拔火罐对竹叶青蛇咬伤患者肢体局部肿胀及炎症与凝血指标的改善作用

Effects of cupping on local swelling,inflammation and coagulation parameters in patients with bites by trimeresurus stejnegeri

目的:探讨拔火罐疗法对竹叶青蛇咬伤患者的作用。方法:选取本院60例青竹蛇咬伤患者随机分为两组,每组各30例。对照组采用常规的中西医结合治疗,观察组在对照组治疗的基础上于蛇咬伤处和/或肿胀部位进行拔火罐,采用患肢肿胀程度和双侧肢体周径测量等评估来观察两组的护理治疗效果。结果:患肢肿胀程度在治疗后第3天观察组比对照组明显改善(P<0.05)。双侧肢体周径差和患肢疼痛评分在对照组治疗后第3天比治疗前和治疗后第1天明显降低(P<0.05);观察组治疗后第1天和第3天均比治疗前明显降低(P<0.05)、且治疗后第3天比第1天明显降低(P<0.05)。而且双侧肢体周径差在治疗后第3天观察组比对照组明显降低(P<0.05)。治疗后第1天与治疗前比较,两组的血清淀粉样蛋白A(Serum Amyloid A,SAA)、超敏C反应蛋白(high-sensitivity C-reactive Protein, hs-CRP)、白细胞(White Blood Cell,WBC)总数和血浆D-二聚体(D-Dimer,D-D)水平均明显升高(P<0.05),纤维蛋白原(Fibrinogen,FIB)水平明显降低(P<0.05),但观察组的SAA和hs-CRP升高没有对照组显著;治疗后第3天与第1天比较,两组SAA、hs-CRP、WBC和D-D水平均有降低趋势,其中观察组D-D降低达到治疗前水平;治疗后第3天观察组FIB水平比对照组明显升高(P<0.05)。结论:拔罐疗法能使竹叶青蛇咬伤患者肢体局部肿胀得到有效消除,并能明显改善患者的炎症和凝血指标。

Objective: To probe into the improvement of cupping on bites by trimeresurus stejnegeri. Methods: 60 patients were divided into two groups, 30 cases in each. The control group was treated in the integrative medicine. The observation group was treated by cupping in the position of bite and/or the location of swelling more. Results: The swelling degree of ill limb in 3 days in the observation group was more improved(P<0.05). The cross section diameter of double limbs and the pain score of ill limb in 3 days were more decreased in the control group than before treatment and in the first day(P<0.05). In the first day and 3 days, the cross section diameter of double limbs and the pain score of ill limb were more decreased in the observation group than before treatment, and those in 3 days were more obviously(P<0.05). The levels of serum amyloid A, high sensitivity C-reactive protein, white blood cell and D-dimer were obviously increased(P<0.05), and the level of fibrinogen was apparently decreased in two groups after treatment(P<0.05). And the increase of SAA and h-CRP was not more apparent in the observation group. The levels of SAA、h-CRP、WBC and D-D showed decreased tendency in two groups in the third day in contrast to the first day. The level of D-D was decreased to the level before treatment in the observation group. The level of FIB was more increased in the observation group than the control group in the third day(P<0.05). Conclusion: Cupping can efficiently eliminate the local swelling of extremities in patients with bites by trimeresurus stejnegeri, and obviously can improve the makers of inflammation and blood coagulation.