绿茶水调金黄散外敷治疗胺碘酮所致静脉炎的效果

黄鸣 楼娟

[摘要]目的 探讨绿茶水调金黄散外敷治疗胺碘酮所致静脉炎的效果。方法 选取2016年12月～2018年4月我科收治的60例因使用胺碘酮所致静脉炎患者作为研究对象，按照随机数字表法分为实验组（30例）与对照组（30例）。实验组患者予以绿茶水调制金黄散成药膏状敷于患处，对照组患者则给予以50%硫酸镁湿敷于患处。观察两组静脉炎患者用药后患处红、肿、胀、痛等症状的改善情况，比较两组患者的局部疼痛缓解时间以及红肿消退时间，并统计比较两组患者的治疗总有效率。结果 实验组患者的总有效率为96.67%，高于对照组的70.00%，差异有统计学意义（P<0.05）。实验组患者的局部疼痛缓解时间以及红肿消退时间均短于对照组，差异有统计学意义（P<0.05）。结論 绿茶水调金黄散外敷比50%硫酸镁湿敷更加能显著改善胺碘酮所致静脉炎患者的红、肿、胀、痛等症状，减轻患者痛苦，提高护理质量。

[关键词]静脉炎；胺碘酮；金黄散；治疗效果

[中图分类号] R543.6 [文献标识码] A [文章编号] 1674-4721（2019）5（b）-0200-03

[Abstract] Objective To explore the effect of external application of Jinhuang Powder adjusted with green tea in the treatment of phlebitis induced by Amiodarone. Methods From December 2016 to April 2018， 60 patients with phlebitis caused by Amiodarone in our department were selected as the study subjects. The patients were divided into the experimental group （30 cases） and the control group （30 cases） by the random number table method. The patients in the experimental group were treated with green tea and Jinhuang Powder as ointment， and the patients in the control group were treated with 50% Magnesium Sulfate. The improvement of the symptoms of redness， swelling， distending， pain and so on in the patients with phlebitis after taking medicine in the two groups were observed， the time of local pain relief and redness and swelling regression between the two groups were compared， and the total effective rate was compared between the two groups. Results The total effective rate of the experimental group was 96.67%， which was higher than 70.00% of the control group， the difference was statistically significant （P<0.05）. The local pain relief time and swelling subsidence time of the experimental group were shorter than those of the control group， and the difference was statistically significant （P<0.05）. Conclusion Compared with 50% Magnesium Sulfate wet compress， the external application of Jinhuang Powder adjusted with green tea can significantly improve the symptoms of phlebitis caused by Amiodarone， such as redness， swelling distending， pain， alleviate the pain of patients， and improve the quality of nursing.

[Key words] Phlebitis； Amiodarone； Jinhuang Powder； Therapeutic effect

胺碘酮属于广谱抗心律失常药物，其临床作用以Ⅲ类药物作用为主，同时也兼具Ⅰ、Ⅱ、Ⅳ类抗心律失常药物的电生理作用。研究显示，胺碘酮对各类室上性及室性快速性心动过速均有较好的治疗效果，能有效预防心房颤动及心室颤动的发生，在临床上使用广泛[1]。胺碘酮的pH值为2.5～4.0，具有较高的渗透压，容易损伤血管内皮，造成静脉炎[2]。据文献报道[3]，经外周静脉持续泵入胺碘酮的静脉炎发生率高达88.2%。临床上泵注胺碘酮发生静脉炎后，不仅增加患者痛苦，还延长了住院时间，加重了患者经济负担，甚至部分进一步发展成深静脉栓塞、败血症等严重并发症[4]。目前，选用50%硫酸镁湿敷外渗部位仍是比较公认的治疗静脉炎的方法[5]，但硫酸镁湿敷易析出结晶而影响药物吸收和治疗效果，另外也会对皮肤造成刺激[6]。为了探索治疗胺碘酮所致静脉炎更简便有效的方法，本研究采用我院中医外科配制的金黄散，用绿茶水调制进行中药敷药法治疗胺碘酮所致静脉炎患者，现将研究结果报道如下。