茵陈理中汤治疗新生儿静脉营养相关性胆汁淤积疗效观察  

An Observation on Curative Effect of Yinchen Lizhong Tang on Neonatal Parenteral Nutrition Associated Cholestasis

作　　者：许靖 李伟伟[1] 艾军 陈洋 张小利 胡洪源 奚碧冰 XU Jing;LI Weiwei;AI Jun;CHEN Yang;ZHANG Xiaoli;HU Hongyuan;XI Bibing

机构地区：[1]广西中医药大学第一附属医院儿科,广西南宁530023 [2]广西中医药大学基础医学院,广西南宁530222 [3]广州中医药大学第二附属医院,广东广州510120 [4]南宁市中医医院,广西南宁530001 [5]广西壮族自治区妇幼保健院新生儿科一区,广西南宁530012

出　　处：《新中医》2020年第21期28-30,共3页New Chinese Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20180080)。

摘　　要：目的:观察茵陈理中汤治疗新生儿静脉营养相关性胆汁淤积(PNAC)临床疗效。方法:制定诊疗及随访流程,纳入门诊治疗的PNAC患儿55例,知情同意后,随机分为2组。熊去氧胆酸组26例予熊去氧胆酸;茵陈理中汤组29例予熊去氧胆酸加用茵陈理中汤治疗。记录2组临床指标纠正胎龄、体质量、体质量Z值、新生儿行为神经测定(NBNA)评分。结果:治疗前,2组患儿性别、分娩方式、出生胎龄、出生体质量、发病日龄、胆红素峰值水平以及就诊时纠正胎龄、体质量、体质量Z值、NBNA评分比较,差异均无统计学意义(P>0.05)。治疗后,加用茵陈理中汤组治疗周期较熊去氧胆酸组缩短,治愈时纠正胎龄更小,体质量、体质量Z值更大,差异均有统计学意义(P<0.01)。熊去氧胆酸组有5例因疗效不佳,使用激素治疗,加用茵陈理中汤组无使用激素治疗。结论:加用茵陈理中汤治疗PNAC可缩短疗程,促进追赶生长。Objective: To observe the clinical effect of Yinchen Lizhong tangon neonatal parenteral nutrition associated cholestasis(PNAC). Methods: After developing the diagnosis, treatment and follow-up procedures, fifty-five newborns with PNAC included in outpatient treatment were randomly divided into two groups after informed consent. Twenty-six cases in the ursodeoxycholic acid group were administered with ursodeoxycholic acid. Twenty-nine cases in the Yinchen Lizhong tang group were treated with both ursodeoxycholic acid and Yinchen Lizhong tang. The clinical indexes in the two groups were recorded, including corrected gestational age, body mass, body mass Z value, and the score of Neonatal Behavioral Neurological Assessment(NBNA). Results: Before treatment, there were no statistically significant differences in the comparison of gender,delivery way,gestational age,birth mass,age of onset,peak of bilirubin,corrected gestational age,body mass,body mass Z value and NBNA score between the two groups(P>0.05). After treatment,the treatment cycle of the Yinchen Lizhong tang group was shorter than that of the ursodeoxycholic acid group, the gestational age corrected during the treatment was smaller, and the body mass and body mass Z value were larger, differences being significant(P<0.01). Five cases in the ursodeoxycholic acid group were treated with hormone due to poor curative effect,while the Yinchen Lizhong tang group was not treated with hormone. Conclusion: The additional application of Yinchen Lizhong tang for newborns with PNAC,can shorten the course of treatment and promote catch-up growth.

关 键 词：新生儿静脉营养相关性胆汁淤积 阴黄 胎怯 茵陈理中汤 纠正胎龄 体质量 体质量Z值 

分 类 号：R722.19[医药卫生—儿科]