均年齡為1.826±0.965歲,病程為1-5天。對照組30例,其中男16例,女14例,年齡6月-5歲,平均年齡為1.717±0.749歲,病程為1-5天。兩組患兒性別、年齡及病程經統(tǒng)計學處理,無顯著性差異,具有可比性。 對照組治療按2010年衛(wèi)生部頒布的手足口病診療指南執(zhí)行；治療組在此基礎上加用抗毒合劑口服或保留灌腸(6月-1歲：10ml/次,日三次；1-3歲：15ml/次,日三次；3-6歲：20ml/次,日三次)。兩組療程均為7天。觀察兩組病例治療前后癥狀、體征及實驗室指標等的變化,并進行臨床綜合評價。統(tǒng)計分析采用SPSS13.0統(tǒng)計軟件,分類資料用x2檢驗,計量資料用t檢驗,等級資料用Ridit分析法。 結果： 1、兩組總療效比較治療組痊愈率為90.32%,總有效率為96.77%；對照組痊愈率為70%,總有效率為86.67%,兩組差異經統(tǒng)計學比較有顯著性意義(P0.05),說明治療組療效優(yōu)于對照組。 2、兩組癥狀比較治療組平均退熱時間為2.731±1.069天,平均皮疹消退時間為3.778±1.609天,對照組平均退熱時間為3.828±1.860天,平均皮疹消退時間為6.052±1.551天；兩組差異經比較有顯著性意義(P均0.05),說明治療組退熱時間及皮疹消退時間較對照組時間均明顯縮短；兩組出現(xiàn)咳嗽癥狀共計44例,其中治療組21例,平均痊愈時間為2.397±0.518天,對照組23例,平均痊愈時間為4.729±1.021天；出現(xiàn)嘔吐癥狀共計41例,其中治療組20例,平均痊愈時間為1.636±1.210天,對照組21例,平均時間為2.532±1.228天；出現(xiàn)大便干結癥狀共計56例,其中治療組29例,恢復正常平均時間為3.008±1.209天,對照組27例,平均時間為4.347±1.761天；兩組在咳嗽、嘔吐及大便干結痊愈時間上差異統(tǒng)計比較有意義(P值均0.05),說明治療組在大便干結、咳嗽、嘔吐痊愈時間方面短于對照組。 3、兩組重癥病例發(fā)生率的比較治療組有1例發(fā)展為重癥病例,重癥病例占3.23%,對照組有4例發(fā)展為重癥病例,重癥病例占13.33%,兩組通過統(tǒng)計比較有顯著意義(P0.05),表明治療組在減少重癥病例發(fā)生方面優(yōu)于對照組。 4、兩組治療后血清EV71抗體轉陰時間比較經治療后治療組血清EV71抗體轉陰30例,平均轉陰時間為4.398±0.751天,對照組轉陰25例,平均轉陰時間5.163±0.906天；兩組統(tǒng)計比較有顯著性差異(P0.01),說明治療組在血清EV71抗體轉陰時間上優(yōu)于對照組。 結論： 清熱解毒疏風祛濕法(抗毒合劑)治療手足口病,總有效率為96.77%、總治愈率為90.32%,療效優(yōu)于西醫(yī)常規(guī)治療組；主癥方面,平均退熱時間為2.731±1.069天,平均皮疹消退時間為3.778±1.609天,能明顯縮短手足口病熱程及皮疹消退時間；次癥咳嗽平均痊愈時間為2.397±0.518天,嘔吐平均痊愈時間為1.636±1.210天,大便干結平均痊愈時間為3.008±1.209天,縮短次要癥狀(大便干結、咳嗽、嘔吐)痊愈時間上明顯優(yōu)于西醫(yī)常規(guī)治療組；僅有1例發(fā)展為重癥病例,重癥病例占3.23%,減少重癥病例發(fā)生方面優(yōu)于西醫(yī)常規(guī)組；治療后血清EV71抗體轉陰30例,平均轉陰時間為4.398±0.751天,縮短血清EV71抗體轉陰時間上優(yōu)于對照組。通過以上臨床研究表明：抗毒合劑具有清熱解毒、疏風祛濕的功效,能明顯縮短手足口病熱程及皮疹消退時間,及早改善大便干結、咳嗽、嘔吐等癥狀,減少重癥病例數(shù),縮短血清EV71抗體轉陰時間,是臨床上治療手足口病的有效藥物,且未發(fā)現(xiàn)與治療有關的毒副反應；清熱解毒疏風祛濕法是手足口病的主要治療大法,值得進一步深入研究。
[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.

【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R272

【參考文獻】

相關期刊論文 前10條

1 尹蔚萍;夏杰;;三豆銀翹散治療小兒手足口病的臨床觀察[J];光明中醫(yī);2009年01期

2 盧有亮;林暄;張澤欽;;中醫(yī)從脾論治小兒手足口病[J];光明中醫(yī);2009年04期

3 吉文亮;秦民堅;王崢濤;;中藥射干的化學與藥理研究進展[J];國外醫(yī)藥(植物藥分冊);2000年02期

4 李向東;清熱祛濕運脾養(yǎng)陰法治療手足口病50例[J];河北中醫(yī);2005年10期

5 李巧香;;銀翹藿茵湯治療小兒手足口病68例總結[J];湖南中醫(yī)雜志;2006年03期

6 楊華升;楊薇;李娜;田一梅;張佳瑩;李秀惠;;手足口病的中醫(yī)學病因特點分析[J];環(huán)球中醫(yī)藥;2010年06期

7 胡克杰,孫考祥,王t熻，

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