布拉氏酵母菌散联合间歇性蓝光照射治疗新生儿黄疸的疗效及对肠道菌群的影响

Effect of Saccharomyces boulardii Sachets combined with intermittent blue light irradiation in the treatment of neonatal jaundice and the impact on gut microbiota

目的探讨布拉氏酵母菌散联合间歇性蓝光照射治疗新生儿黄疸的疗效及对肠道菌群的影响。方法选取2019年3月至2021年1月赣南医学院第二附属医院收治的66例新生儿黄疸患儿作为研究对象,按照随机数字表法分为对照组与观察组,各33例。对照组予以间歇性蓝光照射治疗,观察组在对照组基础上联合布拉氏酵母菌散治疗,比较两组临床疗效与治疗前后黄疸指数、血清胆红素指标[总胆红素(TBiL)、直接胆红素(DBiL)、间接胆红素(IBiL)]、免疫功能指标(IgM、IgA、IgG、CD4^(+)/CD8^(+))及肠道菌群(乳酸杆菌、双歧杆菌)和胎便排空时间、大便次数及不良反应发生率。结果观察组治疗总有效率为93.94%,明显高于对照组的75.76%,差异有统计学意义(P<0.05)。治疗后,两组黄疸指数、TBiL、DBiL及IBiL水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组IgM、IgA、IgG水平均高于治疗前,观察组CD4^(+)/CD8^(+)高于治疗前,且观察组IgM、IgA、IgG及CD4^(+)/CD8^(+)均水平高于对照组,差异有统计学意义(P<0.05);对照组CD4^(+)/CD8^(+)治疗前后比较差异无统计学意义。治疗后,两组乳酸杆菌、双歧杆菌水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组大便次数多于对照组,胎便排空时间短于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为6.06%,对照组为18.18%,两组比较差异无统计学意义。结论布拉氏酵母菌散联合间歇性蓝光照射治疗新生黄疸疗效显著,可明显改善患儿黄疸症状,提升其免疫功能,调整肠道菌群,促进患儿康复。

Objective To investigate the effect of Saccharomyces boulardii Sachets combined with intermittent blue light irradiation in the treatment of neonatal jaundice and the impact on gut microbiota.Methods A total of 66 neonates with jaundice admitted to the Second Affiliated Hospital of Gannan Medical University from March 2019 to January 2021 were selected as the study subjects,they were divided into the control group and the observation group by random number table method,with 33 cases in each group.The control group was treated with intermittent blue light irradiation,while the observation group was treated with Saccharomyces boulardii Sachets on the basis on the treatment of control group,the clinical efficacy,icterus index,serum bilirubin indicators(total bilirubin[TBiL],direct bilirubin[DBiL],and indirect bilirubin[IBiL])immune function indicators(IgM,IgA,IgG and CD4^(+)/CD8^(+)),gut microbiota(Lactobacilli and Bifidobacteria),frequency of bowel movements,meconium emptying time,and incidence of adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 93.94%,which was significantly higher than 75.76%in the control group,the difference was statistically significant(P<0.05).After treatment,icterus index,TBiL,DBiL,and IBiL levels of the two groups were lower than those before treatment,and the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of IgM,IgA and IgG in the two groups were higher than those before treatment,the CD4^(+)/CD8^(+)in the observation group was higher than that before treatment,and the levels of IgA,IgM and IgG,and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05);there was no significant difference in CD4^(+)/CD8^(+)before and after treatment in the control group.After treatment,the levels of Lactobacilli and Bifidobacteria of the two groups were lower than before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05);the frequency of bowel movements in the observation group was more than that in the control group,and meconium emptying time was shorter than that in the control group,the differences were statistically significant(P<0.05).The incidence rates of adverse reactions in the observation group 6.06%,and 18.18%in the control group,there was no significant difference between the groups.Conclusion Saccharomyces boulardii Sachets combined with intermittent blue light irradiation is markedly effective in the treatment of neonatal jaundice,which can significantly improve the symptoms of jaundice in children,enhance their immune function,adjust their gut microbiota,and promote recovery of children.