犀角地黄汤治疗五步蛇咬伤的临床效果

Clinical effect of Xijiao Dihuang Decoction in the treatment of snake bite by Agkistrodon acutus

目的探讨犀角地黄汤治疗五步蛇咬伤的临床效果。方法选择2020年1月至2023年6月在我院治疗的五步蛇咬伤患者86例作为研究对象。采用随机数字表法将所有患者分为对照组和观察组,每组43例。对照组给予基础治疗及抗蛇毒血清治疗,观察组在对照组治疗基础上给予犀角地黄汤治疗。观察比较两组患者的临床疗效、纤维蛋白原(FIB)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、白细胞(WBC)计数、肿瘤坏死因子-a(TNF-a)、高敏C-反应蛋白(hs-CRP)、患肢与健肢周径差、患肢疼痛程度评分及肿胀缓解时间。结果观察组的治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。两组患者治疗前的FIB、TT、APTT、PT、WBC、TNF-a、hs-CRP、患肢与健肢周径差及患肢疼痛程度评分比较,差异均无统计学意义(均P>0.05)。观察组治疗后的FIB高于对照组,TT、APTT、PT均低于对照组,差异均有统计学意义(均P<0.05)。观察组治疗后的WBC、TNF-a、hs-CRP、患肢与健肢周径差、患肢疼痛程度评分均低于对照组,差异均有统计学意义(均P<0.05)。结论犀角地黄汤治疗五步蛇咬伤可有效缓解患肢肿胀、疼痛程度,减轻炎症反应,改善凝血功能指标,值得临床应用。

Objective To discuss the clinical effect of Xijiao Dihuang Decoction in the treatment of snake bite by Agkistrodon acutus.Methods A total of 86 patients with snake bites by Agkistrodon acutus treated in our hospital from January 2020 to June 2023 were selected as the study objects.All patients were divided into control group and observation group by random number table method,with 43 cases in each group.The control group was given basic treatment and antivenom treatment,and the observation group was given Xijiao Dihuang Decoction on the basis of the control group.The clinical efficacy,fibrinogen(FIB),thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),white blood cell(WBC)count,tumor necrosis factor(TNF-a),highly sensitive C-reactive protein(hs-CRP),circumference difference between the affected limb and healthy limb,pain degree scores and swelling relief time of the affected limb of the two groups were observed and compared.Results The total effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).There were no significant differences in FIB,TT,APTT,PT,WBC,TNF-a,hs-CRP,circumference difference between the affected and healthy limbs,pain degree scores between the two groups before treatment(all P>0.05).After treatment,FIB of observation group was higher than that of control group,TT,APTT and PT were lower than that of control group,and the differences were statistically significant(all P<0.05).After treatment,WBC,TNF-a,hs-CRP,circumference difference between the affected and healthy limbs and pain degree scores in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion The use of Xijiao Dihuang Decoction in the treatment of patients with snake bite by Agkistrodon acutus can relieve swelling and pain,reduce inflammation and improve coagulation function index,which is worthy of clinical application.