中西医结合治疗老年人蝮蛇咬伤60例临床观察

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目的:观察中西医结合治疗老年人蝮蛇咬伤的临床疗效。方法:将110例大于60岁蝮蛇咬伤患者随机分为治疗组60例,对照组50例。对照组予抗蝮蛇毒血清、破伤风抗毒素、地塞米松、抗生素等基础治疗。局部常规消毒换药处理,伴肝功能损害、心肌损害者予还原型谷胱甘肽、ATP、辅酶A,血尿者予5%碳酸氢钠碱化尿液,并补液后呋塞米利尿;伴呼吸困难者予氧疗或无创简易呼吸机辅助通气。治疗组在对照组治疗基础上局部八风八邪穿刺、七叶一枝花酊外涂患肢、伤肢红热肿痛者芙黄膏外敷;以季德胜蛇药片及蛇伤解毒汤随证加减口服。结果:总有效率治疗组为98.3%,对照组为86.0%,组间比较,差异有统计学意义(P<0.05)。治疗组中伴肝、肾、心肌损害者血清ALT、AST、CK、BUN、Ccr治疗后均低于对照组(P<0.05)。治疗组最终治愈患者的治愈时间少于对照组(P<0.05)。结论:中西医结合排毒解毒法治疗老年人蝮蛇咬伤疗效良好。 Objective: To observe the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of vitex bites in the elderly. Methods: One hundred and ten patients with viper snakes greater than 60 years old were randomly divided into treatment group (60 cases) and control group (50 cases). The control group was given anti-snake venom serum, tetanus antitoxin, dexamethasone, antibiotics and other basic treatment. Local routine disinfection dressing change, with liver damage, myocardial damage to reduced glutathione, ATP, coenzyme A, hematuria were given 5% sodium bicarbonate alkalinized urine and rehydration furosemide urine; with Those with dyspnea were given oxygen therapy or noninvasive simple ventilator-assisted ventilation. The treatment group in the control group based on the local treatment of eight wind eight evil puncture, seven leaves a flower tincture applied limbs, limbs red hot and sore pain Fu Huang cream topical; to Ji De Sheng snake tablets and snake Shangdudu soup with card plus or minus oral. Results: The total effective rate was 98.3% in the treatment group and 86.0% in the control group. There was significant difference between the two groups (P <0.05). Serum levels of ALT, AST, CK, BUN and Ccr in the treatment group were lower than those in the control group after treatment (P <0.05). The healing time of the final treatment group was less than that of the control group (P <0.05). Conclusion: Integrative medicine detoxification detoxification treatment of vitex bites in elderly patients with good effect.
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