黃鳴 樓娟

[摘要]目的 探討綠茶水調金黃散外敷治療胺碘酮所致靜脈炎的效果。方法 選取2016年12月～2018年4月我科收治的60例因使用胺碘酮所致靜脈炎患者作為研究對象，按照隨機數字表法分為實驗組（30例）與對照組（30例）。實驗組患者予以綠茶水調制金黃散成藥膏狀敷于患處，對照組患者則給予以50%硫酸鎂濕敷于患處。觀察兩組靜脈炎患者用藥后患處紅、腫、脹、痛等癥狀的改善情況，比較兩組患者的局部疼痛緩解時間以及紅腫消退時間，并統(tǒng)計比較兩組患者的治療總有效率。結果 實驗組患者的總有效率為96.67%，高于對照組的70.00%，差異有統(tǒng)計學意義（P<0.05）。實驗組患者的局部疼痛緩解時間以及紅腫消退時間均短于對照組，差異有統(tǒng)計學意義（P<0.05）。結論 綠茶水調金黃散外敷比50%硫酸鎂濕敷更加能顯著改善胺碘酮所致靜脈炎患者的紅、腫、脹、痛等癥狀，減輕患者痛苦，提高護理質量。

[關鍵詞]靜脈炎；胺碘酮；金黃散；治療效果

[中圖分類號] R543.6 [文獻標識碼] A [文章編號] 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

胺碘酮屬于廣譜抗心律失常藥物，其臨床作用以Ⅲ類藥物作用為主，同時也兼具Ⅰ、Ⅱ、Ⅳ類抗心律失常藥物的電生理作用。研究顯示，胺碘酮對各類室上性及室性快速性心動過速均有較好的治療效果，能有效預防心房顫動及心室顫動的發(fā)生，在臨床上使用廣泛[1]。胺碘酮的pH值為2.5～4.0，具有較高的滲透壓，容易損傷血管內皮，造成靜脈炎[2]。據文獻報道[3]，經外周靜脈持續(xù)泵入胺碘酮的靜脈炎發(fā)生率高達88.2%。臨床上泵注胺碘酮發(fā)生靜脈炎后，不僅增加患者痛苦，還延長了住院時間，加重了患者經濟負擔，甚至部分進一步發(fā)展成深靜脈栓塞、敗血癥等嚴重并發(fā)癥[4]。目前，選用50%硫酸鎂濕敷外滲部位仍是比較公認的治療靜脈炎的方法[5]，但硫酸鎂濕敷易析出結晶而影響藥物吸收和治療效果，另外也會對皮膚造成刺激[6]。為了探索治療胺碘酮所致靜脈炎更簡便有效的方法，本研究采用我院中醫(yī)外科配制的金黃散，用綠茶水調制進行中藥敷藥法治療胺碘酮所致靜脈炎患者，現將研究結果報道如下。