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目的探讨茵陈颗粒治疗新生儿高胆红素血症的临床疗效及退黄机理。方法选择2012年8月至2013年7月我院新生儿科收治的高胆红素血症新生儿,抽签分为观察组和对照组,均给予原发病治疗、光疗及口服微生态制剂,观察组加服茵陈配方颗粒(2 g/包)每次1/3包,3次/天,共6天。两组患儿治疗前、治疗第4天、第7天分别检测血清总胆红素水平,收集每日尿液、粪便,测定并比较两组粪便中总胆红素、直接胆红素、尿胆原及尿液中胆红素、尿胆原含量。结果研究期间共入选67例新生儿高胆红素血症患儿,其中观察组28例,对照组39例。两组患儿治疗前血清总胆红素值差异无统计学意义(P>0.05),治疗后观察组血清总胆红素下降值明显高于对照组[第4天:(107.3±49.4)μmol/L比(87.6±43.4)μmol/L,第7天:(178.4±53.3)μmol/L比(144.5±48.8)μmol/L,P<0.05]。观察组每日粪便有形成分总量与对照组比较差异无统计学意义(P>0.05);观察组每日粪便中总胆红素及直接胆红素含量均高于对照组[第1天:总胆红素(3.44±1.17)μmol比(2.26±1.02)μmol,直接胆红素(2.42±0.86)μmol比(1.76±0.92)μmol,第4天:总胆红素(1.96±1.33)μmol比(1.32±1.28)μmol,直接胆红素(1.62±1.13)μmol比(0.98±0.65)μmol,P<0.05];两组粪便中尿胆原及尿液中尿胆红素、尿胆原均阴性。结论中药制剂茵陈颗粒通过减少胆红素肠肝偱环,增加粪便中胆红素排出,从而加快黄疸消退,可作为治疗新生儿高胆红素血症的辅助药物。
Objective To investigate the clinical effects of Yinchen granule on the treatment of neonatal hyperbilirubinemia and its mechanism. Methods Newborn infants with hyperbilirubinaemia admitted to neonatology department of our hospital from August 2012 to July 2013 were randomly divided into observation group and control group. All patients were given primary treatment, phototherapy and oral probiotics. Group plus service Yin Chen formula particles (2 g / bag) each 1/3 bag, 3 times / day, a total of 6 days. Serum total bilirubin level was measured before treatment, on the 4th and 7th day of treatment in both groups, daily urine and feces were collected, total bilirubin, direct bilirubin and urine in both groups were measured and compared Gallbladder and urine bilirubin, urinary gallstater content. Results A total of 67 neonates with hyperbilirubinemia were included in the study, 28 in the observation group and 39 in the control group. The serum total bilirubin value of the two groups had no significant difference before treatment (P> 0.05), and the decrease of serum total bilirubin in the observation group was significantly higher than that of the control group [day 4: (107.3 ± 49.4) μmol / L ratio (87.6 ± 43.4) μmol / L, on the seventh day: (178.4 ± 53.3) μmol / L ratio (144.5 ± 48.8) μmol / L, P <0.05]. There was no significant difference between the observation group and the control group (P> 0.05). The contents of total bilirubin and direct bilirubin in the observation group were higher than those in the control group [day 1 Total bilirubin (3.44 ± 1.17) μmol (2.26 ± 1.02) μmol, direct bilirubin (2.42 ± 0.86) μmol (1.76 ± 0.92) μmol and total bilirubin (1.96 ± 1.33) μmolol (1.32 ± 1.28) μmol, direct bilirubin (1.62 ± 1.13) μmol vs (0.98 ± 0.65) μmol, P <0.05]. Urinary bilirubin and urinary bilirubin The original negative. Conclusion Yinchen granule can be used as an adjuvant drug for the treatment of neonatal hyperbilirubinemia by reducing bilirubin enterohepatic ring and increasing excretion of bilirubin in feces, so as to accelerate the regression of jaundice.