本文選題：新生兒 + 茵陳地黃湯��； 參考：《廣西中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:觀察茵陳地黃湯聯(lián)合藍光治療早期新生兒病理性黃疸的臨床療效及不良反應,為茵陳地黃湯在早期新生兒病理性黃疸的臨床應用提供臨床依據(jù)。方法:將符合納入標準的100例新生兒病理性黃疸患兒按就診順序單號分為觀察組,雙號分為對照組,每組各50例。對照組單純使用基礎治療(常規(guī)藍光治療、口服金雙歧、補液及新生兒常規(guī)護理),觀察組在對照組的基礎上加茵陳地黃湯,3天為一療程。觀察兩組患兒每日經(jīng)皮膽紅素值、總共接受光療時間及一個療程后血清膽紅素值、不良反應發(fā)生率等情況。收集所有觀察指標,進行統(tǒng)計學分析并評價其療效。結果:(1)兩組患兒胎齡、性別、體重、入院日齡、原發(fā)疾病種類、治療前血清總膽紅素、直接膽紅素、間接膽紅素、經(jīng)皮膽紅素值,差異均無統(tǒng)計學意義(p0.05),具有可比性。(2)治療后第1、2、3天觀察組經(jīng)皮測膽紅素值均低于對照組,p均0.05,差異有統(tǒng)計學意義,提示觀察組能更好的降低經(jīng)皮膽紅素值,在今后的治療里觀察組再次光療的機會及光療時間低于對照組。(3)兩組患兒治療前與治療后血清總膽紅素比較,治療后血清總膽紅素值均低于治療前,差異有統(tǒng)計學意義(p0.05),提示兩組均能明顯降低膽紅素水平。(4)兩組患兒治療后血清總膽紅素比較,觀察組血清總膽紅素值低于對照組(p0.05),提示觀察組較對照組能更好地降低血清膽紅素值。(5)兩組患兒光療時間比較,觀察組光療時間低于對照組,差異有統(tǒng)計學意義(p0.05),提示加用茵陳地黃湯能有效縮短光療時間。(6)兩組療效比較,觀察組優(yōu)于對照組,差異有統(tǒng)計學意義(p0.05)。(7)兩組患兒治療后不良反應發(fā)生情況比較,觀察組不良反應發(fā)生率低于對照組,差異有統(tǒng)計學意義(p0.05),說明茵陳地黃湯聯(lián)合藍光治療可明顯降低藍光治療不良反應發(fā)生率。結論:(1)茵陳地黃湯聯(lián)合藍光治療可有效降低早期新生兒病理性黃疸濕熱熏蒸證患兒血清膽紅素、經(jīng)皮膽紅素水平,有較好退黃療效。(2)茵陳地黃湯聯(lián)合藍光治療可縮短光療時間,降低藍光治療不良反應發(fā)生率,值得臨床推廣。
[Abstract]:Objective: to observe the clinical efficacy and adverse reactions of Yinchen Dihuang decoction combined with blue light in the treatment of early neonatal pathological jaundice, and to provide clinical basis for the clinical application of Yinchen Dihuang decoction in the early stage of pathological jaundice of newborn. Methods: 100 neonates with pathological jaundice were divided into observation group (n = 50) and control group (n = 50). The control group was treated only with basic therapy (routine blue light therapy, oral administration of gold bifidus, fluid rehydration and routine nursing care of newborns). The observation group was treated with Yinchendihuang decoction for 3 days on the basis of the control group. The values of daily percutaneous bilirubin, the time of phototherapy, the serum bilirubin and the incidence of adverse reactions were observed. All observation indexes were collected, analyzed statistically and the curative effect was evaluated. Results (1) gestational age, sex, body weight, admission age, type of primary disease, serum total bilirubin, direct bilirubin, indirect bilirubin, percutaneous bilirubin were measured in both groups. There was no significant difference between the two groups (P 0.05, P < 0.05). The results showed that the values of bilirubin in the observation group were significantly lower than those in the control group on the 1st and 2nd day after treatment, which indicated that the observation group could reduce the value of transdermal bilirubin better than that of the control group (P < 0.05). The opportunity and duration of phototherapy in the observation group were lower than those in the control group (P < 0.05). The serum total bilirubin levels were lower before and after treatment in the observation group than in the control group, and the serum total bilirubin levels after treatment were lower than those before treatment. The difference was statistically significant (P 0.05), indicating that the two groups could significantly reduce the level of bilirubin. The serum total bilirubin value in the observation group was lower than that in the control group (p 0.05), suggesting that the observation group could lower the serum bilirubin value better than the control group.) the phototherapy time of the observation group was lower than that of the control group, and that of the observation group was lower than that of the control group. The difference was statistically significant (P 0.05), suggesting that the addition of Yinchen Dihuang decoction could effectively shorten the time of phototherapy between the two groups. The observation group was better than the control group, and the difference was statistically significant. The incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant (P 0.05), which indicated that Yinchendihuang decoction combined with blue light therapy could significantly reduce the incidence of adverse reactions in the blue light therapy. Conclusion (1) Yinchendihuang decoction combined with blue light therapy can effectively reduce serum bilirubin and transdermal bilirubin level in early neonates with pathological jaundice damp-heat fumigation syndrome. Reducing the incidence of adverse reactions in blue light therapy is worthy of clinical promotion.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R722.17

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