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目的观察单磷酸阿糖腺苷注射剂联合溶菌酶肠溶片治疗小儿疱疹性口腔炎的临床疗效及安全性。方法将54例疱疹性口腔炎患儿随机分为对照组27例和试验组27例。对照组予以利巴韦林10 mg·kg~(-1),qd,静脉滴注;试验组予以单磷酸阿糖腺苷5 mg·kg~(-1),qd,静脉滴注+溶菌酶肠溶片20 mg,tid,口服。2组患儿均治疗5 d。比较2组患儿的临床疗效、血清肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白细胞介素-10(IL-10)水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为96.29%(26/27例)和77.78%(21/27例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的TNF-α分别为(2.21±0.29)和(4.18±0.47)μg·L~(-1),CRP分别为(7.85±1.12)和(12.57±1.43)mg·L~(-1),IL-10分别为(158.56±17.49)和(120.68±12.32)ng·L~(-1),差异均有统计学意义(均P<0.05)。试验组发生的药物不良反应以恶心为主,对照组发生的药物不良反应以恶心和注射部位疼痛为主,且试验组和对照组的药物不良反应发生率分别为3.70%和7.41%,差异无统计学意义(P>0.05)。结论单磷酸阿糖腺苷注射剂联合溶菌酶肠溶片治疗小儿疱疹性口腔炎的临床疗效确切,其能够显著降低患儿的血清TNF-α、CRP水平,促进IL~(-1)0表达,且不增加药物不良反应的发生率。
Objective To observe the clinical efficacy and safety of combination of adenosine monophosphate injection and lysozyme enteric-coated tablets in the treatment of pediatric herpetic stomatitis. Methods 54 cases of herpes stomatitis were randomly divided into control group 27 cases and test group 27 cases. The control group was treated with ribavirin 10 mg · kg -1, qd, intravenously; the experimental group was treated with adenosine monophosphate 5 mg · kg -1, qd, intravenous drip plus lysozyme Enteric-coated tablets 20 mg, tid, orally. Two groups of children were treated for 5 days. The clinical efficacy, serum level of tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), interleukin-10 (IL-10) and the incidence of adverse drug reactions were compared between the two groups. Results After treatment, the total effective rates of the experimental group and the control group were 96.29% (26/27 cases) and 77.78% (21/27 cases), respectively, with statistical significance (P <0.05). After treatment, the levels of TNF-αin the experimental and control groups were (2.21 ± 0.29) and (4.18 ± 0.47) μg · L -1, respectively, with CRP of (7.85 ± 1.12) and (12.57 ± 1.43) mg · The levels of IL-1 and IL-10 were (158.56 ± 17.49) and (120.68 ± 12.32) ng · L -1, respectively, with statistical significance (all P <0.05). The adverse drug reaction occurred in the experimental group was mainly nausea. The adverse drug reactions in the control group were mainly nausea and pain in the injection site. The incidences of adverse drug reactions in the experimental group and the control group were 3.70% and 7.41% respectively, with no difference Statistical significance (P> 0.05). Conclusion The combination of L-adenosine monophosphate injection and lysozyme enteric-coated tablets for the treatment of pediatric herpetic stomatitis is effective. It can significantly reduce the level of serum TNF-α and CRP, promote the expression of IL-1, And does not increase the incidence of adverse drug reactions.