开喉剑喷雾剂联合更昔洛韦治疗小儿疱疹性口腔炎的临床研究

目的探讨小儿疱疹性口腔炎应用开喉剑喷雾剂联合更昔洛韦治疗的临床效果。方法选取2015年6月-2018年12月竹山县人民医院收治的338例疱疹性口腔炎患儿,随机分为对照组和治疗组,每组各169例。对照组静脉滴注注射用更昔洛韦,5 mg/(kg·d),用生理盐水将药物浓度稀释至1 mg/mL,恒速静滴,每次给药时间应>1 h。治疗组在对照组基础上采用开喉剑喷雾剂喷患处,2喷/次,6次/d。两组均连续治疗7d。观察两组临床疗效及主要症状、体征的缓解时间;比较治疗前后两组患儿血清免疫球蛋白A(IgA)、前白蛋白(PAB)水平。结果治疗后,对照组和治疗组总有效率分别为90.5%、97.0%,两组比较差异有统计学意义(P<0.05)。治疗组患儿退热时间、进食改善时间、疼痛流涎消失时间、口腔疱疹/溃疡消退时间均显著短于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组外周血象指标(WBC、MONO#、LYM#)的异常率均显著低于治疗前(P<0.05);且治疗后,治疗组患者以上外周血象参数的异常率较对照组同期均显著更低(P<0.05)。与治疗前对比,两组治疗后血清IgA、PAB水平均显著增高(P<0.05);但治疗组治疗后血清IgA、PAB水平均显著高于对照组同期(P<0.05)。结论开喉剑喷雾剂联合更昔洛韦治疗小儿疱疹性口腔炎的整体疗效确切,能有效缩短患儿症状及体征的改善时间,改善外周血象,增强体液免疫功能,具有一定的临床推广应用价值。

Clinical study on Kaihoujian Spray combined with ganciclovir in treatment of herpes stomatitis in children

Objective To investigate the clinical effect of Kaihoujian Spray combined with ganciclovir in treatment of herpes stomatitis in children. Methods 338 Children with herpes stomatitis admitted to Zhushan County People''s Hospital from June 2015 to December 2018 were randomly divided into control group (n=169) and treatment group (n=169). The control group was iv administered with Ganciclovir for injection, 5 mg/(kg·d), and the concentration of the drug was diluted to 1 mg/mL with normal saline, and the drug was dropped at a constant speed. The time of each dosage should be greater than 1 h. Patients in the treatment group were given Kaihoujian Spray, 2 sprays/time, 6 times/d. All patients were treated for 7 days. The clinical efficacy and the remission time of main symptoms and signs were compared between the two groups. Serum immunoglobulin A(IgA) and prealbumin (PAB) levels in two groups before and after treatment were compared. Results The total effective rate in the control and treatment groups was 90.5% and 97.0%, respectively, and there were differences between two groups (P<0.05). The antifebrile time, feeding improvement time, painful salivation disappearance time, oral herpes/ulcer extinction time in the treatment group were all significantly shorter than those in the control group, and there were differences between two groups (P<0.05). The abnormal rates of peripheral blood indexes (WBC and absolute values of monocytes and lymphocytes (MONO# and LYM#) in the two groups after treatment were significantly lower than those before treatment (P<0.05). After treatment, the abnormal rate of peripheral blood parameters in the treatment group was significantly lower than that in the control group (P<0.05). Compared with before treatment, the concentrations of serum IgA and PAB in the two groups increased significantly after treatment (P<0.05). However, the levels of serum IgA and PAB in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion Kaihoujian Spray combined with ganciclovir has definite overall curative effect in the treatment of herpes stomatitis in children, and can effectively shorten the improvement time of symptoms and signs, and can improve peripheral blood picture, enhance humoral immune function, which has a certain clinical application value.