火针散刺放血治疗青竹蛇咬伤疗效观察

Effects of Fire-needle Powder Pricking and Bloodletting Therapy on IL-1β,IL-6 and TNF-αin Patients with Trimeresurus Stejnegeri Bites

目的观察火针散刺放血对青竹蛇咬伤患者的临床效果,并探讨其可能的机制。方法将青竹蛇咬伤患者80例随机分为火针组和非火针组各40例。非火针组给予常规的青竹蛇咬伤治疗方案,火针组首诊先予以火针散刺放血,序贯常规青竹蛇咬伤治疗方案,疗程均为3 d。在治疗前、治疗后72 h抽血检测患者血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)等炎症指标变化,并观察两组患者治疗前及治疗后24、72 h的患肢肿胀程度及肿胀消退时间等指标变化。结果治疗72 h后,两组患者血清细胞因子IL-1β、IL-6、TNF-α等水平均较治疗前显著降低,火针组血清IL-1β、IL-6、TNF-α等炎性指标改善较非火针组明显(P<0.01)。治疗后24、72 h,患者患肢肿胀程度比较,火针组明显优于非火针组,且火针组患肢肿胀改善时间明显优于非火针组(P<0.01)。结论火针散刺放血能明显降低青竹蛇咬伤患者的炎症反应及患肢肿胀程度,可明显缩短治疗周期。

Objective:To observe the clinical effect of fire-needle powder pricking and bloodletting therapy on patients with Trimeresurus Stejnegeri bites and to explore its possible mechanism.Methods:A total of 80 patients who met the inclusion criteria were selected and randomly divided into the treatment group and the con⁃trol group,40 cases in each group.The control group was given conventional treatment.On the basis of convention⁃al therapy,the treatment group was treated with fire needle powder pricking and bloodletting therapy.The course of treatment was 3 days.Before and after 72 hours′treatment,all the patients′serum IL-1β,IL-6 and TNF-αwere tested.The degree of patients′limb swelling before and after treatment for 24 and 72 h,and time of swelling subsidence were observed.Results:The serum levels of IL-1β,IL-6,TNF-αwere significantly increased in the two groups after being bitten by Trimeresurus Stejnegeri.At 72 hours after treatment,the differences of the serum levels of IL-1β,IL-6 and TNF-αbetween the two groups were statistically significant(P<0.01).The degree of limb swelling in the two groups was significantly improved after 24 and 72 h treatment,with statistical significance(P<0.01).The regression time of limb swelling in the observation group was significantly faster than that of the control group(P<0.01).Conclusion:Fire-needle Powder pricking and bloodletting therapy can significantly reduce the inflammatory reaction and swelling degree of limbs in patients with Trimeresurus Stejnegeri Bites,which makes the patients recover quickly.