目的 探討小兒皰疹性口腔炎應(yīng)用開喉劍噴霧劑聯(lián)合更昔洛韋治療的臨床效果。方法 選取2015年6月-2018年12月竹山縣人民醫(yī)院收治的338例皰疹性口腔炎患兒，隨機(jī)分為對照組和治療組，每組各169例。對照組靜脈滴注注射用更昔洛韋，5 mg/（kg·d），用生理鹽水將藥物濃度稀釋至1 mg/mL，恒速靜滴，每次給藥時(shí)間應(yīng)>1 h。治療組在對照組基礎(chǔ)上采用開喉劍噴霧劑噴患處，2噴/次，6次/d。兩組均連續(xù)治療7 d。觀察兩組臨床療效及主要癥狀、體征的緩解時(shí)間；比較治療前后兩組患兒血清免疫球蛋白A（IgA）、前白蛋白（PAB）水平。結(jié)果 治療后，對照組和治療組總有效率分別為90.5%、97.0%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療組患兒退熱時(shí)間、進(jìn)食改善時(shí)間、疼痛流涎消失時(shí)間、口腔皰疹/潰瘍消退時(shí)間均顯著短于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組外周血象指標(biāo)（WBC、MONO#、LYM#）的異常率均顯著低于治療前（P<0.05）；且治療后，治療組患者以上外周血象參數(shù)的異常率較對照組同期均顯著更低（P<0.05）。與治療前對比，兩組治療后血清IgA、PAB水平均顯著增高（P<0.05）；但治療組治療后血清IgA、PAB水平均顯著高于對照組同期（P<0.05）。結(jié)論 開喉劍噴霧劑聯(lián)合更昔洛韋治療小兒皰疹性口腔炎的整體療效確切，能有效縮短患兒癥狀及體征的改善時(shí)間，改善外周血象，增強(qiáng)體液免疫功能，具有一定的臨床推廣應(yīng)用價(jià)值。

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.

R988.2