蛇毒清合剂、放血疗法联合西医常规治疗眼镜蛇咬伤的临床效果

Clinical effect of Sheduqing Mixture,bloodletting combined with routine western medicine in the treatment of Naja bite

目的探讨蛇毒清合剂、放血疗法联合西医常规治疗眼镜蛇咬伤的临床效果。方法选取2017年3月~2019年3月深圳市中医院急诊科收治的60例眼镜蛇咬伤患者作为研究对象,按照随机数字表法将其分为治疗组和对照组,每组各30例。对照组患者给予西医常规治疗,治疗组患者在对照组的基础上联合蛇毒清合剂和放血疗法,两组均治疗1周。比较两组患者治疗前后的血清肌酸激酶(CK)、血浆凝血指标如凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fg)水平、皮肤组织坏死积分及临床疗效。结果治疗3 d后,治疗组患者的血清CK水平和皮肤组织坏死积分均低于对照组,差异有统计学意义(P<0.01)。治疗1周后,治疗组患者的血浆PT、APTT和TT均短于对照组,Fg水平高于对照组,差异有统计学意义(P<0.05)。治疗组患者总显效率高于对照组,差异有统计学意义(P<0.01)。结论在西医常规治疗的基础上联合蛇毒清合剂和放血疗法可有效改善眼镜蛇咬伤患者的凝血指标和咬伤后肢体组织坏死程度,提高其治疗总显效率,效果优于单纯常规西医治疗。

Objective To explore the clinical effect of Sheduqing Mixture,bloodletting combined with routine western medicine in the treatment of Naja bite.Methods A total of 60 patients with Naja bite treated in Department of Emergency,Shenzhen Traditional Chinese Medicine Hospital from March 2017 to March 2019 were selected as the research objects.They were divided into the treatment group and the control group according to random number table method,with 30 cases in each group.In the control group,routine western medicine were used.In the treatment group,oral administration of Sheduqing Mixture combined with bloodletting therapy was used on the basis of the control group.Both groups were treated for 1 week.Serum creatine kinase(CK),plasma coagulation indexes such as prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FG)level,skin tissue necrosis score and clinical efficacy were compared between the two groups before and after treatment.Results After 3 days of treatment,the serum CK level and skin tissue necrosis score in the treatment group were lower than those in the control group,and the differences were statistically significance(P<0.01).After 1 week of treatment,plasma PT,APTT and TT in the treatment group were shorter than those in the control group,and the level of Fg in the treatment group was higher than that in the control group,the differences were statistically significance(P<0.05).The total efficiency in treatment group was higher than that in control group,and the difference was statistically significant(P<0.01).Conclusion On the basis of routine western medicine,the intervention of Sheduqing Mixture and bloodletting therapy could effectively improve the coagulation indexes and the tissue necrosis situation of the Naja bite patients and enhance the total clinical obviously effective rate,with the therapeutic efficacy superior to the simple routine western medicine intervention.