目的 觀察安宮牛黃丸聯(lián)合丙種球蛋白治療重癥病毒性腦炎患兒的臨床效果。方法 選擇2017年2月—2020年2月青海省婦女兒童醫(yī)院收治的94例重癥病毒性腦炎患兒，隨機(jī)分為對(duì)照組和治療組，每組各47例。對(duì)照組靜脈滴注靜注人免疫球蛋白0.4 g/(kg∙d)，1次/d，連用5 d。在對(duì)照組的基礎(chǔ)上，治療組鼻飼或口服安宮牛黃丸，3歲患兒每次1/4丸，4～6歲患兒1/2丸/次，＞6歲患兒1丸/次，將安宮牛黃丸加于生理鹽水（15 mL）中制成勻漿，1次/d，連用5 d。觀察兩組患兒臨床療效，比較治療前后兩組患兒癥狀體征消失時(shí)間，細(xì)胞免疫指標(biāo)CD3^＋、CD4^＋、CD4^＋/CD8^＋水平，氧化應(yīng)激因子丙二醛（MDA）、總抗氧化能力（TAOC）和超氧化物歧化酶（SOD）水平。結(jié)果 治療后，治療組總有效率為95.74%，較對(duì)照組的80.85%顯著升高（P＜0.05）。治療后，治療組患兒癥狀消失時(shí)間明顯短于對(duì)照組（P＜0.05）。治療后，兩組CD3^＋、CD4^＋、CD4^＋/CD8^＋、TAOC、SOD均較本組治療前升高（P＜0.05），且治療組高于對(duì)照組（P＜0.05）；兩組CD19^＋、MDA均較本組治療前降低（P＜0.05），且治療組低于對(duì)照組（P＜0.05）。結(jié)論 安宮牛黃丸聯(lián)合丙種球蛋白治療重癥病毒性腦炎患兒可明顯增強(qiáng)免疫功能，改善氧化應(yīng)激狀態(tài)，促進(jìn)疾病轉(zhuǎn)歸，提高療效，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