刺血拔罐联合中药内服外敷治疗蝮蛇咬伤(火毒证)的疗效观察  

Clinical Observation of Bloodletting Cupping Combined with Internal and External Administration of Traditional Chinese Medicine in Treating Patients with Fire-Toxin Syndrome Caused by Viper Bites

作　　者：牛亚男 李心雨 伍甜甜 李雪苓[3] 曹承楼[3] 赵进东[3] Niu Yanan;Li Xinyu;Wu Tiantian;Li Xueling;Cao Chenglou;Zhao Jindong(Anhui University of Chinese Medicine,Anhui,Hefei 230031,China)

机构地区：[1]安徽中医药大学,安徽合肥230031 [2]山东中医药大学第二附属医院,山东济南250000 [3]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中国中医急症》2025年第3期498-502,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：安徽省卫健委卫生健康科研项目(AHWJ2023BAc10002);安徽中医药大学校级探索性科研项目(2021zxts43);合肥市新安医学与中医药现代化研究所“揭榜挂帅”项目(2023CXMMTCM024,2023CXMMTCM003)。

摘　　要：目的观察刺血拔罐联合中药内服外敷治疗蝮蛇咬伤(火毒证)患者的临床疗效。方法将80例蝮蛇咬伤(火毒证)患者随机分为对照组与治疗组各40例。对照组实施蝮蛇咬伤常规治疗,治疗组在常规治疗基础上予以刺血拔罐联合中药内服外敷的综合性治疗。观察两组患者治疗前及治疗第3、6天患肢肿胀程度、疼痛视觉模拟量表(VAS)评分、消肿率、肝素结合蛋白(HBP)、白细胞计数(WBC)、中性粒细胞计数(N)、谷丙转氨酶(ALT)浓度变化。结果两组治疗第3、6天患肢VAS评分、肿胀程度均较治疗前呈下降趋势(P<0.05),且治疗组较同期对照组下降幅度更显著(P<0.05);两组治疗第6天血清WBC、N、ALT、CK-MB、HBP水平均较治疗前呈下降趋势(P<0.05),且治疗组较对照组降低程度更为显著(P<0.05);治疗第3、6天两组消肿率均较治疗前差异有统计学意义(P<0.05),第6天均较第3天显著提高(P<0.05),且治疗组较同期对照组显著提高(P<0.05)。结论刺血拔罐联合中药内服外敷可缓解蝮蛇咬伤(火毒证)患者全身炎性反应和心肌酶、肝酶异常,减轻局部肿胀疼痛,提高临床疗效。Objective:To evaluate the clinical efficacy of bloodletting cupping combined with internal and external administration of traditional Chinese medicine(TCM)in treating patients with fire-toxin syndrome caused by viper bites.Methods:Following the principle of randomization,80 patients diagnosed with fire-toxin syndrome due to viper bites were randomly divided into a control group and a treatment group,with 40 cases in each group.The control group received conventional treatment for viper bites,while the treatment group was treated with a comprehensive approach combining bloodletting cupping and internal and external administration of TCM in addition to conventional treatment.Changes in swelling degree of the affected limb,visual analog scale(VAS)scores for pain,edema reduction rate,heparin-binding protein(HBP),white blood cell count(WBC),neutrophil count(N),and alanine aminotransferase(ALT)levels were observed before treatment and on days 3 and 6 of treatment.Results:On days 3 and 6 of treatment,the VAS scores and swelling degree of the affected limb in both groups showed a downward trend compared with before treatment(P<0.05),and the decrease in the treatment group was more significant than in the control group(P<0.05).On day 6,serum WBC,N,ALT,CK-MB,and HBP levels in both groups decreased compared with before treatment(P<0.05),and the reduction in the treatment group was more significant than in the control group(P<0.05).The edema reduction rate in both groups on days 3 and 6was significantly different from before treatment(P<0.05),and it increased significantly on day 6 compared with day 3(P<0.05);the improvement in the treatment group was more significant than in the control group(P<0.05).Conclusion:Bloodletting cupping combined with internal and external administration of TCM can alleviate systemic inflammatory reactions,abnormal myocardial enzymes,and liver enzyme levels,reduce local swelling and pain,and improve clinical efficacy in patients with fire-toxin syndrome caused by viper bites.

关 键 词：蝮蛇咬伤 火毒证 刺血拔罐 中药外敷 中药内服 

分 类 号：R646[医药卫生—外科学]