改良蓝光灯箱照射联合中药煮散剂退黄散药浴治疗新生儿黄疸的临床观察

Blue light modified phototherapy combined with Tuihuangsan bath for neonatal jaundice

目的观察改良蓝光灯箱照射联合中药煮散剂退黄散药浴治疗新生儿黄疸的临床疗效。方法将81例新生儿黄疸患儿按照随机数字表法分为2组,对照组41例予常规蓝光箱照射联合茵栀黄口服液治疗,治疗组40例予改良蓝光灯箱照射联合中药煮散剂退黄散药浴治疗。2组均治疗4 d,比较2组患儿治疗前及治疗4 d后中医症状面色黄鲜亮如橘、不欲吮乳、小便黄赤、哭声响亮及腹胀评分变化情况,比较2组治疗前及治疗2、4 d后总胆红素水平变化情况,比较2组治疗期间眼部分泌物、尿布疹、哭闹烦躁、母乳喂养困难和不足、腹泻及体温>37.5℃不良反应发生情况。结果与本组治疗前比较,2组治疗4 d后中医症状面色黄鲜亮如橘、不欲吮乳、小便黄赤、哭声响亮及腹胀评分均降低(P<0.05),但2组治疗4 d后组间比较差异均无统计学意义(P>0.05)。与本组治疗前比较,2组治疗后2、4 d后总胆红素水平均降低(P<0.05),但2组治疗2、4 d后组间同期比较差异均无统计学意义(P>0.05)。治疗组治疗期间眼部分泌物发生率0,尿布疹发生率5.0%(2/40),哭闹烦躁发生率5.0%(2/40),母乳喂养困难和不足发生率5.0%(2/40),腹泻发生率12.5%(5/40),体温>37.5℃发生率5.0%(2/40),对照组分别为24.4%(10/41)、19.5%(8/41)、73.2%(30/41)、48.8%(20/41)、73.2%(30/41)、19.5%(8/41),治疗组各项不良反应发生率均低于对照组(P<0.05)。结论改良蓝光灯箱照射联合中药煮散剂退黄散药浴治疗新生儿黄疸疗效确切、稳定,可改善患儿中医症状表现,降低总胆红素水平,并能有效减少不良反应的发生,护理方便,费用低廉,能保证母乳喂养的开展。

Objective To observe blue light modified phototherapy combined with Tuihuangsan traditional Chinese medicine(TCM)bath for neonatal jaundice.Methods Totally 81 cases of neonatal Jaundice were randomly assigned to receive blue light conventional phototherapy+Yinzhihuang oral liquid(control group,n=41)or blue light modified phototherapy+Tuihuangsan TCM bath(treatment group,n=40)for 4 days.On days 0,2 and 4 days of treatment,the TCM symptoms scores(bright orange complexion,unwilling to suck,yellow urine,loud crying,abdominal distension),and total bilirubin levels,adverse reactions(eye secretion,diaper rash,irritability,breastfeeding difficulties and support insufficient,diarrhea,body temperature>37.5℃)were included as comparators.Results After treatment,the TCM symptom scores on day 4 were significant lower in both groups(P<0.05),but insignificant difference between both groups(P>0.05).The total bilirubin on days 2,4 were significant lower in both groups(P<0.05),but insignificant difference between both groups(P>0.05).The treatment group had significant lower adverse reactions than the control group(P<0.05),including eye secretion for 0 vs 24.4%(10/41),diaper rash for 5.0%(2/40)vs 19.5%(8/41),irritability for 5.0%(2/40)vs 73.2%(30/41),breastfeeding difficulties and support insufficient for 5.0%(2/40)vs 48.8%(20/41),diarrhea for 12.5%(5/40)vs 73.2%(30/41),body temperature>37.5℃for 5.0%(2/40)vs 19.5%(8/41).Conclusion For neonatal jaundice,blue light modified phototherapy+Tuihuangsan TCM bath can improve the TCM symptoms,reduce total bilirubin,decreased adverse reactions,and the characteristic of convenient nursing and cost Inexpensive contribute to breastfeeding development.