职业性慢性正己烷中毒综合疗法与常规疗法效果比较

Comparison of therapeutic effects between comprehensive therapy and routine therapy in treatment of occupational chronic n-hexane poisoning

目的比较综合疗法和常规疗法对职业性慢性正己烷中毒的治疗效果。方法采用随机对照试验,将116例慢性正己烷中毒患者分为对照组和治疗组(每组58例)。对照组患者予常规治疗,包括予维生素B_(12)、维生素B_1营养神经和予丹参、小牛血去蛋白提取物活血化瘀;治疗组患者予综合疗法治疗,即采用在对照组治疗的基础上加用鼠神经生长因子、针灸、物理治疗(红外线、微波照射)、中药熏洗和康复治疗等的中西医结合治疗。12周后,观察2组患者治疗效果和不良反应发生情况;并追踪观察治疗结局和住院时间。结果治疗前,2组患者神经系统症状、体征、日常生活活动能力的评分和神经-肌电图神经源性损害指标[包括正中神经、尺神经、腓肠神经或腓总神经的运动远端潜伏期(MDL)、运动神经传导速度(MCV)、感觉神经传导速度(SCV)和波幅的实测值,以及MDL延长、MCV减慢和SCV减慢的检出率]分别比较,差异均无统计学意义(P>0.05)。治疗后,2组患者上述指标均较同组患者治疗前有改善(P<0.05),且治疗组患者上述指标的改善程度优于对照组(P<0.05)。2组患者均无发生严重不良反应。治疗组患者平均住院时间较对照组短约2个月(P<0.05)。结论综合疗法治疗职业性慢性正己烷中毒效果优于常规疗法,是一种治疗效果确切、安全的疗法。

Objective To evaluate the therapeutic effects between comprehensive therapy and routine therapy in treatment of occupational chronic n-hexane poisoning. Methods By randomized controlled trial,116 cases with occupational chronic n-hexane poisoning were divided into two groups： the control group（ n = 58） and the treatment group（ n = 58）. Subjects in the control group were given vitamin B_（12） and vitamin B_1 for neural nutrition; and Danshen and deproteinized calf blood extractive injection for activating blood circulation to dissipate blood stasis. Subjects in the treatment group were treated with comprehensive treatment including traditional Chinese and Western medicine,which including mouse nerve growth factor,acupuncture,physical therapy（ infraredtherapy,microwave irradiation therapy）,Chinese medicine steamingwashing and comprehensive rehabilitation therapy for a period of 12 weeks in addition to the conventional treatment. The curative effect and adverse reactions of both groups were observed after 12 weeks,and the treatment results and hospital stay were followed up. Results Before treatment,no significant differences（ P〉0. 05） were noted in both groups in scores of neurological symptoms,signs,activities of daily living and neurogenic damage indexes of electroneuromyography[including motor digital latency（ MDL）,motor nerve conduction velocity（ MCV）,sense nerve conduction velocity（ SCV） of median nerve,ulnar nerve,sural nerve or common peroneal nerve; and the detection of lengthen MDL,shorten MCV and SCV]. After treatment,patients in both groups got better in terms of the above indicators（ P〈0. 05）,with larger extend of improvement noted in the treatment group than in the control group（ P〈0. 05）. No obvious adverse reactions were noted in the 2 groups. Hospital stay of patients in the treatment group was about 2 months shorter than that in the control group（ P〈0. 05）. Conclusion The therapeutic effects of comprehensive therapy on occupational chronic n-hexane poisoning are obviously better than routine therapy,which is an effective and safe therapeutic method.