Epidemiological Investigation And Distribution Of TCM Syndrome Types In Venomous Snake Bites In Quanzhou

ObjectiveThe purpose of this study was to obtain the epidemiological characteristics and distribution characteristics of TCM syndrome types in patients with venomous snake bites in Quanzhou,and to provide an important evidence-based medical basis for the prevention and treatment of venomous snakebites and the development of TCM treatment in the area.MethodsA total of 1750 patients with venomous snakebite who were treated in the surgical inpatient department of Quanzhou Hospital of Traditional Chinese Medicine affiliated to Fujian University of Traditional Chinese Medicine from 2017.01.01 to 2019.12.31 were selected as the research objects.The month of the bite,the time of visiting a doctor after the injury,the site of the bite,the species of snake that caused the injury),whether pre-hospital treatment was performed,the severity of the disease,the outcome of the disease and the distribution of TCM syndrome types,fill in the epidemiological history questionnaire and the severity of the patient’s condition The severity score table was used to analyze the data statistically,and to explore the epidemiological characteristics,factors affecting the severity of the disease,the outcome of the disease and the distribution of TCM syndrome types in patients with venomous snake bites in Quanzhou.Results(1)General information of the patients: The patients with venomous snake bites in Quanzhou are mainly male;the age is mainly middle-aged and elderly people,most of whom are 41 to 70 years old;the area with the highest number of snakebite incidents is Nan’an City;In July,August,September and October,there was a peak state;96.69% of the patients were able to go to the hospital for effective treatment within 24 hours after being bitten by a poisonous snake,and the treatment was concentrated in 0 to 4 hours;the injured parts were concentrated in the limbs;Of the venomous snakes that bit the crowd,70.4% were Bamboo Leaf Snakes,with a total of 1232 cases.(2)The severity of the disease: mainly mild,with a total of 1486 cases(84.91%),228cases(13.03%)of moderate patients,and 36 cases(2.06%)of severe cases.The snake species,age,time of visiting a doctor after injury,and whether prehospital treatment was performed were independently related to the severity of snakebite patients.Among them,the proportion of patients with poisonous snakes with wind-toxin syndrome(OR=4.331,95%Cl: 2.054-9.133,P<0.001)and poisonous snakes with wind-fire syndrome(OR=12.933,95%Cl: 7.575-22.083,P<0.001)had a higher incidence of injury.The severity of injuries caused by poisonous snakes with fire poison syndrome was higher;the severity of elderly patients(age >65 years)was higher(OR=1.673,95%Cl: 1.142-2.451,P=0.008);the time to see a doctor after injury was prolonged(>4h))patients had higher severity(OR=11.734,95%Cl: 8.347-16.496,P<0.001);patients without prehospital treatment had significantly higher severity(OR=7.900,95%Cl: 5.531-11.282,P<0.001).(3)Disease outcome: the cure rate was 91.08%,the improvement rate was 8.57%,and the mortality rate was 0.34%.(4)The distribution of TCM syndrome types: fire poison syndrome is the main type,accounting for 87.43% of the total cases,wind poison syndrome accounts for 4.11%,wind fire poison syndrome accounts for 6.57%,and snake venom syndrome accounts for 1.89%.Among the syndrome types,the highest cure rate was fire poison syndrome,reaching 94.51%,and the highest mortality rates were snake venom trapping syndrome and wind poison syndrome,which were 9.09% and 4.16%,respectively.The main species of snakes injured by snake venom invagination are fire poisonous snakes and wind-fired poisonous snakes,accounting for 60.61% and 39.39%,respectively.The time for patients to go to a doctor after injury is mainly >4 hours,accounting for 66.67%,and no pre-hospital treatment is carried out.of patients accounted for 69.70%,and the overall prognosis was poor.Conclusion(1)Most of the snakebite patients in Quanzhou are males and middle-aged and elderly people.Nan’an has a high incidence,and the incidence peaks from July to October.Most of the injured parts are the limbs.Within 4 hours of seeing a doctor,most patients had mild disease severity,and the overall prognosis was good.(2)Elderly patients(age > 65 years old)who did not receive pre-hospital treatment,and the time of visiting a doctor after injury was prolonged(> 4 hours).(3)The distribution of TCM syndrome types in patients with venomous snake bites in Quanzhou is dominated by fire poison syndrome.The syndrome with the highest cure rate in this area is the fire poison syndrome,and the dead patients are concentrated in the wind poison syndrome and the snake venom syndrome.Snake venom invagination syndrome mainly comes from the patients with wind-fire poison syndrome and fire poison syndrome.It is serious and has a poor prognosis,which should be paid attention to.(4)Quanzhou is an area with high incidence of venomous snake bites.It is necessary to improve the snakebite treatment system,build multiple treatment centers,carry out targeted prevention and treatment,and strengthen the popularization of the masses,especially for silver ring snakes,pit vipers,Understanding cobras and learning to conduct pre-hospital first aid treatment are of great significance to reducing the severe rate of snakebite bites in this area,as well as the disability and fatality rates.