检索历史 清除

目的:观察全息经络铜砭刮痧用于蝮蛇咬伤后肢体肿痛中的效果及相关临床检测指标的变化。方法:选择浙江中医药大学附属杭州市中医院2023年5—10月收治的蝮蛇咬伤后肢体肿痛患者74例为研究对象，采用病例对照临床研究方法，按治疗方法不同进行分组，各37例；研究组采取全息经络铜砭刮痧，对照组实施常规干预，比较两组临床资料（性别、年龄、身体质量指数、文化程度、就诊时间、严重程度、咬伤部位等）、肢体肿胀程度、视觉模拟评分（VAS）、实验室检测指标、不良反应等。结果:干预前，两组肢体肿胀程度差异无统计学意义（ P > 0.05）；干预后1 d、3 d、7 d，研究组肿胀程度［（52.41±4.07）mm、（33.07±3.25）mm、（10.45±2.13）mm］均低于对照组的（58.56±4.30）mm、（40.26±3.41）mm、（13.98±2.77）mm（ t=6.32、9.28、6.15， P < 0.001、< 0.001、< 0.001）。干预前，两组VAS差异无统计学意义（ P > 0.05）；干预后1 d、3 d、7 d，研究组VAS评分［（3.41±1.18）分、（3.01±1.05）分、（2.74±0.72）分］均低于对照组的（3.98±1.25）分、（3.52±1.10）分、（3.18±0.96）分（ t=2.01、2.04、2.23， P=0.047、0.045、0.029）。干预前、干预后1 d，两组实验室指标差异均无统计学意义（均 P > 0.05）；干预后3 d、7 d研究组肌酸激酶（CK）［（231.25±25.96）IU/L、（190.67±21.03）IU/L］、肌酐（Scr）［（74.34±7.91）μmol/L、（70.08±7.54）μmol/L］、肌酸激酶同工酶（CK-MB）［（16.61±2.06）IU/L、（12.02±1.74）IU/L］、C反应蛋白（CRP）［（6.54±1.18）mg/L、（4.10±0.96）mg/L］均较对照组的（260.48±28.51）IU/L、（215.34±24.25）IU/L、（79.10±8.23）μmol/L、（74.33±7.91）μmol/L、（19.33±2.31）IU/L、（15.68±1.95）IU/L、（7.30±1.52）mg/L、（5.92±1.23）mg/L降低（ t=4.61、4.67、2.53、2.36、5.34、8.51、2.40、7.09，均 P < 0.05）。两组均未出现严重不良反应。 结论:全息经络铜砭刮痧能够快速减轻患者肢体肿胀程度，同时缓解疼痛，改善肌肉损伤情况，安全性高。

Objective:To investigate the effect of holographic meridian copper coin scraping therapy on limb swelling and pain after a pit viper bite and the changes of related laboratory indicators.Methods:Seventy-four patients with limb swelling and pain after a pit viper bite who received treatment at the Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University from May 2023 to October 2023 were included in this study. Using a case-control study design, these patients were divided into a study group (holographic meridian copper coin scraping therapy) and a control group (conventional intervention), with 37 patients in each group, according to the treatment methods. The clinical data (gender, age, body mass index, education level, time of admission, severity, bite site), the degree of limb swelling, Visual Analogue Scale score, laboratory indicators, and adverse reactions were compared between the two groups.Results:Before intervention, there was no statistically significant difference in the degree of limb swelling between the two groups ( P > 0.05). At 1, 3, and 7 days after intervention, the degree of swelling in the study group [(52.41 ± 4.07) mm, (33.07 ± 3.25) mm, (10.45 ± 2.13) mm] was significantly lower than that in the control group [(58.56 ± 4.30) mm, (40.26 ± 3.41) mm, (13.98 ± 2.77) mm, t = 6.32, 9.28, 6.15, P < 0.001, < 0.001, < 0.001). Before intervention, there was no statistically significant difference in Visual Analogue Scale score between the two groups ( P > 0.05). At 1, 3, and 7 days after intervention, the Visual Analogue Scale scores in the study group [(3.41 ± 1.18) points, (3.01 ± 1.05) points, (2.74 ± 0.72) points] were significantly lower than those in the control group [(3.98 ± 1.25) points, (3.52 ± 1.10) points, (3.18 ± 0.96) points, t = 2.01, 2.04, 2.23, P = 0.047, 0.045, 0.029]. There were no statistically significant differences in laboratory indicators between the two groups before and 1 day after intervention (all P > 0.05). At 3 and 7 days after intervention, the levels of creatine kinase [(231.25 ± 25.96) IU/L, (190.67 ± 21.03) IU/L], creatinine [(74.34 ± 7.91) μmol/L, (70.08 ± 7.54) μmol/L], creatine kinase isoenzyme [(16.61 ± 2.06) IU/L, (12.02 ± 1.74) IU/L], and C-reactive protein [(6.54 ± 1.18) mg/L, (4.10 ± 0.96) mg/L] in the study group were significantly lower than those in the control group [(260.48 ± 28.51) IU/L, (215.34 ± 24.25) IU/L, (79.10 ± 8.23) μmol/L, (74.33 ± 7.91) μmol/L, (19.33 ± 2.31) IU/L, (15.68 ± 1.95) IU/L, (7.30 ± 1.52) mg/L, (5.92 ± 1.23) mg/L, t = 4.61, 4.67, 2.53, 2.36, 5.34, 8.51, 2.40, 7.09, all P < 0.05]. No serious adverse reactions occurred in each group. Conclusion:The holographic meridian copper coin scraping therapy can rapidly reduce the degree of limb swelling in patients, alleviate pain, reduce muscle injury, and is highly safe.