蜂毒清2号联合血液净化治疗对重度蜂蜇伤患者心、肝、肾影响的临床研究
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摘要
目的观察自拟中药(蜂毒清颗粒2号)对重度毒蜂蜇伤患者的临床疗效。方法患者40例随机分为两组,对照组给予常规治疗方案加血液灌流治疗,治疗组在对照组基础上予蜂毒清2号颗粒口服,复查对比其肝功、肾功、心肌酶、血乳酸等相关指标,比较两组急性生理与慢性健康(APACHEⅡ)评分。结果治疗组总有效率为90.00%,显著高于对照组的80.00%(P <0.05)。两组治疗后心肌酶、肝功、肾功、乳酸指标均较治疗前显著下降(P <0.05),治疗组下降更为显著(P <0.05)。治疗后两组APACHEⅡ评分均较治疗前显著下降(P <0.05),治疗组较对照组下降更为明显(P <0.05)。治疗组与对照组患者在治疗(留观)时间上分别是10 d、14 d,差异有统计学意义(P <0.05)。结论重度蜂蜇伤患者在早期给予西医常规治疗联合血液灌流同时,口服(或鼻饲)蜂毒清2号颗粒可以减轻其病痛,更好地改善重度蜂蜇伤患者心肝肾功能,缩短病程时间,提高临床疗效。
Objective: To observe the clinical effect of self-made Chinese medicine(Fengduqing Granule 2)on severe poisonous bee sting. Methods: 40 patients were randomly divided into two groups. The control group was given routine treatment plus hemoperfusion,while the treatment group was given Fenduqing 2 orally on the basis. The liver function,kidney function,myocardial enzymes,blood lactic acid and other related indicators were compared,and the acute physiology and chronic health(APACHEⅡ) scores of the two groups were compared.Results: The total effective rate was 90.00% in the treatment group,significantly higher than 80.00% in the control group(P < 0.05). After treatment,the indices of myocardial enzymes,liver function,kidney function and lactic acid in the two groups were significantly lower than those before treatment(P < 0.05),and the decrease in the treatment group was more significant(P < 0.05). After treatment,APACHE II scores dropped significantly in the two groups(P < 0.05),and the decrease of the treatment group was more obvious than that of the control group(P <0.05). The treatment time of the treatment group and the control group were 10 days and 14 days respectively;the difference was statistically significant(P < 0.05). Conclusion: Routine Western medicine treatment combined with hemoperfusion treatment and taking Fenduqing 2 orally(or nasal feeding) can relieve patients' pain,better improve their heart,liver and kidney function,shorten the course of disease and improve the clinical efficacy in the early stage.
Objective: To observe the clinical effect of self-made Chinese medicine(Fengduqing Granule 2)on severe poisonous bee sting. Methods: 40 patients were randomly divided into two groups. The control group was given routine treatment plus hemoperfusion,while the treatment group was given Fenduqing 2 orally on the basis. The liver function,kidney function,myocardial enzymes,blood lactic acid and other related indicators were compared,and the acute physiology and chronic health(APACHEⅡ) scores of the two groups were compared.Results: The total effective rate was 90.00% in the treatment group,significantly higher than 80.00% in the control group(P < 0.05). After treatment,the indices of myocardial enzymes,liver function,kidney function and lactic acid in the two groups were significantly lower than those before treatment(P < 0.05),and the decrease in the treatment group was more significant(P < 0.05). After treatment,APACHE II scores dropped significantly in the two groups(P < 0.05),and the decrease of the treatment group was more obvious than that of the control group(P <0.05). The treatment time of the treatment group and the control group were 10 days and 14 days respectively;the difference was statistically significant(P < 0.05). Conclusion: Routine Western medicine treatment combined with hemoperfusion treatment and taking Fenduqing 2 orally(or nasal feeding) can relieve patients' pain,better improve their heart,liver and kidney function,shorten the course of disease and improve the clinical efficacy in the early stage.
引文
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[2]王兴华,徐慧琳.秦巴山区蜂蜇伤中毒流行病学调查[J].公共卫生与预防医学,2014,25(4):88-90.
[3]朱伟,王本祥,朱迅.蜂毒素的研究进展[J].白求恩医科大学学报,2007,27(2):212-214.
[4]陈传熹,蒋臻,高永莉.926例蜂蛰伤的回顾性分析[J].中国中医急症,2015,24(12):2103-2105.
[5]郝炎,缪洁.蜂蛰伤后不同时间血常规、心肌酶谱及肝肾功的变化[J].西南国防医药,2014,24(10):1086-1088.
[6]王群,水华.血液净化救治群峰蜇伤并急性肾衰竭三例[J].临床肾病杂志,2008,8(10):442.
[7]王今达,任新生.脓毒症的诊断标准及中西医结合治疗指南的研究(讨论稿)[C].2004年全国危重病急救医学学术会议论文集:中国会议,2004:6-11.
[8]史志城.动物毒物学[M].北京:中国农业大学出版社,2001:568-570.
[9]C.E.Dempsey.Theactions of melittin on membranes[J].Biochim Biophys Acta,1990,1031(2):143-161.
[10]C.C.Lai,G.R.Her.Analysis of phospholipase A2 gilcosylation patterns from venom of indivdual bees by capillary electrophoresis/electrospray ionization mass spectrometry using anion trap mass spectrometer[J].Rapid Commun Mass Spectrom,2000,14(5):2012-2018.
[11]H.Raghuraman,A.Chattopadhyay.Melittin:a membraneactive peptide with diverse function[J].Biosci Rep,2007,27(10):189-223.
[12]徐成坤.中西医结合治疗胡蜂蛰伤48例[J].中国中医急症,2010,19(5):878-879.
[13]曾光,饶志华.严重蜂蜇伤18例临床诊疗分析[J].四川中医,2013,34(11):1634-1635.
[14]林初媛.血液透析联合血液灌流技术抢救蜂蛰伤急性中毒患者护理观察[J].当代医学,2015,21(5):127-128.
[15]王亚丹,杨建波,戴忠.中药金银花的研究进展[J].药物分析杂志,2014,34(11):1928-1935.
[16]宋宝辉,念红.蒲公英及其多糖提取物对小鼠免疫功能的调节研究[J].中国食物与营养,2011,17(10):68-70.
[17]吴国友.连翘药理作用研究进展[J].中医学报,2013,28(10):1508-1509.
[18]李广峰.大黄的药理作用及临床应用分析[J].中国医药指南,2013,11(16):317-318.
[19]曹晖.中医治法对蜂蛰伤患者心、肾功能影响研究[J].中医药临床杂志,2016,28(7):991-992.