毒蜂蜇伤患者血清指标与中医证候的相关性研究  

Study on Correlation between Serum Indexes and TCM Syndromes of Patients Stung by Venomous Bee

作　　者：屈阳 朱定海 Qu Yang;Zhu Dinghai(Ankang Hospital of Traditional Chinese Medicine,Shaanxi,Ankang 725000,China)

机构地区：[1]陕西省安康市中医医院,陕西安康725000

出　　处：《中国中医急症》2024年第9期1636-1639,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家中医药管理局国家中医优势专科培育单位项目(国中医药医政函[2024]90号)。

摘　　要：目的 研究毒蜂蜇伤患者的中医证候分布及与血清指标的相关性。方法 回顾性分析238例毒蜂蜇伤患者的中医四诊信息,由3名中医师讨论确定患者的中医证候要素与中医复合证候,并应用Spearman相关性分析探索中医证候与血清指标的相关性。结果 毒蜂蜇伤患者的中医证候要素分布为:毒证>风证>内火>瘀血>痰湿,中医复合证候分布为:火毒证>风毒证>痰瘀互结证,风毒证与火毒证患者的病程显著短于痰瘀互结证,合并多器官功能障碍综合征(MODS)的比例显著高于痰瘀互结证,差异具有统计学意义(P <0.05)。风毒证、火毒证的C反应蛋白(CRP)、白细胞计数(WBC)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(LDH)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)、肌酐(Scr)水平显著高于痰瘀互结证(P <0.05),火毒证的降钙素原(PCT)、尿素(BUN)水平显著高于风毒证与痰瘀互结证(P <0.05),痰瘀互结证的纤维蛋白原(FIB)、D2聚体(D-D)水平显著高于风毒证与火毒证(P <0.05)。结论 毒蜂蜇伤患者的血清相关指标与中医证候间存在相关性,在临床辨证论治中可参考血清指标水平。Objective:To study the distribution of TCM syndromes in patients stung by venomous bee and their correlation with serum indexes.Methods:The information of the four TCM diagnosis of 238 patients with venom bee sting was retrospectively analyzed.Three TCM physicians discussed and determined the TCM syndrome elements of the patients,and Spearman correlation analysis was used to explore the correlation between TCM syndrome elements and serum indexes.Results:In patients with venomous bee stings,the distribution of TCM syndrome elements was in the order of toxic>wind>internal fire>blood stasis>phlegm-dampness,and the distribution of composite syndromes was in the order of fire-toxic>wind-toxic>phlegm-blood stasis interlacing.The duration of illness in patients with wind-toxic and fire-toxic syndromes was significantly shorter than in patients with phlegm-blood stasis interlacing,and the proportion of patients with multiple organ dysfunction syndrome(MODS)was significantly higher in the wind-toxic and fire-toxic syndromes compared to the phlegm-blood stasis interlacing syndrome(P<0.05).The levels of C-reactive protein(CRP),white blood cell count(WBC),creatine kinase(CK),creatine kinase MB isoenzyme(CK-MB),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),total bilirubin(TBIL),alanine aminotransferase(ALT),gamma-glutamyl transferase(GGT),and creatinine(Scr)in patients with wind-toxic and fire-toxic syndromes were significantly higher than in patients with phlegmblood stasis interlacing(P<0.05).The levels of procalcitonin(PCT)and urea(BUN)in patients with fire-toxic syndrome were significantly higher than in patients with wind-toxic and phlegm-blood stasis interlacing syndromes(P<0.05).The levels of fibrinogen(FIB)and D-dimer(D-D)in patients with phlegm-blood stasis interlacing syndrome were significantly higher than in patients with wind-toxic and fire-toxic syndromes(P<0.05).Conclusion:There is correlation between serum indexes and TCM syndromes in patients with venomous bee stings,which can be referred to in c

关 键 词：毒蜂蜇伤 中医证候 血清 相关性 

分 类 号：R646[医药卫生—外科学]