【作者】 刘风敏；

【导师】 严超英；

【作者基本信息】 吉林大学 ， 临床医学， 2011， 硕士

【摘要】 新生儿黄疸是我国大部分新生儿病室内最主要的收治疾病之一,主要发生于早期新生儿,分为生理性黄疸和病理性黄疸两种。生理性黄疸一般状态良好,一般不需要干预治疗,可自行消退。但约5%～10%的黄疸患儿是需干预治疗的病理性黄疸,如处理不当,严重时可引起胆红素脑病,除可造成神经系统损害外,严重的可引起死亡,故应及时查明病因,并进行积极有效的治疗。目前临床上主要采用综合治疗方法,具体包括:光疗、抗感染、控制溶血等病因治疗,必要时给予碱化血液、白蛋白治疗预防胆红素脑病,达换血指征者予换血治疗。其中又以蓝光照射治疗最为常用,效果显著,但副作用亦较明显。为了减少蓝光照射的副作用,可选择加用口服药缩短光疗时间,但临床上可应用的口服药极少。茵栀黄口服液是根据古方茵陈蒿汤,经长期的临床应用及剂型改革研究才研制而成。鉴于基础医学研究的迅速发展以及对中药制剂研究的高度重视,人们对该制剂的研究日趋活跃。本研究旨在研究茵栀黄口服液的退黄、利胆效果,为临床治疗新生儿黄疸提供一种途径。本文选择了2010年1月至2011年1月于我科诊治的293例诊断新生儿黄疸的足月患儿,均给予综合治疗,治疗组在综合治疗基础上加用茵栀黄口服液。其中治疗组组125例,对照组组168例。对本研究组中的患儿的胎龄(GA)、性别、出生体重(BW)、起病年龄、治疗年龄、大便颜色及性状改变、是否呕吐、腹胀及腹泻、肝功总胆红素(TBIL)、直接胆红素(TBIL)、黄疸消退时间、光疗时间等因素进行记录、统计学分析。比较2组疗效及治疗后1天、3天、5天总胆红素下降值,并对治疗组中早期、晚期新生儿的黄疸的疗效进行对比。其中大便改变、应用药物第3天及第5天胆红素下降值、黄疸消退时间、光疗时间两组比较,P<0.05,有统计学意义。综上得出结论:1.茵栀黄口服液对足月新生儿黄疸的治疗效果确切,可明显减少光疗时间及黄疸消退时间,提高胆红素下降速度。2.茵栀黄口服液起作用时间在用药后的3-5天。3.茵栀黄口服液治疗足月早期新生儿与足月晚期新生儿的黄疸的药效是相同的。4.茵栀黄口服液治疗足月新生儿黄疸不良反应轻微,主要有排稀便、褐色便及大便次数增多等,停药后很快消失,不需要特殊处置。可以作为临床上治疗足月新生儿黄疸的药物之一。更多还原

【Abstract】 Term Neonatal Jaundice is the most common symptoms, also is the main neonatal illness in China. It ofen happens in early newborns. Jaundice can be divided into physiological and pathological jaundice., Newborns suffer from physiological jaundice are in usually good condition,and it can be spontaneous regression without intervention. About 5 to 10% of children suffering from pathologic jaundice needs intervention and treatment.It can be very serious if we do not handle it or mishandle, causing bilirubin encephalopathy, or death seriously.So we should find out the etiology timely, and promote positive effective treatment. The clinical treatment methods are as follows: phototherapy, anti-infection, control hemolysis and so on. Albumin treatment or alkalifying blood can be used to prevent bilirubin encephalopathy.Blood exchange transfusion can also be used when necessary. Blu-ray radiation therapy is the most commonly used blu-ray radiation therapy treatment, the effect is remarkable, but side effects are also obvious. We can add oral liquid to reduce the side effects of blu-ray illuminate,but oral liquid is rare on clinical. Yin zhi huang Oral liquid is developed by the ChenHao soup, concerning the clinical application to rotogravure in long-term study. Researchs on it become more frequentely in view of the rapid development of basic medical research to study. This study aims to study the abilities of Yin zhi huang Oral liquid torefund yellow,and abate jaundice.This article chooses 293 cases of neonatal jaundice children treated in our department from the January 2010 in January 2011.We gave them full comprehensive treatment, the treatment group combined with Yin zhi huang Oral liquid. Therapeutic one 125 cases, compared with 168 patients. Record and analysis statisticsly children’s tire on age (GA), sex, birth weight (BW), onset age, treatment age, defecate color and character change, whether vomiting and abdominal distension and diarrhea, liver meritorious service is total bilirubin (TBIL), direct bilirubin (TBIL), icteric subsidise time, phototherapy time in this group. Compare two groups curative effect and treatment 1 day, three days, five days total bilirubin decline in value, along with groups treated early and late the curative effect of neonatal jaundice contrast. Comparisons among two groups of the defecate change ,the drop data of bilirubin using drugs 3 days and 5 days, icteric subsidise time, phototherapy time is P < 0.05, with a statistical significance.In conclusion:1. Yin zhi huang Oral liquid have better effect on the therapy of newborns jaundice exactly, it can shorten the time of jaundice subsidise, blu-ray irradiation, It can also improve the speed of bilirubin decreasing. 2. Yin zhi huang Oral liquid can be effective between 3 to 5 days . 3. There are less discrepancies between neonatal jaundice of early newborns and late ones by Yin zhi huang Oral liquid treatment. 4. The adverse reactions of Yin zhi huang Oral liquid treatment on term newborns jaundice were minimal, and mainly have looser stools, brown will and the number of defecating increase.It can disappear very quickly after discontinuation. Furthermore, other adverse reaction were rare,so it can be used as a theropy to crease jaundice.更多还原