目的 探讨安宫牛黄丸联合更昔洛韦胶囊治疗重症病毒性脑炎的临床疗效。方法 选取2017年2月-2020年2月在南阳南石医院治疗的62例重症病毒性脑炎患儿为研究对象，将所有患儿随机分为对照组和治疗组，每组各31例。对照组患儿口服更昔洛韦胶囊，1 000 mg/次，3次/d。治疗组患儿在对照组基础上口服安宫牛黄丸，1次/d，3岁以下：1/4丸/次，3~6岁：1/2丸/次，6~10岁：1丸/次。两组患儿接受治疗时间为2周。观察两组患儿的临床疗效，比较两组临床症状消失时间、血清神经元特异性烯醇化酶（NSE）和S100β蛋白水平。结果 治疗后，治疗组总有效率为93.55%，较对照组的80.65%显著较高（P<0.05）。治疗后，治疗组患儿退热时间、症状控制时间、精神症状改善时间、抽搐控制时间、意识清醒时间显著短于对照组（P<0.05）。治疗后，两组患儿血清NSE、S100β蛋白水平显著降低（P<0.05），且治疗组血清NSE、S100β蛋白水平降低程度较大P<0.05）。结论 安宫牛黄丸联合更昔洛韦胶囊治疗重症病毒性脑炎疗效显著，可改善患儿的临床症状，降低血清因子水平，值得临床推广。

Objective To investigate the clinical efficacy of Angong Niuhuang Pills combined with Ganciclovir Capsules in treatment of severe viral encephalitis. Methods Children (62 cases) with severe viral encephalitis in Nanshi Hospital of Nanyang from February 2017 to February 2020 were randomly divided into control and treatment groups, and each group had 31 cases. Children in the control group were po administered with Ganciclovir Capsules, 1 000 mg/time, three times daily. Children in the treatment group were po administered with Angong Niuhuang Pills on the basis of the control group, under 3 years old:1/4 pill/time, 3-6 years old:1/2 pill/time, 6-10 years old:1 pill/time, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and clinical symptom relief times, and the serum levels of NSE and S100β protein in two groups were compared. Results After treatment, the effective rate of the treatment group was 93.55%, which was significantly higher than that of the control group (80.65%) (P<0.05). After treatment, the antipyretic time, symptom control time, mental symptom improvement time, convulsion control time, and conscious time in the treatment group were significantly shorter than those in the control group (P<0.05). After treatment, the serum levels of NSE and S100β protein of the two groups were significantly decreased (P<0.05), and after treatment, the serum levels of NSE and S100β protein in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Angong Niuhuang Pills combined with Ganciclovir Capsules has clinical curative effect in treatment of severe viral encephalitis, can improve the clinical symptoms of children and reduce serum factor levels, which is worthy of clinical application.

R971

河南省科技攻关项目（201701034）