以重度动物咬伤的患者作为研究对象,通过回顾性队列研究,比较了急诊术后单纯使用常规外科抗菌敷料与联合外用嘎木朱尔对动物咬伤伤口的疗效差异,以明确蒙药嘎木朱尔的临床价值及治疗优势。指标包括引流时间、伤口愈合时间、外周血红细胞沉降率、C反应蛋白(CRP)、伤口愈合等级以及伤口并发症。结果显示,外用嘎木朱尔散可促进动物咬伤(III级暴露)的伤口愈合过程,对I期缝合伤口具有显著的抗炎作用,对II期缝合伤口可发挥显著的抗感染、抗炎作用,可显著缩短伤口愈合时间、降低伤口并发症发生率,说明联合外用嘎木朱尔的疗效优于单纯常规外科抗菌敷料。
Animal bite wound is common in the primary medical system, which has a relatively high risk of wound complications and needs an emergency medical intervention. Mongolian medicine Gamuzhuer powder is one of the classic traditional prescriptions of Mongolian medicine for complex wound infection treatment. Through a retrospective parallel control study, the efficacy of conventional surgical antibacterial dressing on animal bite wounds was compared with that of conventional surgical antibacterial dressing combined with external Gamuzhuer. Indicators included drainage time, wound healing time, peripheral blood erythrocyte sedimentation rate, C-reactive protein (CRP), wound healing grade, and wound complications. The results showed that Gamuzhuer powder for external use can promote the wound healing process of animal bite (level III exposure), has significant anti-inflammatory effect on stage I suture wound, has significant anti-inflammatory and antiinflammatory effects on stage II suture wound, significantly shortens the wound healing time and reduces the incidence of wound complications, indicating that the efficacy of Gamuzhuer powder for external use is better than that of conventional surgical antibacterial dressing.
[1] 王传林.常见动物致伤规范化诊疗总则[C].中国医学救援协会动物伤害救治分会,2021:11-13.
[2] 吴彦领.《常见动物致伤诊疗规范》解读[C].中国医学救援协会动物伤害救治分会,2021:36.
[3] 郭建华,闫绒.做好狂犬病暴露后的处置工作预防狂犬病发生[J].基层医学论坛,2015,19(11):2.
[4] 王传林,张晓威,白峰.犬咬伤伤口一期缝合与延迟缝合的对比分析[J].临床急诊杂志,2012,13(4):263-265.
[5] 侯春林,刘小林.中国显微外科历史回顾[J].中华显微外科杂志,2015,38(5):417-419.
[6] 内蒙古自治区卫生厅.内蒙古蒙成药标准[S].赤峰:内蒙古科学技术出版社,1984:386.
[7] 陆姜燕,云长林,于楠,等.嘎木朱尔散外敷联合红光理疗促进肛周脓肿手术创面愈合的临床及护理观察[J].中国民族医药杂志,2016,22(11):1-3.
[8] 尹剑,海燕,尔德尼,等.蒙药嘎木朱尔促进肛门术后创面愈合的临床观察[J].中国民族医药杂志,2009,15(5):3-4.
[9] 金丽娟.蒙西医结合治疗肛门湿疹36例临床观察[J].中国民族医药杂志,2013,19(2):27,43.
[10] 董敏.蒙药嘎木朱尔联合红光理疗治疗压疮的效果观察[J].中国实用医药,2020,15(3):161-163.
[11] 巴音额古乐,黎明,鲁敏.蒙药嘎木朱尔治疗骨折术后伤口不愈合的体会[J].中国民族医药杂志,2012,18(3):10-11.
[12] 郭志涛,王传林,黄涛.清创缝合术对动物重度咬伤伤口愈合效果的影响[J].中国预防医学杂志,2017,18(12):3.
[13] 王经伟,甄东,邱冰.不同切口长度及缝合方式的跟腱手术切口愈合情况的比较[J].中国微创外科杂志,2021,21(5):5.
[14] 毕力夫.蒙药炮制规范化研究[M].呼和浩特:内蒙古人民出版社,2007:9.
[15] 韩玉宝,白彦满都拉,乌恩毕力格,等.嘎木朱尔在大鼠伤口愈合过程中对白细胞介-1β影响的实验研究[J].内蒙古民族大学学报(自然科学版),2014,29(1):62-64.
[16] 国家中医药管理局.中华本草·蒙药卷[M].上海:上海科学技术出版社,2004:9.
[17] 周雅萍.浅谈中药石决明的性能及应用[J].中国城乡企业卫生,2015,30(5):38-39,42.
[18] 马绍扬.银朱膏外敷治疗术后切口延期愈合80例[J].中国民间疗法,2007(5):20-21.
[19] 朱秀嫒,徐桂芳,程雨时,等.麝香的药理研究III.麝香抗炎作用原理[J].中国医学科学院学报,1989(1):52-56.
[20] 马燕,倪燕,张娜,等.蒙药嘎木朱尔散与增强型透明贴联合应用治疗III、IV期压疮的临床研究[J].中国民族医药杂志,2013,19(10):21-22.