蛇伤外敷散超微散剂辅助治疗蝮蛇咬伤患者30例临床观察

Clinical Observation on Sheshang Waifu Superfine Powder(蛇伤外敷散超微散剂) in the Treatment of 30 Cases of Agkistrodon Halys Bite

目的探讨蛇伤外敷散超微散剂辅助治疗蝮蛇咬伤的临床疗效。方法 90例蝮蛇咬伤患者随机分为超微组、普通组、对照组各30例。各组均给予抗蝮蛇蛇毒血清、抗生素、激素等西医基础治疗同时,超微组给予蛇伤外敷散超微散剂外敷,每日3次;普通组给予蛇伤外敷散普通散剂外敷,每日3次;对照组给予季德胜蛇药片研末外敷,每日10余次。各组均治疗1周。于治疗前和治疗第2天检测血清磷脂酶A2(PLA2)和透明质酸酶(HAase)含量,治疗前后进行疼痛视觉模拟评分法(VAS)评分,治疗后判定临床疗效,记录痊愈患者痊愈时间,随访3个月观察痊愈患者复发情况。结果治疗后超微组临床疗效总有效率为90.00%,普通组为76.66%,对照组为63.33%,超微组明显高于普通组和对照组(P<0.05);超微组痊愈患者痊愈时间为(4.87±0.93)天,明显短于普通组的(6.48±1.04)天及对照组的(7.64±1.31)天(P<0.05)。治疗第2天各组患者血清PLA2、HAase含量均较本组治疗前降低,且超微组低于普通组和对照组(P<0.05);治疗后各组患者VAS评分均较本组治疗前明显降低,且超微组低于普通组和对照组(P<0.05)。随访3个月,35例痊愈患者均未复发。结论蛇伤外敷散超微散剂辅助治疗蝮蛇咬伤患者可提高临床疗效,减轻疼痛程度,有效降低患者血清PLA2、HAase含量。

Objective To investigate the clinical efficiency of Sheshang Waifu Superfine Powder（蛇伤外敷散超微散剂） in the treatment of 30 cases of agkistrodon halys bite. Methods A total of 90 patients with bites from Agkistrodon were randomly divided into superfine group,ordinary group and control group,with 30 cases in each group. Each group was administrated anti-Agkistrodon halys venom serum,antibiotic,hormone and western medicine basic treatment. Additionally the superfine group was given external application of Sheshang Waifu Superfine Powder,3 times a day. The ordinary group was given external application of Sheshang Waifu Powder,3 times a day. The control group was given external application of Jidesheng Antivesom Tablets（季德胜蛇药片） powder,over 10 times a day.All groups were treated for 1 week. Serum phospholipase A2（PLA2） and hyaluronidase（HAase） levels were measured before treatment and on the 2 nd day of treatment. Pain visual analogue scale（VAS） scores were obtained before and after treatment. The clinical efficacy was determined after treatment,and the recovery time of recovery patients was recorded. The recurrence of the recovered patients was observed in the 3 months＇ follow-up. Results After treatment,the total effective rate of superfine group（90. 00%） was significantly higher than that of the ordinary group（76. 66%） and the control group（63. 33%）（P〈0. 05）. The time of heal in the superfine group（4. 87 ± 0. 93）was significantly shorter than the control group（7. 64 ± 1. 31 d）,and ordinary group（6. 48 ± 1. 04 d）（P〈0. 05）. On the 2 nd day of treatment,the serum levels of PLA2 and HAase in all group were lower than those before treatment,and the superfine group was lower than the ordinary group and the control group（P〈0. 05）. After treatment,the VAS scores of each group were significantly decreased than those before treatment,and the superfine group was lower than the ordinary group and the control group（P〈0. 05）. After 3 months of follow-up,35 patients who recovered were not relapsed. Conclusion Sheshang Waifu Superfine Powder in the treatment of agkistrodon halys bite can improve clinical efficacy,reduce the pain,and effectively lower serum levels of PLA2 and HAase.