五炭煎剂对竹叶青蛇咬伤致DIC患者凝血机制的影响  

Effect of Wutan Jianji on DIC caused by Trimeresurus medoensis

作　　者：侯杰[1] 陈晓旗 李馨 周岁锋[1] 苏立成[1] 赖贵龙 HOU Jie;CHENG Xiaoqi;LI Xin;ZHOU Suifeng;SU Licheng;LAI Guilong(The Hospital of Traditional Chinese Medicine of Zhongshan City Affiliated of Guangzhou University of Traditional Chinese Medicine,Guangdong Zhongshan 528400,China)

机构地区：[1]广州中医药大学附属中山市中医院,广东中山528400

出　　处：《中医药临床杂志》2020年第12期2306-2308,共3页Clinical Journal of Traditional Chinese Medicine

基　　金：中山市医学科研基金项目2019J158。

摘　　要：目的:观察五炭煎剂对竹叶青蛇伤致DIC的影响。方法:用前瞻、随机对照研究方法将32例竹叶青蛇伤患者分为常规组、研究组。常规组就诊后即予清创局封、静滴抗蝮蛇毒血清、根据需要输注新鲜冰冻血浆、对症支持治疗。研究组在常规治疗的基础上,加用五炭煎剂,床边急煎,温服,2次/d,于就诊时、给药后1d、3d、5d、7d 检测血小板(PLT)、凝血酶原时间(PT)、部分活化凝血活酶时问(APTT)、纤维蛋白原(Fg)、纤维蛋白降解产物(FDP)及D二聚体(D-D),并观察患者出血情况。结果:2组凝血指标的变化趋势高度一致,在伤后1d左右即达极值。研究组在提升Fg、降低D-D上有治疗效果,与常规组比有统计学差异;对改善PT及FDP也在一定效果,但与常规组比无统计学意义。结论:五炭煎剂能一定程度上减轻DIC程度,但不能阻断其发生趋势。Objective:To observe the effect of five-charcoal decoction on DIC caused by green bamboo snake wound.Methods:A prospective,randomized controlled study method was used to divide 32 cases of green bamboo snake injury patients into a routine group and a study group.The routine group was treated with debridement,intravenous infusion of anti-Agkistrodon venom serum,fresh frozen plasma as needed,and symptomatic supportive treatment.On the basis of conventional treatment,the research group added five charcoal decoction,bedside emergency decoction,warm service,twice a day,and detection of platelets(PLT)and thrombin at 1d,3d,5d,7d after administration The original time(PT),partially activated thromboplastin time(APTT),fibrinogen(Fg),fibrin degradation products(FDP)and D dimer(DD),and observe the patient’s bleeding.Results:The change trend of the coagulation indexes of the two groups was highly consistent,reaching the extreme value about 1 day after injury.The study group had a therapeutic effect in increasing Fg and reducing D-D,which was statistically different from the conventional group;it also had a certain effect on improving PT and FDP,but it was not statistically significant compared with the conventional group.Conclusion:Wutan decoction can reduce the degree of DIC to a certain extent,but it cannot block its occurrence.

关 键 词：竹叶青蛇 DIC 五炭煎剂 

分 类 号：R278[医药卫生—中医学]