中药外敷治疗蛇咬伤的疗效观察

Observation of Chinese Medicine Topical on the Patients with Snake Bites

目的探讨中药外敷对蛇咬伤中毒患者肢体肿胀的治疗优势。方法选取我院2016年4~10月收治的20例伴有肢体肿胀的蛇咬伤中毒患者为研究对象,随机分为局部切开组(n=10)和中药外敷组(n=10)。局部切开组,由骨科医师对肿胀肢体行3~5条"一"字形切口;中药外敷组,将中药复方研磨成细粉后,以蜂蜜调成糊状,外敷于伤口周围及肢体肿胀部位。同时两组患者均给予保肝、保心及活血化瘀等对症支持治疗。观察两组患者谷草转氨酶(aspartate transaminase,AST)、谷丙转氨酶(alanine aminotransferase,ALT)、乳酸脱氢酶(lactate dehydrogenase,LDH)、血小板计数及凝血酶原时间等指标变化情况,比较两组患者的住院时间、感染率、患肢周径及治疗费用等指标。结果两组患者中各有2例出现LDH及AST水平升高,2例ALT水平升高,1例血小板计数减少及凝血酶原时间延长。局部切开组患者中,4例发生局部感染,其中有1例患者因出院后再次发生局部感染而接受二次住院治疗;中药外敷组中,无感染病例发生。与局部切开组比较,中药外敷组患者的患肢周径更长,但住院时间更短,治疗费用更低,组间差异具有统计学意义(P<0.05)。结论中药外敷治疗蛇咬伤中毒患者的肢体肿胀效果显著,安全性高,值得临床推广应用。

Objective To explore the advantages of chinese medicine topical to the patients with the snake bites poisoning. Methods 20 snake bites poisoning patients accompanied by limb swelling were chosen from April2016 to October 2016 from the Department of Nephrology in our hospital.Patients were randomly divided into local cut group（n=10）and chinese medicine topical group（n=10）.3 to 5＂一＂ ＂shaped incision were given by the Orthopedic surgeon to the patients of the local cut group,while in the other group,Chinese medicine compound was grinded into powder,the paste of the chinese medicine powder were grounded by the honey.The chinese medicine paste were applied to the wound around and the swelling limb.In addition,protection of the liver and the heart,the improvement of blood circulation were given to the two groups of patient s.The abnormalities of indicators such as aspartate aminotransferase,alanine aminotransferase,lactate dehydrogenase,platelet count and prothrombin time were observed.The indicators of the hospitalization days,the infection cases and the hospitalization costs between the two groups were compared. Results There were two patients with the elevated LDH and AST levels between the two groups.2 patients were with elevated ALT levels,and 1 patients with decreased in platelet count and prolonged prothrombin time.Four patients of the local cut group had localized infection,one patient of which was received a second hospitalization because of the re-occurrence of local infection.There was no was no infection cases occurred in the Chinese medicine group.Compared with the local cut group,the hospitalization days of the chinese medicine topical group was shorter,the Limb circumference of the chinese medicine topical group was larger,and the cost of hospitalization was lower,the differences were statistically significant（P〈0.05）. Conclusion Chinese medicine topical was safe and effective to the patients with the snake bites poisoning accompanied by limb swelling,it is worthy of clinical application.