Abstract:Objective To analyze the clinical efficacy，serum nuclear factor-κB (NF-κB) changes，and predictive value for viral encephalitis (VE) in children with hand，foot，and mouth disease (HFMD) treated with Wuwei Xiaodu Decoction. Methods A total of 116 children with HFMD who visited Shanghai Childrens Medical Center were selected for a retrospective study from December 2020 to December 2022. According to the different treatment methods， they were divided into two groups, with 58 cases in each group. The control group received routine Western medicine treatment，while the observation group received Wuwei Xiaodu Decoction on the basis of control group. The clinical efficacy，clinical symptom disappearance time，serum NF-κB level，serum inflammatory factor indicators ［tumor necrosis factor-α (TNF-α)，interleukin-6 (IL-6)，C-reactive protein (CRP)］，total incidence of adverse reactions， and incidence of VE were compared between the two groups. After treatment，the children were divided into a VE group (n=11) and a non-VE group (n=105) according to whether they developed VE. The serum NF-κB levels within 24 h after admission in the two groups were compared，and the receiver operating characteristic curve (ROC) was plotted to analyze the predictive value of serum NF-κB for VE. Results The total clinical efficiency of the observation group was higher than that of the control group (96.55% vs 77.59%, χ²=9.265, P＜0.01). The total incidence of adverse reactions in the observation group (5.17%) was not significantly different from that in the control group (8.62%)，but the incidence of VE in the observation group (1.72%) was lower than that in the control group (17.24%), and the difference was statistically significant (P＜0.05). The serum NF-κB level in the non-VE group within 24 hours after admission was lower than that in the VE group［(2.99±0.34) μg/mL vs (3.85±0.51) μg/mL， t=7.590， P＜0.01］. When the serum NF-κB cutoff value was 1.65 μg/mL，the best prediction for VE was obtained，with an area under ROC curve (AUC) of 0.826 (95%CI: 0.731-0.952)，a sensitivity of 94.28%, and a specificity of 90.06%. Conclusion Wuwei Xiaodu Decoction can effectively alleviate the symptoms of children with HFMD such as rash and ulcers on hands and feet, decrease serum NF-κB level, reduce inflammation response and the incidence of VE, which is safe and effective. Moreover, serum NF-κB has high sensitivity and specificity in predicting the occurrence of VE in children with HFMD, which has certain reference value.