【摘要】：目的:觀察健脾祛濕退黃方治療新生兒病理性黃疸(陽黃)的臨床療效及不良反應(yīng),為本病提供一個(gè)安全有效的治療方法。方法:將符合診斷標(biāo)準(zhǔn)的患兒分為治療組和對(duì)照組,治療組32例,對(duì)照組30例。治療組采用健脾祛濕退黃方(黨參、白術(shù)、黃芪、炒麥芽、六神曲、茵陳、梔子、茯苓、柴胡、金銀花)+基礎(chǔ)治療(藍(lán)光治療+有感染者加用抗生素治療),對(duì)照組使用茵梔黃口服液+基礎(chǔ)治療(藍(lán)光治療+有感染者加用抗生素治療),7天為一療程。觀察治療前后兩組患兒中醫(yī)主證、次證積分變化,一個(gè)療程后血清總膽紅素變化、間接膽紅素變化,住院天數(shù),血清總膽紅素、間接膽紅素下降幅度,對(duì)兩組療效進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.對(duì)照組治愈9例,顯效8例,好轉(zhuǎn)7例,無效6例。治療組治愈18例,顯效8例,好轉(zhuǎn)4例,無效2例。兩組療效的比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),治療組優(yōu)于對(duì)照組。2.治療后治療組總膽紅素下降幅度179±2.31umol/L,間接膽紅素下降幅度173.74±0.58umol/L,對(duì)照組總膽紅素下降幅度159.05±8.79umol/L,間接膽紅素下降幅度154.97±1.42umol/L,治療后對(duì)照組與治療組相比,經(jīng)t檢驗(yàn),P0.05,差異有統(tǒng)計(jì)學(xué)意義,治療后兩組血中總膽紅素、間接膽紅素水平均較前下降,治療組下降的幅度更大;治療后對(duì)照組與治療組中醫(yī)證候積分相比,經(jīng)t檢驗(yàn),P0.05,差異有統(tǒng)計(jì)學(xué)意義,治療后兩組中醫(yī)證候積分均較治療前下降,治療組證候積分下降的較顯著。3.治療組住院天數(shù)6.29±0.42天,對(duì)照組住院天數(shù)7.89±0.32天,治療組住院時(shí)間短于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:采用健脾祛濕退黃方治療新生兒病理性黃疸,療效明顯,對(duì)于降低血清總膽紅素值、間接膽紅素值、改善中醫(yī)證候、降低不良反應(yīng)及治愈好轉(zhuǎn)率明顯優(yōu)于茵梔黃口服液對(duì)照組,值得臨床進(jìn)一步推廣。
[Abstract]:Objective: to observe the clinical efficacy and adverse reactions of Jianpi Qushi Huihuanfang in the treatment of neonatal pathological jaundice (Yang Huang), so as to provide a safe and effective treatment method for this disease. Methods: 32 cases in treatment group and 30 cases in control group were divided into two groups: treatment group (n = 32) and control group (n = 30). The treatment group was treated with basic treatment (Codonopsis pilosula, Atractylodes, Astragalus membranaceus, stir-fried malt, six-Shenqu, Yinchen, Gardenia, Poria cocos, Bupleurum chinense, Flos Lonicerae) basic treatment (blue light treatment with infected persons plus antibiotic treatment), The control group was treated with basic treatment of Yinzhihuang oral liquid (blue light treatment with infection plus antibiotics), 7 days as a course of treatment. After treatment, the changes of serum total bilirubin, indirect bilirubin, hospitalization days, serum total bilirubin and indirect bilirubin were observed before and after treatment, and the decrease of serum total bilirubin, serum total bilirubin and indirect bilirubin were observed before and after treatment. The curative effect of the two groups was analyzed statistically. Results: 1. In the control group, 9 cases were cured, 8 cases were markedly effective, 7 cases were improved and 6 cases were ineffective. In the treatment group, 18 cases were cured, 8 cases were markedly effective, 4 cases were improved and 2 cases were ineffective. There was a significant difference in curative effect between the two groups (P0.05). The treatment group was better than the control group. After treatment, the total bilirubin decreased 179 鹵2.31umol / L, indirect bilirubin 173.74 鹵0.58umol / L in the treatment group, 159.05 鹵8.79umol / L in the control group, 154.97 鹵1.42umoll / L in the indirect bilirubin group. After treatment, the control group compared with the treatment group, the t-test, P 0.05, the difference was statistically significant. After treatment, the total bilirubin and indirect bilirubin levels in the two groups were lower than before, and the decrease in the treatment group was greater than that in the control group. After treatment, the scores of TCM syndromes in the control group and the treatment group were significantly lower than those in the treatment group (t test, P 0.05, P 0.05). After treatment, the scores of TCM syndromes in the two groups were all lower than those before treatment. 3. The scores of TCM syndromes in the treatment group were significantly lower than those in the treatment group. The length of hospitalization was 6.29 鹵0.42 days in the treatment group and 7.89 鹵0.32 days in the control group. The length of hospitalization in the treatment group was shorter than that in the control group, and there was a significant difference between the two groups (P0.05). Conclusion: the method of invigorating the spleen and removing dampness and removing yellow water is effective in the treatment of neonatal pathological jaundice, which is effective in reducing the total serum cholinoid value, indirect cholinergic value and improving the syndrome of traditional Chinese medicine (TCM). The rate of reducing adverse reaction and improving cure was obviously better than that of Yinzhihuang oral liquid group, which was worthy of further popularization in clinical practice.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R272

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