醒脑静联合血必净注射液治疗急性有机磷农药中毒昏迷临床研究
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R595.4

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2017年度河南省医学科技攻关计划项目(20170239)


Clinical Study Curative Effect of Xingnaojing Injection Combined with Xuebijing Injection on Acute Organophosphorus Pesticide Complicated with Coma
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    摘要:

    目的:观察醒脑静联合血必净注射液治疗急性有机磷农药中毒(AOPP) 伴昏迷的临床疗效。方法:选取74 例重度AOPP 伴昏迷患者,按随机数字表法分为治疗组及常规组各37 例。常规组给予洗胃、营养、补液、纠正酸碱及电解质紊乱、碘解磷定、长托宁等常规治疗,治疗组在常规组基础上给予醒脑静联合血必净注射液治疗,2 组均治疗5 d。比较2 组临床治疗指标(长托宁用量、胆碱酯酶活性恢复60%时间、意识清醒时间、住院时间、抢救成功率),观察2 组治疗前后血清炎症因子水平(TNF-α、IL-6、IL-8、IL-10) 和心肌损伤指标[肌酸激酶(CK)、乳酸脱氢酶(LDH)、天冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)] 变化,观察2 组并发症发生情况。结果:治疗期间,治疗组的长托宁用量少于常规组,胆碱酯酶活性恢复60%时间、意识清醒时间和住院时间短于常规组,治疗组抢救成功率高于常规组,差异均有统计学意义(P<0.05)。治疗后,2 组TNF-α、IL-6、IL-8 及CRP 水平均较治疗前下降(P<0.05),治疗组上述4 项水平均低于常规组(P<0.05)。治疗后,2 组CK、LDH、AST 及CK-MB 水平均较治疗前下降(P<0.05),治疗组上述4 项水平均低于常规组(P<0.05)。治疗组并发症总发生率为21.62%,低于常规组51.35%,2 组比较,差异有统计学意义(P<0.05)。结论:醒脑静联合血必净注射液治疗AOPP 昏迷患者疗效显著,能有效降低药物使用剂量,缩短住院时间以及意识清醒时间,提高抢救成功率,同时减少并发症,安全性较高。

    Abstract:

    Abstract:Objective:To observe the clinical effect of Xingnaojing injection combined with Xuebijing injection on patients with acute organophosphorus pesticide poisoning(AOPP) complicated with coma. Methods: Seventy- four patients with severe AOPP complicated with coma were selected and divided into the treatment group and the conventional group according to random number table method, 37 cases in each group. The conventional group was given gastric lavage, nutrition,fluid replenishment,correction of acid-base and electrolyte disorders,iodophodine,Changtuoning(penehyclidine hydrochloride injection) and other conventional treatments,while the treatment group was given Xingnaojing combined with Xuebijing injection based on the treatment of the conventional group. Both groups were treated for five days. The clinical indexes(dosage of Changtuoning, recovery time of 60% cholinesterase activity, conscious time, length of hospital stay, success rate of rescue) were compared between the two groups. Changes in serum inflammatory factors(TNF-α,IL-6,IL-8、 IL-10) and myocardial injury Creatine kinase(CK)、Lactate dehydrogenase(LDH)、Aspartate aminotransferase(AST)、creatine kinase isoenzymes(CK- MB) before and after treatment were observed between the two groups, and the incidence of complications between the two groups were observed. Results:During the treatment,the dosage of Changtuoning in the treatment group was less than that in the conventional group; the recovery time of 60% cholinesterase activity, the conscious time and the hospitalization time were shorter than those in the conventional group;and the success rate of rescue was higher than that in the conventional group,differences being significant(P<0.05). After treatment,the levels of TNF-α, IL- 6, IL- 8 and CRP in the two groups were decreased when compared with those before treatment(P<0.05), and the levels of the above four indexes in the treatment group were lower than those in the conventional group(P<0.05). After treatment,the levels of CK,LDH,AST and CK-MB in the two groups were decreased when compared with those before treatment(P<0.05), and the levels of the above four indexes in the treatment group were lower than those in the conventional group(P<0.05). The total incidence of complications was 21.62% in the treatment group,lower than those of 51.35% in the conventional group, the difference being significant(P<0.05). Conclusions: The therapy of Xingnaojing injection combined with Xuebijing injection has significant curative effect on AOPP patients complicated with coma, which can effectively reduce medicine dosage, shorten hospitalization time and conscious time, improve the success rate of rescue,and reduce complications,with high safety.

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李瑞俭,孙屹屹,陈林志,何培良,刘媛媛.醒脑静联合血必净注射液治疗急性有机磷农药中毒昏迷临床研究[J].新中医,2021,53(17):70-74

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  • 在线发布日期: 2021-09-09
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