目的 观察安宫牛黄丸联合丙种球蛋白治疗重症病毒性脑炎患儿的临床效果。方法 选择2017年2月—2020年2月青海省妇女儿童医院收治的94例重症病毒性脑炎患儿，随机分为对照组和治疗组，每组各47例。对照组静脉滴注静注人免疫球蛋白0.4 g/(kg∙d)，1次/d，连用5 d。在对照组的基础上，治疗组鼻饲或口服安宫牛黄丸，3岁患儿每次1/4丸，4～6岁患儿1/2丸/次，＞6岁患儿1丸/次，将安宫牛黄丸加于生理盐水（15 mL）中制成匀浆，1次/d，连用5 d。观察两组患儿临床疗效，比较治疗前后两组患儿症状体征消失时间，细胞免疫指标CD3^＋、CD4^＋、CD4^＋/CD8^＋水平，氧化应激因子丙二醛（MDA）、总抗氧化能力（TAOC）和超氧化物歧化酶（SOD）水平。结果 治疗后，治疗组总有效率为95.74%，较对照组的80.85%显著升高（P＜0.05）。治疗后，治疗组患儿症状消失时间明显短于对照组（P＜0.05）。治疗后，两组CD3^＋、CD4^＋、CD4^＋/CD8^＋、TAOC、SOD均较本组治疗前升高（P＜0.05），且治疗组高于对照组（P＜0.05）；两组CD19^＋、MDA均较本组治疗前降低（P＜0.05），且治疗组低于对照组（P＜0.05）。结论 安宫牛黄丸联合丙种球蛋白治疗重症病毒性脑炎患儿可明显增强免疫功能，改善氧化应激状态，促进疾病转归，提高疗效，且安全性高。

Objective To observed the effect of Angong Niuhuang Pills combined with human immunoglobulin in treatment of children with severe viral encephalitis. Methods Children (94 cases) with severe viral encephalitis in Qinghai Province Women's and Children's Hospital from February 2017 to February 2020 were randomly divided into control and treatment group, and each group had 47 cases. Children in the control group were iv administered with Human Immunoglobulin (pH4) for Intravenous Injection for 5 d, 0.4 g/(kg∙d), once daily. Children in the treatment group were nasally or po administered with Angong Niuhuang Pills for 5 d on the basis of the control group, 1/4 pill/time for 3 years children, 1/2 pill/time for 4 -6 years children, 1pill/time for more than 6 years children, Angong Niuhuang Pills were added to normal saline (15mL) to make homogenate, once daily. After treatment, the clinical evaluation was evaluated, the disappearance time of symptoms and signs, the levels of cellular immune indexes CD3⁺, CD4⁺ and CD4⁺/CD8⁺, the oxidative stress factors MDA, TAOC and SOD levels in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 95.74%, which was significantly higher than that of the control group (80.85%) (P < 0.05). After treatment, the disappearance time of symptoms in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺, TAOC and SOD in two groups were higher than those before treatment (P < 0.05), and those in the treatment group were higher than those in the control group (P < 0.05), the levels of CD19⁺ and MDA in two groups were lower than those before treatment (P < 0.05), and which in the treatment group were lower than those in the control group (P < 0.05). Conclusion Angong Niuhuang Pills combined with human immunoglobulin in treatment of children with severe viral encephalitis can obviously enhance the immune function, improve the state of oxidative stress, promote the prognosis of the disease, improve the curative effect, and has high safety.

R971;R985