蝮蛇解毒汤治疗蝮蛇咬伤的临床研究  

Clinical study of Viper Detoxifying Decoction in the treatment of viper bite patients

作　　者：陈海东[1] 龚旭初[1] 张允申[1] 杨万富[1] 陈旭[1] CHEN Hai-dong;GONG Xu-chu;ZHANG Yun-shen;YANG Wan-fu;CHEN Xu(Nantong Hospital of Traditional Chinese Medicine,Nantong 226001,China)

机构地区：[1]南通市中医院,南通226001

出　　处：《中华中医药杂志》2018年第12期5738-5742,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：江苏省中医药管理局重点科研项目(No.Z D201510);南通市市级科技计划项目(No.HS149154)~~

摘　　要：目的:观察蝮蛇解毒汤治疗蝮蛇咬伤的临床疗效,探讨中医药干预在蝮蛇咬伤救治中的疗效。方法:收集300例蝮蛇咬伤患者,采用随机数字表法分A、B、C 3组,各100例。A组采用西医常规疗法;B组在西医常规疗法基础上口服季德胜蛇药片;C组在西医常规疗法基础上口服蝮蛇解毒汤;共治疗6d。观察并分析3组临床疗效及患者的局部症状(疼痛程度、肿胀程度)、全身体征(复视、瞳孔、眼睑下垂、张口困难、颈项及全身肌肉酸痛、烦躁、呼吸)、实验室检查指标中性粒细胞计数百分比(N%)、尿红细胞计数(URBC)、谷丙转氨酶(ALT)、肌酸激酶同工酶(CK-MB)、血清肌酐(Cr)、C-反应蛋白(CRP)的变化情况。结果:治疗后,C组显效率显著优于A组和B组(P<0.05);各组患肢疼痛、肿胀程度、全身症状积分均有缓解(P<0.01),C组疼痛缓解程度显著优于A、B组(P<0.01),B组与A组无统计学差异;C组肿胀程度、全身症状积分显著优于B组(P<0.01),B组显著优于A组(P<0.05);实验室指标上,各组治疗后N%、URBC、Cr、CK-MB、CRP均较治疗前有显著改善(P<0.05);ALT治疗前后仅C组有改善;且在N%、URBC、Cr、ALT、CRP指标改善情况上C组优于B组、A组(P<0.05)。结论:西药常规疗法加用蝮蛇解毒汤治疗蝮蛇咬伤具有更好的临床效果,值得推广应用。Objective:To observe the clinical effect of Viper Detoxifying Decoction in the treatment of viper bite and discuss the efficacy of TCM intervention in the treatment.Methods:A total of 300 cases of viper bite were observed and divided into Group A,Group B and Group C by random number table,100 cases in each group.Group A was treated by routine western medical therapy.Group B was treated with JI De-sheng Sheyao Tablets and Group C was treated wtih Viper Detoxifying Decoction in the basis of routine western medical therapy.Three groups of clinical curative effect were recorded,and the local symptoms of the patients (the degree of pain,swelling degree),systemic signs (diplopia,pupil,drooping eyelids,difficulty with open mouth,neck and body muscle ache,be agitated,breathing)and laboratory examination indexes [neutrophil count percentage (N%),urine red blood cell count (URBC),cereal third transaminase (ALT),creatine kinase-MB (CK-MB),serum creatinine (Cr), C-reactive protein (CRP)]changes were statistically analyzed.Results:After the treatment,significant efficiency in Group C was superior to the Group A and B (P<0.05).Pain,swelling degree and systemic symptoms were relieved in all three groups (P<0.01), pain relief degree of Group C was better than Group A and B (P<0.01),and there was no statistical difference between Group B and Group A (P<0.05).On the score of swelling degree and systemic symptoms,group C was superior to group B (P<0.01),and Group B was superior to Group A (P<0.05).In the laboratory index,N%,URBC,Cr,CK-MB,CRP were significantly improved after treatment in the three groups (P<0.05).Only Group C improved ALT after treatment.On the improvement of N%,URBC, Cr,ALT and CRP,Group C was superior to the other two groups (P<0.05).Conclusion:Routine western medical therapy with of Viper Detoxifying Decoction in the treatment of viper bite has a better clinical treatment effect and is worthy of promotion and application.

关 键 词：蝮蛇咬伤 蝮蛇解毒汤 季德胜蛇药片 中医药干预 临床研究 

分 类 号：R269[医药卫生—中西医结合]