茵陈理中汤化裁内服联合熏蒸对新生儿黄疸患者血清胆红素、黄疸消退情况影响

Clinical Research on the Effect of Serum Bilirubin and Jaundice Subsided Staste for Treating Neonatal Jaundice Children with Yinchen Lizhong Decoction for Oral and Fumigation

目的:观察用茵陈理中汤化裁而成的中药汤剂内服联合熏蒸对新生儿黄疸的治疗效果,并探讨其对患者血清胆红素及黄疸消退情况的影响。方法:选取2013年4月—2014年11月就诊于我院的寒湿阻滞型新生儿黄疸82例,按照随机数字表法分为对照组和观察组各41例。对照组患儿给予苯巴比妥片内服及蓝光照射治疗;观察组患儿则在此基础上联合给予由茵陈理中汤化裁而成的中药汤剂内服联合熏蒸,1剂/d,连续治疗7 d;治疗后观察患儿主要症状的缓解情况,计算临床治疗的有效率;检测患儿胆红素水平变化;记录胆红素降至正常的时间及黄疸消退时间、住院时间。结果:患儿经治疗后面目皮肤发黄、黄色晦黯、脘痞腹胀、便溏、乏力倦怠等主要症状有不同程度的改善,观察组患儿的改善尤其明显,其有效率90.2%明显高于对照组治疗的有效率70.7%,差异具有统计学意义(P<0.05);两组患儿的胆红素水平与治疗前相比有所降低,观察组患儿的降低幅度明显大于对照组患儿,差异具有统计学意义(P<0.05);观察组患儿胆红素降至正常的时间、黄疸消退时间及住院时间较对照组更短,差异具有统计学意义(P<0.05)。结论:茵陈理中汤化裁而成的中药汤剂长于温中化湿,其谨守患儿"寒湿困脾"的病机特点,内服联合熏蒸能显著改善新生儿黄疸的症状,利于胆红素水平的降低及黄疸的消退,有效缩短病程,疗效确切,凸显出中医药辨证论治儿科疾病的优势与特色,值得临床广泛推广运用。

Objective：To investigate the clinical efficacy of treatingneonatal jaundice children with Yinchen Lizhong Decoction, and explore the effect of serum bilirubin and jaundice subsided state. Methods ： 82 neonatal jaundice children were randomly divided into a control group of 41 cases and anobservation group of 41 cases from April 2013 to November 2014.Patients in the control group were treated with phenobarbital tablets and blue light;while patients in the observation group were treated with Yinehen Lizhong Decoction for oral and fumigation, 1 agent/day, 7 days for treatment. We observed the improvement state of symptoms, and evaluated the clinical curative effect ; we tested the level of serum bilirubinpretherapy and post-treatment, and recorded the time of bilirubin drop to normal, jaundice recession and hospital stays. Results ： After treatment, the main clinical symptoms of the patients in two groups, such as facial skin yellow, dark yellow, abdominal distension, loose stool and lack of burnout, were improved clearly compared with before treatment, the degree of change in the observation group was more pronounced, the efficiency for patients in the observation group is 90.2%, which was higher than that of the controlgroup 70.7%, the difference is significant （ P〈0.05 ）; the level of serum bilirubin went down clearly, the degree of change in the observation group was more pronounced, the difference is significant （P〈0.05）; the time of bilirubin drop to normal, jaundice recession and hospital staysfor patients in the observation group was shorter than that of the controlgroup, the difference is significant （ P〈0.05 ）. Conclusion ： The self-made decoction is form yinchen lizhong decoction and good at warming the spleen and dissipating dampness, which is closely matched with thepathogenesis characteristics of cold-dampness disturbing spleen. The therapy can improve the clinical symptoms. Meanwhile, it is good at lowing the level of serum biliruhin and jaundice recession, can effectively shorten the duration of symptoms, which has curative effect, can high light the advantages and characteristics of treating pediatric disease with traditional Chinese medicine, is worthy of further research and development.