中西医结合治疗对蝮蛇咬伤外周血炎性因子水平及临床疗效的研究  

Study on clinical efficacy of combination of traditional Chinese medicine and western medicine in treatment of pit viper bites and peripheral blood inflammatory factors

作　　者：方志美[1] 胡国华[1] 何宝祥 尹亦清[1] 吴玲玲[1] 何国产[1] 

机构地区：[1]金华职业技术学院医学院,浙江金华321017 [2]浙江省兰溪永昌街道满塘岗村社区卫生服务站,浙江兰溪321100

出　　处：《中国中药杂志》2013年第7期1087-1090,共4页China Journal of Chinese Materia Medica

基　　金：浙江省金华市科技局项目(2008-3-054)

摘　　要：目的:探讨中西医结合治疗下蝮蛇咬伤患者外周血炎性因子(hs-PCR,IL-6,TNF-α)水平变化及临床疗效。方法:将98例患者按照入院时间分为西药组32例,中药组32例,中西医结合组35例。西医组用抗蝮蛇毒血清6000U,每天1次静脉滴注,连用5d。中药组用中药抗蝮蛇2号浓煎剂300mL,每日分2～3次口服,5d为1疗程。中西医结合组即抗蝮蛇毒血清联合中药抗蝮蛇2号(用法同上)。所有患者均于治疗前后采集血标本,用ELISA法检测外周血清炎性因子(hs-PCR,IL-6,TNF-α)。并选取同期30例健康人群为健康对照组。结果:3组患者治疗前血清炎性因子水平均高于健康组(P<0.01),治疗后3组患者炎性因子水平均降低,但中西医结合组比单纯中药与西药组明显降低(P<0.01);3组治疗后局部症状消退情况:与单纯中医组、西医组在第1天和第3天比中西医结合组局部症状消退情况最为显著(P<0.05,P<0.01);临床总有效率分别是中西医结合组100%,单纯中药组84.37%,单纯西药组65.62%,中西医结合组明显优于单纯中药与西药组(P<0.01)。结论:蝮蛇咬伤患者外周血炎性因子水平明显增高;中西药结合治疗蝮蛇咬伤能明显降低血炎性因子水平,增加临床疗效,比单纯用中药与西药临床疗效显著。Objective： To observe the clinical efficacy of combination of traditional Chinese medicine and western medicine in the treatment of patient bitten by agkistrodon halys pallas, and the changes in peripheral blood inflammatory factors （hs-PCR, IL-6, TNF-α）. Method： Ninty-eight patients were divided into three groups according to their hospitalization dates： the western medicine group, in which 32 patients were treated with antivenom serum （6 000 U） for five days, once every day ; the traditional Chinese medicine group, in which 32 patients were treated with anti pit viper No. 2 concentrated decoction （300 mL）, twice to three times every day, for five days; and the combined traditional Chinese medicine and western medicine group, in which 35 patients were treated with the combination of Chinese and Western medicine treatment described above. Then blood samples of all of patients were obtained, and serum factors （ hs-PCR, IL-6, TNF-cα） in peripheral blood were measured by Elisa assay. Another 30 health volunteers were chosen as the normal control group. Result： The serum inflammatory factors were significantly higher in all patients of the three groups than that in healthy control before treatment （P 〈 0. 01 ）, and decreased significantly after treatment. In particular, the more remarkable reduction was found in the combined traditional Chinese medicine and western medicine group compared with the western medicine group and the traditional medicine group （ P 〈 0. 01 ）. Symptom elimination in the three groups was superior to the western medicine group and the traditional medicine group at the first day and the third day of treatment （P 〈0. 05, P 〈0. 01 ）. Total clinical effective rate was 100% in the combined traditional Chinese medicine and western medicine group, 84. 37% in the traditional medicine group and 65.62% in the western medicine group, the clinical effective rate of the combined traditional Chinese medicine and western medicine group was notably superior to tha

关 键 词：炎性因子 抗腹蛇2号 抗蝮蛇毒血清 中西医结合 

分 类 号：R646[医药卫生—外科学]