茵栀黄口服液、布拉氏酵母菌散联合间歇蓝光照射治疗新生儿黄疸的疗效及对血清NSE、ALP、FFA的影响

Therapeutic effect of Yinzhihuang oral liquid and saccharomyces boulardii powder combined with intermittent blue light irradiation on neonatal jaundice and its effect on serum NSE,ALP and FFA

目的探讨茵栀黄口服液、布拉氏酵母菌散联合间歇蓝光照射治疗新生儿黄疸的效果及对血清神经元特异性烯醇化酶(NSE)、碱性磷酸酶(ALP)、游离脂肪酸(FFA)的影响。方法将2019年1月至2021年11月长沙市第四医院收治的122例新生儿黄疸纳入本次前瞻性研究,根据区组随机法分为对照组(n=61)与研究组(n=61)。对照组患儿给予布拉氏酵母菌散+多次间歇蓝光照射治疗,研究组给予茵栀黄口服液+布拉氏酵母菌散+多次间歇蓝光照射治疗。比较两组的临床疗效,住院时间和黄疸消退时间,治疗前后总胆红素(TBIL)、间接胆红素(IBIL)、结合胆红素(DBIL)水平,治疗前后NSE、ALP、FFA水平及不良反应发生率。结果研究组治疗的总有效率为96.72%,显著高于对照组(86.89%),差异有统计学意义(P<0.05)。研究组患儿黄疸消退时间和住院时间分别为(6.50±2.60)d、(7.30±2.10)d,均显著短于对照组[(9.50±2.40)d、(11.00±2.70)d],差异均有统计学意义(P<0.05)。观察组治疗后的血清TBIL、IBIL、DBIL水平为(113.52±8.62)、(104.55±6.88)、(7.25±1.02)μmol/L,均较显著低于对照组[(145.28±9.17)、(138.46±7.75)、(9.07±1.21)μmol/L],差异均有统计学意义(P<0.05)。研究组治疗后的血清NSE、ALP和FFA分别为(22.15±4.03)、(133.52±15.06)、(2536.55±135.12)ng/L,均显著低于对照组[(39.02±4.26)、(169.76±16.11)、(3041.95±144.76)ng/L],差异均有统计学意义(P<0.05)。两组患者中不良反应发生率比较(13.11%vs.8.20%),差异无统计学意义(P>0.05)。结论茵栀黄口服液、布拉氏酵母菌散联合间歇蓝光照射疗法治疗新生儿黄疸的疗效良好,且安全性较高,可缩短患儿住院时间,显著降低血清胆红素、NSE、ALP、FFA水平,值得临床推广应用。

Objective To explore the effect of Yinzhihuang oral liquid and saccharomyces boulardii powder combined with intermittent blue light irradiation on neonatal jaundice(NNJ)and its effect on serum neuron specific enolase(NSE),alkaline phosphatase(ALP)and free fatty acid(FFA).Methods A total of 122 patients with NNJ admitted to the Fourth Hospital of Changsha from January 2019 to November 2021 were enrolled in this prospective study.They were randomly divided into control group(n=61)and study group(n=61).Children in the control group were treated with saccharomyces boulardii powder plus multiple intermittent blue light irradiation,and those in the study group were treated with Yinzhihuang oral liquid+saccharomyces boulardii powder+multiple intermittent blue light irradiation.The clinical efficacy,hospitalization time and jaundice regression time,the level of total bilirubin(TBIL),indirect bilirubin(IBIL),direct bilirubin(DBIL)before and after treatment,the levels of NSE,ALP and FFA before and after treatment and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of treatment in the study group was 96.72%,which was significantly higher than that in the control group(86.89%),and the difference was statistically significant(P<0.05).The jaundice subsidence time and hospitalization time of the children in the study group were(6.50±2.60)d and(7.30±2.10)d,respectively,which were significantly shorter than those in the control group[(9.50±2.40)d,(11.00±2.70)d],and the differences were statistical significance(P<0.05).The levels of serum TBIL,IBIL and DBIL in the observation group after treatment were(113.52±8.62)μmol/L,(104.55±6.88)μmol/L,(7.25±1.02)μmol/L,which were significantly lower than those in the control group[(145.28±9.17)μmol/L,(138.46±7.75)μmol/L,(9.07±1.21)μmol/L],the differences were statistically significant(P<0.05).The levels of serum NSE,ALP and FFA after treatment in the study group were(22.15±4.03)ng/L,(133.52±15.06)ng/L and(2536.55±135.12)ng/L,respectively,which were significantly lower than those in the control group[(39.02±4.26)ng/L,(169.76±16.11)ng/L and(3041.95±144.76)ng/L],the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(13.11%vs.8.20%)(P>0.05).Conclusion Yinzhihuang oral liquid and saccharomyces boulardii powder combined with intermittent blue light irradiation is effective and safe in the treatment of NNJ.It can shorten the hospitalization time and significantly reduce the levels of serum bilirubin,NSE,ALP and FFA.It is worthy of clinical application.