复方茵陈糖浆联合益生菌与间歇光疗治疗新生儿母乳性黄疸疗效观察

Curative effect of compound yinchen syrup combined with probiotics and intermittent phototherapy in the treatment of neonatal breast milk jaundice

目的观察复方茵陈糖浆联合益生菌及光疗治疗新生儿母乳性黄疸的临床疗效。方法选择2017年9月至2018年8月青海省人民医院收治的母乳性黄疸新生儿80例为研究对象。将患儿分为对照组和观察组,每组40例。2组患儿均不停止母乳,在此基础上,对照组患儿给予双歧杆菌三联活菌肠溶胶囊0. 105 g,每日2次,治疗5 d,如胆红素水平达到光疗标准即进行光疗;观察组患儿在对照组治疗基础上给予复方茵陈糖浆1 mL,口服,每日2次,治疗5 d。比较2组患儿的临床疗效,治疗前后血清胆红素水平和T细胞亚群水平。结果治疗后,观察组和对照组患儿总有效率分别为100%(40/40)和85%(34/40),观察组患儿治疗总有效率显著高于对照组(χ^2=4. 505,P <0. 05)。治疗前2组患儿血清总胆红素水平比较差异无统计学意义(P> 0. 05);治疗后,2组患儿血清总胆红素水平均低于治疗前(P <0. 05);且观察组患儿血清总胆红素水平显著低于对照组(P <0. 05)。观察组患儿光疗总时长和经皮胆红素测定值下降至119. 5μmol·L^-1的时间均显著低于对照组(P <0. 05)。观察组患儿日均胆红素下降值显著高于对照组(P <0. 05)。治疗前2组患儿CD3^+、CD4^+细胞百分比和CD4^+/CD8^+比值比较差异均无统计学意义(P> 0. 05)。治疗后2组患儿CD3^+、CD4^+细胞百分比和CD4^+/CD8^+比值均高于治疗前(P <0. 05);2组患儿治疗前后CD8^+细胞百分比比较差异无统计学意义(P> 0. 05)。治疗后,观察组患儿CD3^+、CD4^+细胞百分比和CD4^+/CD8^+比值高于对照组(P> 0. 05);2组患儿CD8^+细胞百分比比较差异无统计学意义(P> 0. 05)。观察组和对照组患儿不良反应发生率分别为5. 0%(2/40)和7. 5%(3/40),2组患儿不良反应发生率比较差异无统计学意义(P> 0. 05)。结论复方茵陈糖浆联合益生菌与间歇光疗治疗新生儿母乳性黄疸疗效显著。

Objective To observe the curative effect of compound yinchen syrup combined with probiotics and intermittent phototherapy in the treatment of neonatal breast milk jaundice. Methods Eighty newborns with breast milk jaundice admitted to Qinghai Provincial People’s Hospital from September 2017 to August 2018 were divided into control group and observation group,with 40 cases in each group. All children did not stop breast milk,based on this,the children in the control group were given bifidobacterium trifecta enteric capsule 0. 105 g,twice a day for 5 days. If the level of bilirubin reached the standard of phototherapy,phototherapy was performed. Based on the treatment of the control group,the children in the observation group were given compound yinchen syrup 1 mL orally,twice a day for 5 days. The clinical efficacy of children in the two groups was observed,and the changes of bilirubin levels and T cell subsets level before and after treatment were compared between the two groups. Results After treatment,the total effective rate of children in the observation group and the control group was 100. 00% and 85. 00% respectively;the total effective rate of children in the observation group was significantly higher than that in the control group(χ^2= 4. 505,P < 0. 05). There was no statistic difference in the serum levels of total bilirubin between the two groups before treatment(P > 0. 05). The serum levels of total bilirubin of children in the two groups after treatment were lower than those before treatment(P < 0. 05). After treatment,the serum levels of total bilirubin of children in the observation group were lower than those in the control group(P < 0. 05). The total time of phototherapy and the time of the percutaneous measurement value of bilirubin decreased to 119. 5 μmol·L^-1 were significantly shorter than those in the control group(P < 0. 05). The average daily decrease value of bilirubin in the observation group was significantly higher than that in the control group(P < 0. 05). There was no significant difference in the CD3^+,CD4^+cell percentage and CD4^+/CD8^+ value between the two groups before treatment(P > 0. 05). The CD3^+,CD4^+ cell percentage and CD4^+/CD8^+ value of children in the two groups after treatment were higher than those before treatment(P < 0. 05);there was no significant difference in the CD8^+ cell percentage before and after treatment in the two groups(P > 0. 05). After treatment,the CD3^+,CD4^+ cell percentage and CD4^+/CD8^+ value of children in the observation group was significantly higher than that in the control group(P < 0. 05);there was no significant difference in the CD8^+cell percentage between the two group(P > 0. 05).The incidence of adverse reactions of children in the observation group and control group was 5. 00%(2/40) and 7. 50%(3/40) respectively;there was no significant difference in the incidence of adverse reactions of children between the two group(χ^2= 0. 213,P > 0. 05). Conclusion Compound yinchen syrup combined with probiotics and intermittent phototherapy has a significant effect on neonatal breast milk jaundice.