中西医结合治疗急性毒蕈中毒的临床疗效

Clinical efficacy of integrated traditional Chinese and western medicine in treatment of acute toadstool poisoning

目的观察急性毒蕈中毒的临床特征及中西医结合治疗的临床疗效。方法回顾性分析2018年6月-2019年6月湖南省人民医院收治的急性毒蕈中毒患者31例的临床资料,观察患者临床症状、器官损伤情况,比较中西医结合治疗前后生化指标及临床转归。结果31例患者毒蕈中毒临床症状多样,以腹泻(87.1%)、腹痛(71.0%)、呕吐(71.0%)多见。毒蕈中毒可累及多器官损伤,以消化道损伤多见(100.0%),其次为肝脏损伤(51.6%)、心肌损伤(38.7%)。在灵芝超微粉结合内科对症支持治疗基础上辅以血液净化治疗(血液灌流、血浆置换及联合血液净化),肝功能、肾功能、凝血功能及心肌酶学等生化指标明显好转,治疗有效率为96.8%,其中治愈13例(41.9%),好转17例(54.9%),死亡1例(3.2%)。结论急性毒蕈中毒临床表现多样,可累及多器官损伤,在灵芝超微粉结合内科对症支持治疗基础上,给予血液净化治疗有效率高,未发现明显不良反应。

Objective To observe the clinical characteristics of acute toadstool poisoning and the clinical efficacy of integrated traditional Chinese and western medicine treatment.Methods The clinical data of 31 patients with acute toadstool poisoning admitted to Hunan Provincial People's Hospital from June 2018 to June 2019 were retrospectively analyzed.The clinical symptoms and organ damage of the patients were observed,and the biochemical indicators and clinical outcomes were compared before and after treatment with integrated traditional Chinese and western medicine.Results The 31 patients with mushroom poisoning had various clinical symptoms,included diarrhea(87.1%),abdominal pain(71.0%),and vomiting(71.0%).Toadstool poisoning could involve multiple organ damages,the most common was gastrointestinal damage(100.0%),followed by liver damage(51.6%),and myocardial damage(38.7%).On the basis of Ganoderma lucidum ultrafine powder combined with medical symptomatic and supportive treatment,supplemented with blood purification treatment(hemoperfusion,plasma exchange and combined blood purification),liver function,kidney function,blood coagulation function and myocardial enzymes and other biochemical indicators had been significantly improved.The effective rate of treatment was 96.8%,of which 13 cases were cured(41.9%),17 cases improved(54.9%),and 1 case died(3.2%).Conclusion Acute toadstool poisoning has various clinical manifestations,which can involve multiple organ damage.On the basis of Ganoderma lucidum ultrafine powder combined with medical symptomatic and supportive treatment,blood purification treatment is highly effective,and no obvious adverse reactions have been found.