| 杨敏,余涛.凉血解毒方治疗五步蛇咬伤的研究[J].浙江中西医结合杂志,2025,35(3): |
| 凉血解毒方治疗五步蛇咬伤的研究 |
| Study on the treatment of Agkistrodon acutus bite by Liangxue Jiedu decoction |
| 投稿时间：2024-03-28 修订日期：2025-01-14 |
| DOI： |
| 中文关键词: 凉血解毒方 五步蛇咬伤 基质金属蛋白酶-9 蛇毒金属蛋白酶 |
| 英文关键词:Liangxue Jiedu decoction Agkistrodon acutus bite Matrix Metalloproteinase-9 Snake venom metalloproteinase |
| 基金项目:1.凉血解毒方对五步蛇毒金属蛋白酶清除作用的研究；2.中性粒细胞胞外诱捕网NETs影响抗蝮蛇毒血清蛇毒中和力的作用研究 |
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| 中文摘要: |
| 目的：探究凉血解毒方对五步蛇咬伤的疗效及血清基质金属蛋白酶-9(MMP-9)的影响。方法：选取2021年1月~2023年8月期间我院急诊收治的五步蛇咬伤患者120例作为研究对象,随机分为对照组(抗五步蛇毒血清8000u、地塞米松10mg、抗感染、利尿消肿),治疗组(对照组治疗的基础上加服凉血解毒方),比较两组患者肢体肿胀消退情况、局部溃疡坏死发生率、PLT、PT、 APTT、 TT、FIB、MMP-9的变化。结果：治疗前,两组患者凝血功能对比无明显差异(P＞0.05),治疗第2d、治疗第4d治疗组PT、TT、APTT较对照组低,FIB、PLT较对照组高(P＜0.05),治疗第6d时2组患者均恢复正常水平,对比无明显差异(P＞0.05)。治疗前,两组患者双侧肢体周径差值、局部溃疡坏死率对比无明显差异(P＞0.05),治疗第2d、治疗第4d、治疗第6d治疗组双侧肢体周径差值较对照组小,局部溃疡坏死率较对照组低(P＜0.05)。治疗前,两组患者MMP-9含量水平对比无明显差异(P＞0.05),治疗第2d、治疗第4d、治疗第6d治疗组MMP-9含量水平较对照组低(P＜0.05)。结论：凉血解毒方治疗五步蛇咬伤能够更快改善凝血功能及消肿,降低局部溃疡坏死率,有效降低MMP-9,其作用机制可能在于清除蛇毒金属蛋白酶(SVMPs),安全有效,值得推广。 |
| 英文摘要: |
| Objective: To investigate the therapeutic effect of Liangxue Jiedu recipe on Agkistrodon acutus bite and the effect of serum matrix metalloproteinase-9(MMP-9). Methods: 120 cases of Agkistrodon acutus bite were selected from the emergency department of our hospital from January 2021 to August 2023, they were randomly divided into two groups: control group (8000U of anti-agkistrodon acutus venom serum, 10mg of dexamethasone, anti-infection, diuresis and detumescence) and treatment group (treatment group with Liangxue Jiedu Fang on the basis of treatment) , the changes of limb swelling, local ulcer necrosis, PLT, PT, APTT, TT, FIB and MMP -9 were compared between the two groups. Results: There was no significant difference in coagulation function between the two groups before treatment (P > 0.05) , PT、TT and APTT were lower and FIB, PLT were higher in the treatment group than those in the control group on the 2nd day and 4th day after treatment (p < 0.05) . On the 6th day after treatment, the levels of PT、TT and APTT in the treatment group were higher than those in the control group (p < 0.05) . Before treatment, there was no significant difference in the difference of bilateral limb circumference and local ulcer necrosis rate between the two groups (P > 0.05) . The difference of bilateral limb circumference in the treatment group was smaller than that in the control group on the 2nd day, the 4th day and the 6th day after treatment, the local ulcer necrosis rate was lower than that of the control group (p < 0.05) . There was no significant difference in the level of MMP-9 between the two groups before treatment (P > 0.05) . The level of Mmp-9 in the treatment group was lower than that in the control group at the 2nd day, the 4th day and the 6th day after treatment (p < 0.05) . Conclusion: Liangxue jiedu Fang can improve coagulation function, reduce swelling, reduce local ulcer necrosis rate and effectively reduce MMP-9 in the treatment of Agkistrodon acutus bite. The mechanism of Liangxue Jiedu Fang may be that it is safe and effective to remove metalloproteinase from snake venom (SVMPs) , it is worth promoting. |
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