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

摘要： 背景　手足口病（HFMD）是一种好发于5岁以下婴幼儿的急性发疹性传染病，可由20多种肠道病毒感染引起，以发热及手、足、口腔、臀部等部位出现疱疹、斑丘疹或溃疡为主要临床症状，大多经治疗后可缓解，不留后遗症，但重症HFMD可造成周围神经麻痹、中枢神经系统损伤，甚至危及患儿的生命，因此，采取有效的干预措施是非常必要的。目的　研究常规理疗联合针刺对重症HFMD中枢神经系统受损致神经肌肉系统功能异常患儿运动功能障碍的干预效果。方法　选取2014年6月—2017年12月在郑州大学附属儿童医院就诊的重症HFMD中枢神经系统受损致神经肌肉系统功能异常患儿88例。将患儿随机分为对照组和观察组，每组44例。两组患儿均给予常规西医治疗（包括抗病毒、抗感染、促受损神经恢复及维持水、电解质和酸碱平衡），对照组加用常规理疗，观察组加用常规理疗联合针刺治疗，两组治疗周期均为1个月。比较两组临床疗效，治疗前后粗大运动功能量表（GMFM）、Berg平衡量表（BBS）评分，中枢神经系统受损的相关症状（包括呕吐、易惊、肢体抖动、肌无力、嗜睡）消失时间，治疗前后生化指标〔白介素6（IL-6）、超敏C反应蛋白（hs-CRP）、白细胞计数（WBC）、肌酸激酶（CK）水平〕及不良反应发生情况。结果　观察组临床疗效优于对照组（P<0.05）。治疗后，观察组GMFM、BBS评分高于对照组（P<0.05）；治疗后两组GMFM、BBS评分高于本组治疗前（P<0.05）。观察组呕吐、易惊、肢体抖动、肌无力、嗜睡消失时间短于对照组（P<0.05）。治疗后，观察组IL-6、hs-CRP、WBC、CK水平低于对照组（P<0.05）；治疗后两组IL-6、hs-CRP、WBC、CK水平低于本组治疗前（P<0.05）。两组治疗期间未出现明显的不良反应。结论　常规理疗联合针刺治疗重症HFMD中枢神经系统受损致神经肌肉系统功能异常患儿，可显著改善患儿运动功能，缩短病程，减轻炎性反应，且无明显不良反应。

关键词: 手足口病, 中枢神经系统, 针刺疗法, 运动障碍