中西医联合物理降温对中暑患者降温效果的研究应用

Study on cooling effect of heatstroke patients with Chinese and western medicine combined with physical cooling

目的探究中西医联合物理降温对中暑患者降温效果的临床应用。方法选取2016年1月至2017年12月急诊科收治确诊为重度中暑的患者80例,按照随机数字表法分为治疗组和对照组各40例,对照组患者均给予物理降温与常规治疗,治疗组患者在此基础上给予中医治疗干预,比较2组患者临床疗效、体温变化以及不良反应发生情况。结果治疗组临床有效率为100.00%(40/40),明显高于对照组的85.00%(34/40),2组比较差异有统计学意义(Z=6.125,P<0.05);治疗组患者高热持续时间、发热持续时间、症状体征恢复时间分别为(0.57 ± 0.46)、(3.12 ± 0.75)、(7.25 ± 3.18)h,明显短于对照组的(1.43 ± 0.89)、(5.37 ± 0.63)、(12.47 ± 4.53)h,2组比较差异均有统计学意义(t=5.429、14.528、5.965,P<0.01);治疗组患者治疗后外周血肌钙蛋白、肌酸激酶同工酶水平分别为(3.13 ± 0.15)μg/L、(412.02 ± 156.33)U/L,明显低于对照组的(3.54 ± 0.26)μg/L、(748.32 ± 119.20)U/L,2组比较差异均有统计学意义(t=8.639、10.819,P<0.01);2组患者不良反应发生率比较差异无统计学意义(χ^2=2.222,P=0.263)。结论中西医联合物理降温对中暑患者降温效果明显,且不增加不良反应发生风险,值得临床推广应用。

Objective To explore the clinical application of combined cooling of Chinese and Western medicine on the cooling effect of patients with heatstroke.Methods A total of 80 patients with severe heat stroke admitted to the emergency department of our hospital from January 2016 to December 2017 were selected and divided into treatment group and control group according to the random number table method. 40 patients in the control group were given physical cooling. For conventional treatment, patients in the treatment group were given TCM treatment interventions on the basis of this, and clinical efficacy, changes in body temperature, and adverse screening events were compared between the two groups.Results The clinical effective rate (100.00%,) in the treatment group was significantly higher than that in the control group (85.00%, Z=6.125, P<0.05). The duration of high fever, duration of fever, and recovery time of symptoms and signs were (0.57±0.46), (3.12±0.75), (7.25±3.18) h in the treatment group, (1.43±0.89), (5.37±0.63), (12.47± 4.53) h in the control group, there were significant differences between the two groups (t=5.429, 14.528, 5.965, P<0.05). After treatment, the levels of cTnl and CK-MB in the peripheral blood of the two groups decreased significantly (P<0.05). The levels of cTnl and CK-MB in peripheral blood of patients in the treatment group were (3.13±0.15) μg/L, (412.02±156.33) U/L, (3.54±0.26) μg/L, (748.32±119.20) U/L in the control group, there were significant differences between the two groups (t=8.639, 10.819,P <0.05).There was no significant difference in the incidence of adverse reactions between the two groups (χ^2=2.222, P=0.263).Conclusion The combination of Chinese and Western medicine physical cooling has a significant cooling effect on patients with heat stroke, and does not increase the risk of adverse reactions, it is worth clinical Promotion and application.