针刺+负压真空罐疗技术联合抗蛇毒血清对蝮蛇咬伤患者疗效的影响  

Outcomes of acupuncture and vacuum cupping therapy plus snake antivenom in snake bite

作　　者：王海涛[1] 周子翔 李丽[1] 王常畅 谢志莹 彭庆军 WANG Haitao;ZHOU Zixiang;LI Li;WANG Changchang;XIE Zhiying;PENG Qingjun(Department of Emergency Surgery,The Third People's Hospital of Bengbu,Bengbu 233000,Anhui,China)

机构地区：[1]蚌埠市第三人民医院急诊外科,安徽蚌埠233000

出　　处：《皖南医学院学报》2024年第6期543-547,共5页Journal of Wannan Medical College

基　　金：安徽省医学会急诊医学分会急诊临床研究计划项目(Ky2021014)。

摘　　要：目的:研究针刺+负压真空罐疗技术联合抗蝮蛇毒血清对蝮蛇咬伤患者临床疗效的影响。方法:选取2020年3月~2023年3月在蚌埠市第三人民医院就诊的蝮蛇咬伤患者212例,应用随机数字表法分为研究组和对照组各106例。对照组采用传统切开排毒+抗蝮蛇毒血清治疗,研究组采用针刺+负压真空罐疗技术联合抗蝮蛇毒血清治疗,5 d后比较两组患者疗效、局部症状、炎症相关指标、脏器功能指标等。结果:研究组治疗总有效率高于对照组(P<0.05);两组患者治疗5 d后视觉模拟评分法(VAS)评分、肿胀程度均较治疗前下降(P<0.05),且研究组患者VAS评分、肿胀程度下降幅度高于对照组(P<0.05);研究组患者肿胀消退时间短于对照组(P<0.05);两组治疗5 d后超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞计数(WBC)均较治疗前升高,中性粒细胞百分比(NEUT%)较治疗前降低(P<0.05),研究组患者hs-CRP、IL-6、WBC升高幅度低于对照组,NEUT%降低幅度高于对照组(P<0.05);两组治疗5 d后乳酸脱氢酶(LDH)、谷丙转氨酶(ALT)、尿素氮(BUN)、肌酐(Cr)均较治疗前升高(P<0.05),研究组患者LDH、ALT、BUN、Cr升高幅度低于对照组(P<0.05)。结论:相比传统切开排毒,针刺+负压真空罐疗技术联合抗蝮蛇毒血清对蝮蛇咬伤患者疗效显著,可明显减轻患者疼痛和患肢肿胀,缓解炎症水平,减少脏器功能损伤。Objective:To investigate the clinical effect of acupuncture and vacuum cupping therapy combined with snake antivenom in the treatment of patients attacked by Agkistrodon halys.Methods:A total of 212 patients bitten by Agkistrodon halys,treated in our hospital between March 2020 and March 2023,were included,and divided into the treatment group and the control group by random number table method(n=106 in each group).Patients in the control group were treated with detoxification by incision plus conventional snake antivenom,and those in the treatment group were treated by acupuncture and vacuum cupping therapy combined with snake antivenom.Then the two groups were compared regarding the efficacy,local symptoms improvement,inflammation related indicators,and organ function indicators after five days of treatment.Results:The overall effectiveness rate was higher in the treatment group than in the control group(P<0.05).VAS scores and swelling degree were decreased in both groups after 5 days of treatment(P<0.05),and the decrease was more obvious in the treatment group(P<0.05).Swelling regression time in the treatment group was significantly shorter than that in the control group(P<0.05).The levels of high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)as well as white blood cell count(WBC)were elevated,yet neutrophil percentage(NEUT%)was declined in both groups after five days of treatment(P<0.05).The increase in hs-CRP,IL-6 and WBC,and decrease in NEUT%was dominant in the treatment group(P<0.05).After 5 days of treatment,the levels of lactate dehydrogenase(LDH),alanine transaminase(ALT),blood urea nitrogen(BUN)and creatinine(Cr)were increased in both groups(P<0.05),whereas the levels of above liver and kidney function indicators were better improved in the treatment(P<0.05).Conclusion:Compared with traditional detoxification by incision,acupuncture and vacuum cupping therapy combined with snake antivenom is more effective in the treatment of patients bitten by Agkistrodon halys.Importantly,this combined

关 键 词：蛇咬伤 蝮蛇 蛇毒血清 针刺 负压真空罐 炎症 肿胀 

分 类 号：R646[医药卫生—外科学] R996.3[医药卫生—临床医学] R245