黄芪颗粒佐治新生儿缺氧缺血性脑病疗效研究

The Study of the Efficacy of Astragalus Granule on Neonatal Hypoxic Ischemic Encephalopathy

目的:研究黄芪颗粒对新生儿缺氧缺血性脑病(HIE)的治疗效果。方法:106例HIE患儿随机分为两组,两组基础治疗相同,治疗组于入院第3日口服黄芪颗粒,对照组于入院第3日口服尼莫地平,3月后改服吡硫醇,均按年龄增长调整剂量,10d为一疗程,停药3d后再行下一疗程,总疗程7个月。两组患儿由专人对HCT、新生儿行为测定(NBNA)、酶学检查、总胆红素、脑电图、复查的异常症状、体征,再入院强化治疗次数做了对照及疗效评估。结果:治疗组临床症状、酶学检查、胆红素测定、NBNA与对照组比较差异有统计学意义(χ2=4.73,P<0.05)。长期随访治疗组在异常症状、体征、HCT、EEG恢复及再入院次数、脑性瘫痪方面与对照组比较差异有统计学意义(P<0.05,<0.01)。结论:黄芪颗粒佐治HIE近远期疗效肯定,用药安全,值得推广应用。

Objective： To study the efficacy of astragalus granule in treating neonatal hypoxic ischemic encephalopathy （HIE）. Methods： One hundred and six newborns with HIE were divided into treatment group and control group with the same basic treatment in both groups. The patients of the treatment group were given astragalus oral granules in addition on the third day of hospitalization, and the dose of astragalus granule was gradually added until the end of the seventh month. The patients of the control group were given oral nimodipine also on the third day of hospitalization, and three monthes later, nimodipine were changed into pyritinol whose dose was also gradually added until the end of the seventh month. Some related items, such as head CT, neonatal behavioral neurological tests （NBNA）, enzymology check, total bilirubin, electroencephalogram （EEG）, clinical symptoms and signs revealed in re-examination and the numbers of patients re-hospitalized for intensive therapy, were controlled and evaluated by professionals. Results： After treatment, the differences between treatment group and control group in clinical symptoms and signs, enzymology check, total bilirubin, NBNA, were statistically significant （χ^2 =4.73, P〈0.05）. After long-term follow-up, the differences in abnormal symptoms and signs, HCT, recovery of EEG, the numbers of re-hospitalization for intensive therapy and cerebral palsy were also statistically significant （ P 〈 0. 05, P 〈 0. 01 ）. Conclusions： Astragalus granule is effective and safe in treating HIE, and is worthy of popularization and application.