清热退黄灌肠方对高胆红素血症新生儿近期神经行为影响的临床研究  

A clinical study on the effect of enema prescription for clearing heat and eliminating jaundice on recent neurobehavior in neonates with hyperbilirubinemia

作　　者：叶红玉 阮为勇[1] 马鹏胜 冯伟伟[1] 步伟全[1] YE Hongyu

机构地区：[1]江苏省中西医结合医院,江苏南京210028 [2]苏州市中西医结合医院,江苏苏州215101

出　　处：《中医临床研究》2024年第13期81-85,共5页Clinical Journal Of Chinese Medicine

基　　金：江苏省中医药研究院自主科研项目(BM2018024-2019011)。

摘　　要：目的:探讨清热退黄灌肠方对高胆红素血症新生儿神经行为的影响。方法:本研究纳入高胆红素血症患儿58例,其中试验组30例、对照组28例。对照组予蓝光照射、苯巴比妥及金双歧口服等常规治疗5天,试验组在对照组基础上予以清热退黄灌肠方灌肠治疗5天。检测两组患儿治疗前后血清总胆红素(Total bilirubin,TBIL)、间接胆红素(Indirect Bilirubin,IBIL)、白蛋白(Albumin,ALB)、神经元特异性烯醇化酶(Neuron-specific Enolase,NSE)水平,计算总胆红素/白蛋白(B/A)值,并进行新生儿神经行为测定(Neonatal Behavioral Neurological Assessment,NBNA)评分。结果:两组治疗后的血清TBIL、IBIL、B/A值均有下降,且试验组下降更为明显,组间及组内差异有统计学意义(P<0.05);两组NSE治疗后较治疗前下降,组间差异有统计学意义(P<0.05),但治疗后两组组内NSE差异无统计学意义(P>0.05);两组治疗后NBNA评分均较治疗前上升,试验组上升更明显,组间及组内差异有统计学意义(P<0.05)。经Pearson相关性分析,黄疸患儿IBIL、B/A值均与NBNA评分呈负相关,但NSE水平与NBNA评分无明显相关性。不良反应方面,试验组出现腹泻2例,对照组有1例,差异无统计学意义(P>0.05)。结论:清热退黄灌肠方治疗新生儿高胆红素血症疗效明确,可促使新生儿的部分神经行为恢复。Objective:To investigate the effects of enema prescription for clearing heat and eliminating jaundice on neurobehavior in neonates with hyperbilirubinemia.Methods:A total of 58 neonates with hyperbilirubinemia were included in this study,with 30 cases in the experimental group and 28 cases in the control group.The control group was treated by conventional therapies such as blue light irradiation,oral administration of phenobarbital and gold bifidum for 5 days,and the experimental group was treated with enema prescription for clearing heat and eliminating jaundice for 5 days on the basis of the treatment in the control group.Serum levels of total bilirubin(TBIL),indirect bilirubin(IBIL),albumin(ALB),and neuron-specific enolase(NSE)in the two groups were detected before and after treatment.The ratio of TBIL to ALB(B/A)was calculated,and the neonatal behavioral neurological assessment(NBNA)score was evaluated.Results:After treatment,the levels of serum TBIL,IBIL,B/A were decreased in both groups,the decrease was more obvious in the experimental group,and the differences between and within the groups were statistically significant(P<0.05).The level of NSE in the two groups were decreased after treatment compared with before treatment,the difference between the groups was statistically significant(P<0.05),but there was no statistically significant difference in NSE level within each group after treatment(P>0.05).The NBNA scores in the two groups were increased after treatment compared with before treatment,the increase in the experimental group was more obvious,and the differences between and within the groups were statistically significant(P<0.05).The Pearson correlation analysis showed that the levels of IBIL and B/A in children with jaundice were negatively correlated with NBNA scores,but there was no significant correlation between NSE level and NBNA score.There were 2 cases of diarrhea in the experimental group and 1 case of diarrhea in the control group,and the difference was not statistically significant(P>0.05

关 键 词：新生儿高胆红素血症 神经行为 清热退黄灌肠方 神经元特异性烯醇化酶 

分 类 号：R452[医药卫生—治疗学]