茵陈地黄汤联合蓝光治疗早期新生儿病理性黄疸的临床观察

发布时间：2018-05-23 20:52

本文选题：新生儿 + 茵陈地黄汤　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:观察茵陈地黄汤联合蓝光治疗早期新生儿病理性黄疸的临床疗效及不良反应,为茵陈地黄汤在早期新生儿病理性黄疸的临床应用提供临床依据。方法:将符合纳入标准的100例新生儿病理性黄疸患儿按就诊顺序单号分为观察组,双号分为对照组,每组各50例。对照组单纯使用基础治疗(常规蓝光治疗、口服金双歧、补液及新生儿常规护理),观察组在对照组的基础上加茵陈地黄汤,3天为一疗程。观察两组患儿每日经皮胆红素值、总共接受光疗时间及一个疗程后血清胆红素值、不良反应发生率等情况。收集所有观察指标,进行统计学分析并评价其疗效。结果:(1)两组患儿胎龄、性别、体重、入院日龄、原发疾病种类、治疗前血清总胆红素、直接胆红素、间接胆红素、经皮胆红素值,差异均无统计学意义(p0.05),具有可比性。(2)治疗后第1、2、3天观察组经皮测胆红素值均低于对照组,p均0.05,差异有统计学意义,提示观察组能更好的降低经皮胆红素值,在今后的治疗里观察组再次光疗的机会及光疗时间低于对照组。(3)两组患儿治疗前与治疗后血清总胆红素比较,治疗后血清总胆红素值均低于治疗前,差异有统计学意义(p0.05),提示两组均能明显降低胆红素水平。(4)两组患儿治疗后血清总胆红素比较,观察组血清总胆红素值低于对照组(p0.05),提示观察组较对照组能更好地降低血清胆红素值。(5)两组患儿光疗时间比较,观察组光疗时间低于对照组,差异有统计学意义(p0.05),提示加用茵陈地黄汤能有效缩短光疗时间。(6)两组疗效比较,观察组优于对照组,差异有统计学意义(p0.05)。(7)两组患儿治疗后不良反应发生情况比较,观察组不良反应发生率低于对照组,差异有统计学意义(p0.05),说明茵陈地黄汤联合蓝光治疗可明显降低蓝光治疗不良反应发生率。结论:(1)茵陈地黄汤联合蓝光治疗可有效降低早期新生儿病理性黄疸湿热熏蒸证患儿血清胆红素、经皮胆红素水平,有较好退黄疗效。(2)茵陈地黄汤联合蓝光治疗可缩短光疗时间,降低蓝光治疗不良反应发生率,值得临床推广。
[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.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R722.17

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