新生儿退黄洗液对黄疸治疗作用的实验及临床研究

Animal Experiment and Clinical Study on Chinese Herbal Jaundice-Abating Lotion (Tui Huang Xi Ye) in Treatment of Jaundice

目的探讨新生儿退黄洗液对实验性溶血性黄疸大鼠和新生儿病理性黄疸的疗效。方法 (1)动物实验:50只大鼠按随机数字表法分为5组,每组10只,其中1组为正常组,另4组采用腹腔内注射乙酰苯肼的方法制成大鼠溶血性黄疸模型,再分为模型组和高、中、低浓度洗液组。高、中、低浓度洗液组采用新生儿退黄洗液(由茵陈、大黄、栀子、柴胡、郁金、金钱草、车前子、白术、党参、茯苓、甘草、鸡内金、枳壳、麦芽、丹参等中药组成,原液稀释5倍、10倍、50倍)对黄疸大鼠模型进行泡浴,正常组、模型组采用温水泡浴。测定各组大鼠血清总胆红素、直接胆红素、间接胆红素、谷丙转氨酶、谷草转氨酶、总胆汁酸含量。(2)临床研究:90例病理性黄疸患儿按随机数字表法分为治疗组和对照组各45例。两组口服药相同,治疗组增加低浓度新生儿退黄洗液(原液稀释50倍)泡浴,两组治疗期间若黄疸加重则转蓝光治疗。比较两组的转光疗率及血清总胆红素、直接胆红素、间接胆红素含量。结果 (1)实验研究:乙酰苯肼成功制造大鼠溶血性黄疸模型;高、中、低浓度洗液组大鼠血清总胆红素、直接胆红素、间接胆红素、谷丙转氨酶、谷草转氨酶、总胆汁酸含量均明显低于模型组(P<0.05),但仍明显高于正常组(P<0.05);高、中、低浓度洗液组大鼠血清总胆红素、直接胆红素、间接胆红素、谷丙转氨酶、谷草转氨酶、总胆汁酸含量比较,差异无统计学意义(P>0.05)。(2)临床研究:治疗组转光疗率为11.11%(5/45),明显低于对照组的28.89%(13/45)(P<0.05);剔除转光疗的患儿后,治疗前两组患儿血清总胆红素、直接胆红素、间接胆红素水平比较,差异无统计学意义(P>0.05);治疗后两组血清总胆红素、间接胆红素含量较治疗前明显下降(P<0.05),但治疗组下降程度比对照组大(P<0.05)。治疗后两组患儿血清直接胆红素水平均较治疗前下降,但差异无统计学意义(P>0.05),治疗后治疗组下降程度比对照组大(P<0.05)。结论新生儿退黄洗液对实验性溶血性黄疸大鼠有效,对新生儿病理性黄疸疗效显著。

Objective To study the effects of Chinese herbal jaundice-abating lotion （Tui Huang Xi Ye） on hemolytic jaundice among rats and neonatal jaundice. Methods ① Animal experiment：50 adult rats were randomly divided into five groups according to random number table, 10 rats in each group. Except the normal group,the rats in other four groups were induced hemolytic jaundice by intraperitoneal injection of acetylphenylhydrazine （APH） and were divided into model group and high-,moderate- and low-concentration groups. The rats in the high-,moderate- and low-concentration groups were treated with different concentrations of Chinese herbal lotion-bath （diluted by 5,10,50 times）, while the rats in the normal group and model group were treated with distilled water-bath. The levels of serum total bilirubin,direct bilirubin, indirect bilirubin, glutamic-pyruvic transaminase （ALT）, glutamic-oxalacetic transaminase （AST） and total bile acid（TBA） were measured in all groups. ② Clinical research： 90 newborn infants with pathologic jaundice were randomly divided into two groups according to random number table,45 neonates in the treatment group and 45 in the control group. Both groups received oral drugs and the infants in the treatment group received low concentration ofChinese herbal lotion-bath additionally （diluted by 50 times）. The infants would receive phototherapy as soon as the level of bilirubin reached the range of phototherapy in both groups. The rate of phototherapy requirement, the serum levels of total bilirubin, direct bilirubin and indirect bilirubin were detected in both groups. Results ① Experiment study ：The rat model of hemolytic jaundice was successful induced by APH. The serum levels of total bilirubin, direct bilirubin,indirect bilirubin,ALT,AST and TBA in the high-,moderate- and low-concentration groups were significantly lower than those in the model group （P 〈0.05） ,but were significantly higher than those in the normal group （P 〈0.05）. The serum levels of total bilirubin,direct bilirubin,indirect bilirubin,ALT,AST and TBA showed no significant difference among high-, moderate- and low-concentration groups （P 〉 0.05 ）. ② Clinical study ：The rate of neonates received phototherapy in the treatment group were less than that in the control group[ 11.11% （5/45） vs 28.80% （13/45）,P 〈0.05 ]. There was no significant difference in the sermn levels of total bilirubin,direct bilirubin and direct bilirubin before treatment between two groups except the neonates received phototherapy （ P 〉 0.05 ）. After treatment, the serum levels of total bilirubin and indirect bilirubin declined significantly in comparison with those before treatment in both groups （P 〈 0.05 ）, but the decrease in the treatment group was more significant than that in the control group （ P 〈 0.05 ）. After treatment, the serum levels of direct bilirubin declined in both groups, but showed no significant difference in comparison with those before treatment, the decrease in the treatment group was more significant than that in the control group （ P 〈 0.05 ）. Conclusion The therapeutic effect of Chinese herbal jaundice-abating lotion is effective for treating rats with hemolytic jaundice as well as has a significant efficacy on neonatal pathologic jaundice.