红光照射联合七叶一枝花酊外涂治疗蝮蛇咬伤患肢肿痛的临床研究
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摘要
目的观察红光照射联合七叶一枝花酊外涂治疗蝮蛇咬伤患肢肿痛的临床疗效。方法选取2017年4月—10月于中医外科住院的蝮蛇咬伤患者80例,按入院先后顺序编号,单号入选观察组,双号入选对照组,各40例。2组均完成常规救治措施,予抗蝮蛇毒血清、破伤风抗毒素、激素、抗生素、清热解毒汤剂口服及对症治疗等。观察组患肢予红光照射(2次/d)联合七叶一枝花酊外涂(间隔2 h喷涂1次),5 d为1个疗程;对照组患肢单纯予七叶一枝花酊外涂。观察治疗前、治疗后第3天、治疗后第5天患者患肢肿胀值、疼痛评分、伤口愈合时间。结果治疗后第3、5天患肢肿胀值及疼痛评分均较治疗前减小;在治疗后第5天,观察组患肢肿胀值、疼痛评分显著小于对照组(P <0. 01)。观察组患者伤口愈合时间为(2. 93±1. 12) d,短于对照组的(3. 60±1. 39) d,差异有统计学意义(P <0. 05)。结论红光照射联合七叶一枝花酊外涂能显著缓解蝮蛇咬伤患肢肿痛,促进伤口愈合。
Objective To investigate the effect of Red light therapy combined with external application of Paris polyphylla Smith Tincture in treatment of patients with viper bite.Methods Totally 80 patients with viper bite were divided into observation group( n = 40) and control group( n =40) according to the admission order.All patients received routine treatment including agkistrodon halys antivenin,tetanus antitoxin,hormone therapy,antibiotics and antipyretic-detoxicate decoctions.In the control group,patients were given the treatment by external application of Paris polyphylla Smith Tincture.In the observation group,patients were given a red light irradiation combined with external use of Paris polyphylla Smith Tincture( spraying once with an interval of 2 hours),5 days as a course of treatment.The outcomes included limb swelling,pain score and wound healing time.Results The limb swelling value and pain score were decreased three and five days after treatment compared with the baseline,and were lower in the observation group than those in the control group five days after the treatment( P < 0.01).The wound healing time was shorter in the observation group than in the control group( 2.93 ±1.12 vs.3.60 ±1.39,P <0.05).Conclusion Red light irradiation combined with external use of Paris polyphylla Smith Tincture can significantly reduce the pain of limb swelling and promote wound healing in patients with viper bite.
Objective To investigate the effect of Red light therapy combined with external application of Paris polyphylla Smith Tincture in treatment of patients with viper bite.Methods Totally 80 patients with viper bite were divided into observation group( n = 40) and control group( n =40) according to the admission order.All patients received routine treatment including agkistrodon halys antivenin,tetanus antitoxin,hormone therapy,antibiotics and antipyretic-detoxicate decoctions.In the control group,patients were given the treatment by external application of Paris polyphylla Smith Tincture.In the observation group,patients were given a red light irradiation combined with external use of Paris polyphylla Smith Tincture( spraying once with an interval of 2 hours),5 days as a course of treatment.The outcomes included limb swelling,pain score and wound healing time.Results The limb swelling value and pain score were decreased three and five days after treatment compared with the baseline,and were lower in the observation group than those in the control group five days after the treatment( P < 0.01).The wound healing time was shorter in the observation group than in the control group( 2.93 ±1.12 vs.3.60 ±1.39,P <0.05).Conclusion Red light irradiation combined with external use of Paris polyphylla Smith Tincture can significantly reduce the pain of limb swelling and promote wound healing in patients with viper bite.
引文
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[17]PINTO C,SCHAFER F,ORELLANA J J,et al.Efficacy of red light alone and methyl-aminolaevulinatephotodynamic therapy for the treatment of mild and moderate facial acne[J].Indian J Dermatol Venereol Leprol,2013,79(1):77-82.
[18]金晓明,韩思佳,吴雁翔.红光治疗仪联合胰岛素治疗2型糖尿病足模型大鼠的实验研究[J].海南医学院学报,2017,23(18):2461-2463.
[19]蒋琪霞,李晓华,周昕,等.红光和红外线辅助治疗创伤性伤口减痛促愈效果观察[J].护理学杂志,2012,27(22):19-22.
[20]戴薇薇,张其健,付小爱,等.湿性敷料联合物理治疗在1例下肢多处静脉溃疡患者伤口护理中的应用[J].中国护理管理,2017,17(12):1711-1714.
[21]JI J,ZHANG L L,DING H L,et al.Comparison of5-aminolevulinic acid photodynamic therapy and red light for treatment of photoaging[J].Photodiagnosis Photodyn Ther,2014,11(2):118-21.
[22]LOGAN I D,MCKENNA P G,BARNETT Y A.An investigation of the cytotoxic and mutagenic potential of low intensity laser irradiation in Friend erythroleukemia cells[J].Mutat Res,1995,347(2):67-71.
[2]马秀君,王卫忠,汤树庆,等.蝮蛇咬伤患者临床护理路径的构建[J].解放军护理杂志,2014,31(2):24-27.
[3]中华中医药学会外科分会.毒蛇咬伤中医诊疗方案专家共识(2016版)[J].中医杂志,2017,58(4):357-360.
[4]施胜钰,赵炎,武瑞仙.七叶一枝花酊治疗蝮蛇咬伤致肢体肿胀100例[J].中国中医急症,2011,20(10):1661.
[5]占婷婷,徐海霞.刺血拔罐联合中药外敷治疗蝮蛇咬伤局部肿痛的护理[J].中国临床护理,2014,6(1):11-12.
[6]潘变景,韩宁林.刺血拔罐法治疗蝮蛇咬伤后肢体肿胀的临床观察[J].中国中医急症,2017,26(1):115-117.
[7]张艳斐.红光治疗对四肢骨软组织肿瘤术后切口愈合和疼痛程度的影响研究[J].中国实用医药,2016,11(25):127-128.
[8]朱荣丽,陶菊,龚旭初.红光治疗对蝮蛇咬伤伤口愈合和肿胀疼痛的疗效观察[J].蛇志,2016,28(2):141-142.
[9]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:148.
[10]余培南,钟汉,余永州.中国蛇伤学[M].太原:山西科学技术出版社,2009:113.
[11]李仲廉.临床疼痛治疗学[M].天津:天津科学技术出版社,2003:205.
[12]吴宗耀,励建安.物理医学与康复医学发展的挑战、机遇和危机---ISPRM第五届国际大会讨论综述[J].中华物理医学与康复杂志,2009,31(11):721-724.
[13]姚勤,刘会珍,胡俊扬,等.重楼醇提物镇痛抗炎作用研究[J].南京中医药大学学报,2012,28(6):561-563.
[14]国家药典委员会.中华人民共和国药典[M].中国医药科技出版社,2015:362.
[15]何海燕,张连阳,叶茂.短期红光照射治疗对创面愈合和缓解疼痛的效果观察[J].解放军医药杂志,2013,25(7):20-22.
[16]雷霆,陈华,董自庆.红光照射联合中药坐浴湿敷促进肛周脓肿术后创面愈合的临床观察[J].中医外治杂志,2017,26(3):6-8.
[17]PINTO C,SCHAFER F,ORELLANA J J,et al.Efficacy of red light alone and methyl-aminolaevulinatephotodynamic therapy for the treatment of mild and moderate facial acne[J].Indian J Dermatol Venereol Leprol,2013,79(1):77-82.
[18]金晓明,韩思佳,吴雁翔.红光治疗仪联合胰岛素治疗2型糖尿病足模型大鼠的实验研究[J].海南医学院学报,2017,23(18):2461-2463.
[19]蒋琪霞,李晓华,周昕,等.红光和红外线辅助治疗创伤性伤口减痛促愈效果观察[J].护理学杂志,2012,27(22):19-22.
[20]戴薇薇,张其健,付小爱,等.湿性敷料联合物理治疗在1例下肢多处静脉溃疡患者伤口护理中的应用[J].中国护理管理,2017,17(12):1711-1714.
[21]JI J,ZHANG L L,DING H L,et al.Comparison of5-aminolevulinic acid photodynamic therapy and red light for treatment of photoaging[J].Photodiagnosis Photodyn Ther,2014,11(2):118-21.
[22]LOGAN I D,MCKENNA P G,BARNETT Y A.An investigation of the cytotoxic and mutagenic potential of low intensity laser irradiation in Friend erythroleukemia cells[J].Mutat Res,1995,347(2):67-71.