摘要
目的观察五虎追风散配合咪达唑仑治疗重症破伤风患者痉挛的临床效果,并分析其安全性。方法选择我院2014年1月-2017年12月收治的150例重症破伤风患者作为研究对象,采用随机数字表法,将患者分为对照组和观察组,每组75例。所有患者均采用肌肉注射破伤风免疫球蛋白、破伤风抗毒素,并采用青霉素或甲硝唑抗感染。对照组患者气管切开,行机械通气,并采用咪达唑仑静脉泵入镇静;观察组在对照组的基础上给予加味五虎追风散治疗,两组均为7 d一个疗程,治疗1～2个疗程。观察记录两组患者痉挛缓解时间、住院时间,治疗前后痉挛发作次数、发作持续时间以及张口大小,使用Ramsay评分法对患者意识状态进行评价,并记录镇静药物使用时间和并发症发生情况,对中医证候进行评分,评价疗效。结果治疗后,观察组痉挛发作次数、发作持续时间均少于对照组,张口大小大于对照组(P <0. 05),差异有统计学意义;观察组治疗后Ramsay评分低于对照组,且镇静药物使用时间低于对照组(P <0. 05),差异有统计学意义;观察组痉挛缓解时间、住院时间均低于对照组(P <0. 05),差异有统计学意义;治疗后,观察组中医证候评分低于对照组(P <0. 05),差异有统计学意义;观察组并发症发生率低于对照组(P <0. 05),差异有统计学意义;观察组有效率高于对照组(P <0. 05),差异有统计学意义。结论使用五虎追风散配合咪达唑仑治疗重症破伤风患者,能够明显改善患者痉挛症状,提高疗效,并且缩短住院时间,减少并发症发生,值得临床推广。
Objective To explore the clinical effects on spasticity in the patients with severe tetanus treated with wuhu zhuifeng san and midazolam and analyze its safety.Methods From January 2014 to December 2017,150 eligible patients with severe tetanus were collected.According to random number table,they were divided into a control group and an observation group,75 cases in each one.Every patient received intramuscular injection with tetanus immunoglobulin,tetanus antitoxin,as well as penicillin or metronidazole for anti-infection.In the control group,the tracheotomy for mechanical ventilation was used and the intravenous pumping with midazolam for sedation.In the observation group,on the base of the treatment as the control group,the modified wuhu zhuifeng san was added.The treatment for 7 days was as one session and 1 to 2 sessions were required.The remission time of spasm and hospital stays were observed in the two groups,as well as seizure frequency,attack duration and mouth-open size.Using Ramsay scale,the consciousness state was evaluated.The use time of sedative and incidence of complication were recorded.The TCM symptoms and therapeutic effects were evaluated.Results After treatment,seizure frequency and attack duration in the observation group were less than the control group and the mouth-open size was bigger than the control group( P <0.05),with statistical significance.In the observation group,Ramsay score after treatment was lower than the control group and the use time of sedative was less than the control group( P <0.05),indicating the statistical significance.After treatment,TCM symptom score in the observation group was lower than the control group( P <0.05),indicating the statistical significance.The incidence of complication in the observation group was lower than the control group( P <0.05),indicating the statistical significance.The effective rate in the observation group was higher than the control group( P <0.05),indicating the statistical significance.Conclusion The co-medication of wuhu zhuifeng
作者
秦浩
吴凤影
魏金刚
QIN Hao;WU Feng-ying;WEI Jin-gang(Department of Intensive Care Medicine,Shijiazhuang Fifth Hospital,Shijiazhuang Hebei 050021;Department of Surgery,Shijiazhuang Fifth Hospital,Shijiazhuang Hebei 050021)
出处
《世界中西医结合杂志》
2019年第2期250-253,共4页
World Journal of Integrated Traditional and Western Medicine
基金
2017年石家庄市科学技术研究与发展指导计划(171461703)
