Department of Emergency, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
Guangzhou University of Chinese Medicine, Guangzhou Panyu Central Hospital,Guangzhou,China.
PLoS Negl Trop Dis. 2022 Dec 16;16(12):e0010997. doi: 10.1371/journal.pntd.0010997. eCollection 2022 Dec.
This study aimed to evaluate the clinical therapeutic efficacy of anti-snake venom serum blockade in treating local tissue necrosis caused by Chinese cobra (Naja atra) bites.
Patients bitten by a Chinese cobra (Naja atra) (n = 50) that met the inclusion criteria were randomly divided into two groups: the experimental group (n = 25) and the control group (n = 25). The experimental group received regular as well as anti-snake venom serum blocking treatment, whereas regular treatment plus chymotrypsin blocking therapy was given to the control group. The necrotic volumes around snake wounds in these groups were detected on the first, third and seventh days. On the third day of treatment, some local tissues in the wounds were randomly selected for pathological biopsy, and the necrosis volume of the local tissue was observed. Furthermore, the amount of time required for wound healing was recorded.
On the third and seventh days post-treatment, the necrotic volume of the wound of the experimental group was much smaller than that of the control group, and the experimental group's wound healing time was shorter than that of the control group (all p < 0.05). Moreover, the pathological biopsies taken from the control group showed nuclear pyknosis, fragmentation, sparse nuclear density, and blurred edges, and the degree of necrosis was much higher than that of the experimental group.
Anti-snake venom blocking therapy is a new and improved therapy with good clinical effect on local tissue necrosis caused by Chinese cobra bites; moreover, it is superior to conventional chymotrypsin blocking therapy in the treatment of cobra bites. It can better neutralize and prevent the spread of the toxin, reduce tissue necrosis, and shorten the course of the disease by promoting healing of the wound. Furthermore, this treatment plan is also applicable to wound necrosis caused by other snake toxins, such as tissue necrosis caused by elapidae and viper families.
This trial is registered in the Chinese Clinical Trial Registry, a primary registry of International Clinical Trial Registry Platform, World Health Organization (Registration No. ChiCTR2200059070; trial URL:http://www.chictr.org.cn/edit.aspx?pid=134353&htm=4).
本研究旨在评估抗蛇毒血清阻断疗法治疗中华眼镜蛇(Naja atra)咬伤所致局部组织坏死的临床疗效。
符合纳入标准的 50 例中华眼镜蛇咬伤患者被随机分为两组:实验组(n=25)和对照组(n=25)。实验组接受常规加抗蛇毒血清阻断治疗,对照组则给予常规加糜蛋白酶阻断治疗。检测两组患者蛇伤周围组织坏死体积,分别于第 1、3、7 天进行。治疗第 3 天,随机选取部分伤口局部组织行病理活检,观察局部组织坏死体积,并记录创面愈合时间。
治疗后第 3、7 天,实验组的伤口坏死体积明显小于对照组,实验组的创面愈合时间短于对照组(均 P<0.05)。对照组的病理活检显示核固缩、碎裂、核密度稀疏、边缘模糊,坏死程度明显高于实验组。
抗蛇毒血清阻断疗法是一种治疗中华眼镜蛇咬伤后局部组织坏死的新方法,疗效良好,优于常规糜蛋白酶阻断疗法。它可以更好地中和和阻止毒素的扩散,减少组织坏死,促进伤口愈合,缩短疾病病程。此外,该治疗方案还适用于其他蛇毒引起的伤口坏死,如眼镜蛇科和蝰科引起的组织坏死。
本试验在中国临床试验注册中心注册,该中心是世界卫生组织国际临床试验注册平台的一级注册机构(注册号 ChiCTR2200059070;试验网址:http://www.chictr.org.cn/edit.aspx?pid=134353&htm=4)。