ABSTRACT
OBJECTIVE: To evaluate the therapeutic effects between comprehensive therapy and routine therapy in treatment of occupational chronic n-hexane poisoning. METHODS: By randomized controlled trial,116 cases with occupational chronic n-hexane poisoning were divided into two groups: the control group( n = 58) and the treatment group( n = 58). Subjects in the control group were given vitamin B_(12) and vitamin B_1 for neural nutrition; and Danshen and deproteinized calf blood extractive injection for activating blood circulation to dissipate blood stasis. Subjects in the treatment group were treated with comprehensive treatment including traditional Chinese and Western medicine,which including mouse nerve growth factor,acupuncture,physical therapy( infraredtherapy,microwave irradiation therapy),Chinese medicine steamingwashing and comprehensive rehabilitation therapy for a period of 12 weeks in addition to the conventional treatment. The curative effect and adverse reactions of both groups were observed after 12 weeks,and the treatment results and hospital stay were followed up. RESULTS: Before treatment,no significant differences( P > 0. 05) were noted in both groups in scores of neurological symptoms,signs,activities of daily living and neurogenic damage indexes of electroneuromyography[including motor digital latency( MDL),motor nerve conduction velocity( MCV),sense nerve conduction velocity( SCV) of median nerve,ulnar nerve,sural nerve or common peroneal nerve; and the detection of lengthen MDL,shorten MCV and SCV]. After treatment,patients in both groups got better in terms of the above indicators( P < 0. 05),with larger extend of improvement noted in the treatment group than in the control group( P < 0. 05). No obvious adverse reactions were noted in the 2 groups. Hospital stay of patients in the treatment group was about 2 months shorter than that in the control group( P < 0. 05). CONCLUSION: The therapeutic effects of comprehensive therapy on occupational chronic n-hexane poisoning are obviously better than routine therapy,which is an effective and safe therapeutic method.
ABSTRACT
OBJECTIVE: To collect,analyze and summarize the clinical characteristics of occupational chronic n-hexane poisoning cases reported in the literatures published in domestic open public periodicals in order to provide evidence for the revision of GBZ 84 Diagnostic Criteria of Occupational Chronic n-Hexane Poisoning. METHODS: By the bibliometrics method,the databases of CNKI,VIP and WANFANG were used to retrieve literatures on the occupational chronic n-hexane poisoning published from 1990 to 2014. The literatures with detailed clinical data were screened and selected for summary and analysis. RESULTS: A total of 68 reference literatures meeting the inclusion criteria were chosen in 25 years of domestic publication. These literatures reported 1 027 cases of occupational n-hexane poisoning,including 165 males and 862 females. The median of age was 28. 3( 13. 0-59. 0) years. Most of the cases had a disease incubation period of 2. 0-10. 0months. The diagnostic classification was made in 817 cases( 79. 6%),with mild,moderate and severe chronic n-hexane poisoning in 418,241 and 158 cases,respectively. The n-hexane levels in workplace air were reported in 736 cases( 71. 7%),91. 8%( 676 /736) of which had exceeded the national occupational exposure limit. Chronic n-hexane poisoning was mainly characterized by peripheral nerve damage,626 cases( 61. 0%) had feeling and movement disorders,256 cases( 24. 9%) had movement disorder and 145 cases( 14. 1%) had feeling disorders. The clinical characteristics of these disorders were bilaterally symmetric feeling or movement disorders in distal limbs. The nerve-electromyography examination showed the neurogenic damage,which was parallel with the severity of patients' condition and could be detected at early stage of illness. The gas chromatography was used to detect the 2,5-hexanedione level of 156 cases( 15. 2%) of patients and the positive detection rate was 50. 6%( 70 /156). Currently,there was no specific medication or other therapy for treatment of chronic n-hexane poisoning. The comprehensive therapy which mainly include nerve restoration was the general therapy method. Addition of mouse nerve growth factor to the conventional therapy had significant treatment effects. The therapeutic effect was reported in 954 cases with the recovery rate of 83. 6%( 798 /954),and the complication in nervous system was observed in 156 cases who were not cured. CONCLUSION: The main clinical manifestation of chronic n-hexane poisoning is peripheral neuropathy. The nerve-electromyography is the most important diagnostic method. Currently,comprehensive therapy is used with good prognosis in the patients.