十三味方对血循毒蛇咬伤患者肢体肿胀影响的临床研究

Clinical Study on Effect of Shi San Wei Prescription on Limb Swelling of Patients Bitten by Venomous Snake

目的观察十三味方对血循毒蛇咬伤患者肢体肿胀的临床疗效。方法选取2017年8月~2018年7月我院蛇伤科血循毒蛇咬伤致肢体肿胀患者100例,随机分为治疗组与对照组,每组各50例。对照组给予常规血循毒蛇咬伤的治疗方案及龙胆泻肝汤合五味消毒饮中药内服,治疗组给予常规血循毒蛇咬伤的治疗方案及蛇伤十三味方中药内服。观察比较两组患者治疗后第1、3、5、7天患肢与健肢周径差、血清肌酸激酶水平、肢体肿胀消退时间及疗程等情况。结果两组患者治疗第1、3天患肢与健肢周径差、血清肌酸激酶水平比较,差异均无统计学意义(t周径差=0.205、0.301,P>0.05;t血清肌酸激酶=-1.448、-1.179,P>0.05)。治疗组治疗后第5、7天患肢与健肢周径差、血清肌酸激酶水平均明显低于对照组(t周径差=-2.964、-6.249,P<0.05;t血清肌酸激酶=-2.168、-4.967,P<0.05)。治疗组患者肢体肿胀消退时间与疗程明显短于对照组(t=-7.033、-6.806,P<0.05)。结论十三味方可缩短血循毒蛇咬伤患者肢体肿胀消退时间,缩短疗程,降低血清肌酸激酶水平。

Objective To observe the clinical effect of Shi San Wei Prescription on limb swelling of patients bitten by venomous snakes on blood circulation.Methods 100 patients with limb swelling caused by snakebite in the Department of snakebite of our hospital from August 2017 to July 2018 were randomly divided into treatment group and control group with 50 cases in each group.The control group was given a routine treatment of snakebite and oral administration of Longdan Xiegan Prescriptions combined with Wuwei Disinfection Prescriptions.The treatment group was given a routine treatment of snakebite and oral administration of Shi San Wei Prescription.The perimeter difference of injured arm and healthy arm,serum creatine kinase level,arm swelling regression time and course of treatment of two groups was observed on the 1st,3rd,the 5th and 7th day after treatment.Results There were no significant differences on perimeter difference of injured arm and healthy arm and serum creatine kinase level between two groups on the first and third days after treatment ( t perimeter difference=0.205,0.301,P >0.05;t creatine kinase=-1.448,-1.179,P >0.05).The perimeter difference of injured arm and healthy arm and serum creatine kinase level in the treatment group were significantly lower than those in the control groupon the fifth and seventh days after treatment( t perimeter difference=-2.964,-6.249,P <0.05;t creatine kinase=-2.168,-4.967,P <0.05).The arm swelling regression time and course of treatment group were shorter than those in the control group( Z =-7.033,-6.806,P <0.05).Conclusion Shi San Wei Prescription can significantly shorten the time and course of swelling subsidence and reduce the level of serum creatine kinase.