五黄解毒汤联合西医治疗早期蝮蛇咬伤患肢肿痛的效果  

Observation of Wuhuangjiedu Decoction combined with Westorn medicine treatment of leg swelling and pain of early Agkistrodon halys bite

作　　者：郭颖 邢涛[2] GUO Ying;XING Tao(Department of Emergency Medicine,2.Department of Neurosurgery,Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suzhou City,Jiangsu Province,215000,China)

机构地区：[1]南京中医药大学附属苏州市中医医院急诊科,江苏苏州215000 [2]南京中医药大学附属苏州市中医医院神经外科,江苏苏州215000

出　　处：《蛇志》2023年第4期435-438,449,共5页Journal of Snake

基　　金：苏州市卫生青年骨干人才“全国导师制”培训项目(项目编号:苏卫健科教〔2019〕8号)。

摘　　要：目的探讨五黄解毒汤联合西医治疗早期蝮蛇咬伤患肢肿痛的临床效果。方法将2020年4月至2022年10月临床确诊的84例蝮蛇咬伤患者随机分为观察组和对照组,每组42例。对照组给予西医常规治疗,观察组在对照组的基础上联合五黄解毒汤内服与泡洗治疗,比较两组患者的患肢止痛起效时间、消肿时间和消肿程度。结果治疗后,观察组的患肢止痛起效时间约为2 h,明显短于对照组的6 h,两组比较差异具有统计学意义(P<0.05)。治疗后,观察组的消肿时间为(2.14±0.98)d,短于对照组(4.07±1.93)d,两组比较差异有统计学意义(P<0.05)。两组患者治疗后患肢与健肢周径差比较,观察组治疗2 d时为(1.16±0.52)cm,治疗3 d时为(0.48±0.28)cm;对照组治疗2 d时为(1.97±0.68)cm,治疗3 d时为(1.75±0.52)cm;观察组的消肿程度改善优于对照组,差异有统计学意义(均P<0.05)。结论蝮蛇咬伤早期在常规西医治疗基础上联合五黄解毒汤内服与外用泡洗患肢的止痛和消肿效果更佳,疗效满意,缩短了治疗时间,促进患肢功能康复。Objective To investigate the therapeutic effect of Wuhuangjiedu decoction combined with western medicine in treatment of limb swelling and pain of early Agkistrodon halys bite.Methods 84 patients with Agkistrodon halys bite treated from April 2020 to October 2022 were randomly divided into observation group and control group,with 42 cases in each group.The control group was treated with conventional western medicine treatment,and the observation group was treated with Wuhuangjiedu decoction plus soaking and washing.The analgesic onset time,detumescence time and detumescence degree of the two groups were observed and compared.Results After treatment,the analgesic onset time in the observation group was about 2 hours,which was significantly shorter than 6 hours in the control group,and the difference was statistically significant(P<0.05).The detumescence time of observation group was(2.14±0.98)days after treatment,which was shorter than that of control group(4.07±1.93)days,and the difference between the two groups was statistically significant(P<0.05).After treatment,the difference between the circumference of the affected limb and the healthy limb in the two groups was(1.16±0.52)cm after 2 days of treatment and(0.48±0.28)cm after 3 days of treatment in the observation group,and(1.97±0.68)cm after 2 days of treatment and(1.75±0.52)cm after 3 days of treatment in the control group,and the degree of swelling reduction was better than that in the control group.The differences were statistically significant(all P<0.05).Conclusion On the basis of conventional treatment,combined with Wuhuangjiedu decoction for internal administration and external soaking,the analgesic and swelling reduction effects of Agkistrodon halys bite are better,and the curative effect is satisfactory.Wuhuangjiedu decoction can be used internally and externally to improve the utilization rate of traditional Chinese medicine,shorten the treatment time and promote the functional rehabilitation of the affected limb.

关 键 词：五黄解毒汤 内服 泡洗 蝮蛇咬伤 肢体肿痛 

分 类 号：R646[医药卫生—外科学]