关键词: 手足口病, 中枢神经系统, 针刺疗法, 运动障碍

Abstract: Background　Hand-foot-mouth disease （HFMD） is an acute eruptive infectious disease that occurs in infants and young children under 5 years old. It can be caused by more than 20 kinds of enterovirus infections，and its main clinical symptoms are fever and herpes，maculopapule or ulcer in hands，feet，mouth and buttocks，and most can be relieved after treatment without sequelae，but severe HFMD can cause peripheral nerve palsy，central nervous system damage，and even endanger the lives of children patients. Therefore，effective intervention is necessary.Objective　To explore the intervention effects of routine physiotherapy combined with acupuncture on motor dysfunction in children with neuromuscular system dysfunction caused by central nervous system damage of severe HFMD．Methods　A total of 88 children with neuromuscular system dysfunction caused by central nervous system damage of severe HFMD in Children's Hospital Affiliated of Zhengzhou University from June 2014 to December 2017 were selected and randomly divided into control group and observation group，each with 44 subjects.Both groups were given conventional western medicine （including antiviral，anti-infection and promotion of damaged nerve recovery，maintenance of water，electrolytes and acid-base balance），the control group was additionally given routine physiotherapy，and the observation group given routine physiotherapy and acupuncture.The two groups were treated for 1 months.The clinical efficacy，scores of gross motor function measure（GMFM） and Berg balance scale （BBS） before and after treatment，disappearance time of related symptoms （including vomiting，frightening，limb shaking，muscle weakness，somnolence） of central nervous system damage，levels of biochemical indexes〔interleukin-6 （IL-6），high-sensitivity C-reactive protein （hs-CRP），white blood cell count（WBC） and creatine kinase （CK）〕 before and after treatment，occurrence of adverse reactions were compared between the two groups.Results　The clinical efficacy in observation group was significantly higher than that in control group（P<0.05）．After treatment，the scores of GMFM and BBS in observation group were higher than those in control group（P<0.05）．The scores of GMFM and BBS in the two groups after treatment were higher than those before treatment（P<0.05）．The disappearance times of vomiting，frightening，limb shaking，muscle weakness and somnolence in observation group were significantly shorter than those in control group（P<0.05）．After treatment，the levels of IL-6，hs-CRP，WBC and CK in observation group were lower than those in control group（P<0.05）．The levels of IL-6，hs-CRP，WBC and CK in the two groups were lower than those before treatment （P<0.05）．There was no obvious adverse reactions occurred during treatment in the two groups.Conclusion　Routine physiotherapy combined with acupuncture can significantly improve the motor function，shorten course of disease and reduce inflammatory reactions without obvious adverse reactions in the treatment of children with neuromuscular system dysfunction caused by central nervous system damage of severe HFMD.

Key words: Hand, foot and mouth disease；Central nervous system；Acupuncture therapy；Movement disorders