规范化中医治疗方案在蝮蛇咬伤合并肝肾功能损害中的应用及疗效评价  

Application and efficacy evaluation of traditional Chinese medicine treatment plan in the treatment of patients bitten by agkistrodon halys with functional lesion of the liver and kidney

作　　者：张允申[1] 刘海红[1] 方勇 陶菊 龚旭初 倪毓生 ZHANG Yun-shen;LIU Hai-hong;FANG Yong;TAO Ju;GONG Xu-chu;NI Yu-sheng(Nantong Hospital Affiliated to Nanjing University of Chinese Medicine,Nantong 226001,China)

机构地区：[1]南京中医药大学南通附属医院,南通226001

出　　处：《中华中医药杂志》2021年第3期1752-1756,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：南通市市级科技计划项目(No.HS149154,No.MSZ19228);江苏省中医药管理局科技重点项目(No.ZD201510);江苏省中医药管理局科技项目(No.YB2017064);第二批江苏省名老中医药专家传承工作室建设项目(No.苏中医科教[2016]6号)。

摘　　要：目的:评价规范化中医治疗方案治疗蝮蛇咬伤合并肝肾功能损害的临床疗效。方法:160例蝮蛇咬伤合并肝肾功能损害患者按随机数字表法分为对照组和试验组,各80例,对照组予西医常规治疗方案,试验组予西医常规治疗及规范化中医治疗方案,分别于治疗前后记录两组伤者伤肢肿痛程度及症状消失时间、全身症状积分,检测两组C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、尿素氮(BUN)、肌酐(Cr),计算治疗愈显率。结果:在伤肢肿胀、疼痛程度及症状消失时间、全身症状积分方面,试验组治疗效果较对照组更为显著(P<0.05);试验组治疗后血清CRP、TNF-α、IL-6及ALT、AST、BUN、Cr较对照组下降更显著(P<0.05);试验组愈显率(97.5%,78/80)显著优于对照组(82.5%,66/80)(P<0.05)。结论:规范化中医治疗方案在缓解蝮蛇咬伤伤肢肿痛及全身症状、减轻炎症反应、促进肝肾功能恢复方面效果显著,适于临床推广应用。Objective: To evaluate the clinical efficacy of treatment of traditional Chinese medicine in agkistrodon halys bite with functional lesion of the liver and kidney. Methods: A total of 160 patients with agkistrodon halys bites were randomly divided into the control group and experimental group the according random number table method, 80 cases in each group, the control group was given routine treatment of western medicine, while the experimental group was given standardized treatment of traditional Chinese medicine on the basis of the control group. The degree of swelling and pain of the injured limbs, the disappearance time of symptoms and the integral of systemic symptoms were recorded before and after the treatment, levels of serum C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), alanine aminotransferase(ALT), aspartate aminotransferase(AST), urea nitrogen(BUN) and creatinine(Cr) were detected in the two groups;the effective rate of treatment was calculated. Results: In terms of the degree of swelling and pain of injured limbs, the disappearance time of symptoms and the integral of systemic symptoms, the therapeutic effect of the experimental group was more obvious than that of the control group(P<0.05). After treatment, the levels of serum CRP, TNF-α, IL-6, ALT, AST, BUN and Cr in the experimental group decreased more significantly than those in the control group(P<0.05), The effective rate in the treatment group was 97.5%(78/80), while the control group was 82.5%(66/80), the experimental group was significantly better than the control group(P<0.05). Conclusion: The standardized treatment of traditional Chinese medicine has remarkable effect in alleviating limb swelling and pain, relieving inflammation and promoting the recovery of liver and kidney function, and it is suitable for clinical application.

关 键 词：蝮蛇咬伤 肝肾功能损害 肢体肿痛 炎症反应 中医治疗方案 规范化 疗效评价 

分 类 号：R269[医药卫生—中西医结合]