目的 探讨连花清瘟颗粒联合单磷酸阿糖腺苷治疗儿童手足口病的临床效果。方法 选取2016年3月—2019年3月南方医科大学附属中山博爱医院收治的102例手足口病患儿，随机分成对照组（n=51）和治疗组（n=51）。对照组静脉滴注注射用单磷酸阿糖腺苷，5 mg/kg加入生理盐水100 mL中充分稀释，1次/d。治疗组在对照组基础上口服连花清瘟颗粒，2 g/次，3次/d。两组均连续治疗1周。观察两组的临床疗效，比较两组患者治疗前后症状体征的改善时间、外周血常规参数、血清学指标的情况。结果 治疗后，对照组和治疗组患者的治愈率分别是88.2%、100.0%，两组比较差异具有统计学意义（P<0.05）。治疗过程中，治疗组即刻退热时间、完全退热时间、手足皮疹结痂时间、新鲜皮疹消失时间、口腔溃疡消退时间和食欲改善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，两组淋巴细胞、单核细胞及中性粒细胞的绝对值（LYM#、MONO#和NEUT#）值均较治疗前显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组这些血常规参数显著低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组血清肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、C反应蛋白（CRP）、淀粉样蛋白A（AA）水平均较治疗前显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；治疗后，治疗组这些血清学指标显著低于对照组，两组比较差异有统计学意义（P<0.05）。结论 连花清瘟颗粒联合单磷酸阿糖腺苷治疗儿童手足口病的整体疗效确切，能迅速缓解患儿相关症状体征，改善外周血象，减轻机体炎症反应，具有一定的临床推广应用价值。

Objective To investigate the clinical effects of Lianhua Qingwen Granules combined with vidarabine monophosphate in treatment of children with hand-foot-and-mouth disease. Methods 102 Children with hand-foot-and-mouth disease in Zhongshan Boai Hospital Affiliated to Southern Medical University from March 2016 to March 2019 were randomly divided into control group (n=51) and treatment group (n=51). Patients in the control group were iv administered with Vidarabine Monophosphate for injection, 5 mg/kg was diluted with normal saline 100 mL, once daily. Patients in the treatment group were po administered with Lianhua Qingwen Granules, 2 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the improvement time of symptoms and signs, bood routine parameters and serological indicators in two groups were compared. Results After treatment, the recovery efficacy in the control and treatment groups were 88.2% and 100.0%, respectively, and there were differences between two groups (P<0.05). After treatment, immediate antipyretic time, complete antipyretic time, scab time of rash on hands and feet, disappearance time of fresh rash, decay time of oral ulcer, and appetite improvement time in the treatment group were shorter than those in the control group, and there were differences between two groups (P<0.05). After treatment, LYM#, MONO#, and NEUT# in two groups were significantly decreased, and there were differences in the same group (P<0.05). After treatment, the bood routine parameters in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, TNF-α, IL-6, CRP, and AA in two groups were significantly decreased, and there were differences in the same group (P<0.05). After treatment, the serological indicators in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). Conclusion Lianhua Qingwen Granules combined with vidarabine monophosphate has overall efficacy in treatment of children with hand-foot-and-mouth disease, and can rapidly relieve the related symptoms and signs of children, and improve peripheral blood image, and reduce the body's inflammatory response, which has a certain clinical application value.

广东省医学科学技术研究基金资助项目（20161141551612）