ObjectTo systematically review the efficacy and safety of intravenous immunoglobulin (IVIG) for children with severe hand, foot and mouth disease in China.
MethodDatabases including CNKI, CBM, WanFang Data, PubMed and The Cochrane Library (Issue 2, 2015) were searched to collect randomized controlled trials (RCTs) about IVIG combined with conventional therapy versus conventional therapy alone for severe hand, foot and mouth disease from inception to March 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 and Stata 9.0 software.
ResultA total of 23 RCTs involving 2271 patients were included. The results of meta-analysis showed that, compared with the conventional therapy group, the IVIG group had higher total effective rate (RR=1.18, 95%CI 1.11 to 1.26, P<0.00001), shorter fever relieving time (MD=-1.47, 95%CI -1.80 to -1.15, P<0.00001), shorter rash regression time (MD=-1.61, 95%CI -2.51 to -0.71, P=0.0005), shorter remission time of nervous symptoms (MD=-2.14, 95%CI -3.02 to -1.25, P<0.00001), shorter mouth ulcer regression time (MD=-1.36, 95%CI -2.27 to -0.4, P=0.004), and shorter average length of hospital stay (MD=-2.46, 95%CI-3.29 to -1.63, P<0.00001).
ConclusionCompared with conventional therapy alone, IVIG combined with conventional therapy can improve the effect for severe hand, foot and mouth disease. Due to the limited quality of the include studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo observe the effect of health education on hand, foot and mouth disease knowledge of the parents and their psychological status, in order to provide a reference for regulating clinical intervention measures.
MethodsBetween October 2011 and February 2013, self-made questionnaire was used to survey the parents of 286 children with hand, foot and mouth disease for their knowledge about the disease. We promoted health education including distributing pamphlets, holding lectures, and carrying out psychological counseling. Then, parents' knowledge and their psychological status were compared before and after the implementation of health education.
ResultsAfter health education, parents' suspicion, anxiety, fear, indulgence in children and other negative psychological scores were significantly lower than those before intervention (P<0.05). Their knowledge on the disease was also significantly enhanced (P<0.05). Gender, age and educational background were the main influence factors for health education.
ConclusionMulti-form comprehensive health education can enhance parents' knowledge on hand, foot and mouth disease effectively and alleviate various negative psychological situations, which assists them to participate in the treatment work actively, thus greatly promotes early rehabilitation of the child patients.
Objective To systematically review the effectiveness and safety of Tanreqing for curing the hand-foot-mouth disease. Methods Such databases as PubMed, EMbase, CENTRAL, CBM, CNKI, VIP and WanFang Data are electronically searched to collect the randomized controlled trials (RCTs) on the effectiveness and safety of Tanreqing for hand-foot-mouth disease till February 2013. According to the inclusion and exclusion criteria, literature was screened, data were extracted, and the methodological quality of included studies was also assessed. Then, meta-analysis was performed using RevMan 5.2.7 software. Results Twelve RCTs on Tanreqing versus ribavirin involving 1 258 cases and 27 RCTs on Tanreqing plus ribavirin versus ribavirin involving 3 289 cases were included. The results of meta-analysis showed that, compared to ribavirin, Tanreqing has higher total efficiency in the treatment of hand-foot-mouth disease (OR=5.03, 95%CI 3.28 to 7.71, Plt;0.000 01), cooling time (MD= –1.09, 95%CI –1.51 to –0.68, Plt;0.000 01), simplex regression time (MD= –0.90, 95%CI –1.20 to –0.60, Plt;0.000 01), and healing time (MD= –1.76, 95%CI –2.52 to –0.99, Plt;0.000 01), with significant differences. Compared to ribavirin, the group of Tanreqing plus ribavirin has higher total efficiency on treatment of hand-foot-mouth disease (OR=5.32, 95%CI 4.02 to 7.06, Plt;0.000 01), cooling time (MD= –1.32, 95%CI –1.63 to –1.01, Plt;0.000 01), simplex regression time (MD= –0.5, 95%CI –0.98 to –0.2, Plt;0.000 01), and healing time (MD= –1.41, 95%CI –1.83 to –0.98, Plt;0.000 01), with significant differences. The results of indirect comparative analysis showed that, there was no significant difference in the treatment options of Tanreqing plus ribavirin and Tanreqing alone concerning total efficiency, cooling time, simplex regression time, and healing time. Conclusion The study shows that Tanreqing alone and Tanreqing plus ribavirin are similar for curing the hand-foot-mouth disease, and both groups have better clinical effectiveness than ribavirin alone.
ObjectiveTo explore the risk factors associated with severe hand-food-mouth disease (HFMD) in Chongqing, in order to carry out intervention work in the future, provide reference for reducing the incidence and fatality rate of severe HFMD cases.
MethodsNinety severe HFMD cases treated between 2011 and 2014 in Chongqing were enrolled as case group while another 90 mild HFMD cases were randomly selected as control group in the same period. All subjects’ parents or babysitters were asked to fill in a questionnaire which included demography, ways of babysitting, behavior and the like. All HFMD cases were diagnosed by both clinical symptoms and nuclear acid testing. Data were processed by EpiData 3.1 and analyzed by SPSS 13.0.
ResultsSingle-factor analysis showed that there were 14 risk factors of severe HFMD including virus type, registered residence type, current address type, cultural degree of their caregivers, season of the onset, existence of fever and rash, first hospital diagnosis type, and whether the first diagnosis was HFMD (P ＜ 0.05) . Multifactor analysis showed the risk factors included the current rural residence type [OR=27.29, 95%CI (3.71, 200.72) ], misdiagnosis as disease other than HFMD in the first visit to the hospital [OR=141.03, 95%CI (12.43, 1 599.70) ], and virus type of EV71 [OR=244.32, 95%CI (18.99, 3 143.74) ].
ConclusionsActive surveillance should be carried out on the risk factors of severe HFMD. At the same time, active and effective preventive measures, and timely treatment of patients with severe HFMD can help to reduce the incidence and case fatality rate.
Objective To share the experience of the diagnosis and treatment of children with hand-foot-mouth disease. Methods We retrospectively analyzed 31 children with hand-foot-mouth disease in our hospital from April 2007 to June 2007 in terms of epidemiology, clinical features, treatment and prognosis. Results The average age of the children was 2.8 years, and 20 out of the 31 cases were from nurseries and kindergartens. Eighteen had clear contact history. Typical signs and symptoms, including oral ulcerative herpes and blister-like rash in extremities, were found in all cases. All the children were cured after timely diagnosis and early treatment with ribavirin, without any severe complications. Conclusion Timely treatment based on early diagnosis and considerate care are important for children with hand-foot-mouth disease. Nurseries, kindergartens and primary schools should attach great importance to relevant prophylaxis and isolation. These are essential for reducing the occurrence and prevalence of this disease.
Objective To investigate the etiological and clinical characteristics of the outbreak of hand-foot-mouth disease (HFMD) in Chengdu in 2008. Methods A retrospective analysis was conducted to investigate 482 children with hand-foot-mouth disease in Chengdu from January to December 2008 in terms of epidemiology and clinical characteristics. Results Among the 482 children, 76.14% of the cases were infants, and male children numbered more than female ones. The proportion in the urban area was higher than that in the rural area. May to July was the peak epidemic period. Skin rash and fever were major clinical manifestations. Three cases were diagnosed as viral encephalitis. Conclusion The incidence of hand-foot-mouth disease is related to age and season. Effective prevention measures and isolated treatment are critical for prevention and therapy.
【摘要】 目的 對住院的手足口病患兒，在相同治療和護理基礎上，應用復方黃連素片劑融入復方爐甘石洗劑外用觀察其療效和安全性，為傳染病的防制提供臨床經驗。 方法 2008年5月-2010年5月收治手足口病患兒184例，采用隨機分組法，以復方黃連素片劑融入復方爐甘石洗劑外用92例為治療組，未用復方黃連素片劑融入復方爐甘石洗劑外用92例為對照組，進行療效比較。 結果 治療組5 d痊愈率為94%，總有效率為100%，與對照組比較差異有統計學意義（Plt;0.01）。 結論 應用復方黃連素片劑融入復方爐甘石洗劑外用治療手足口病安全可靠。【Abstract】 Objective To observe the therapeutic and nursing effect on hand-foot-mouth disease (HFMD) with infection after medication for external use. Methods A total of 184 patients with HFMD from May 2008 to May 2010 were randomly divided into two groups: 92 patients in the treatment group underwent medication for the external use topical with berberine tablet blending in calamine lotion for, and another 92 patients in the control group didn’t undergone the medication for the external use. Results The total cure rate within 5 days in treatment group was 94% and the total effective rate was 100%, which was significantly different from that in the control group (Plt;0.01). Conclusion Berberine tablet blending in calamine lotion application is safe and effective on patients with HFMD with infection.
