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目的观察茵栀黄颗粒联合三联活菌对新生儿黄疸血清总胆汁酸、转铁蛋白和C反应蛋白的影响。方法 82例新生儿黄疸随机分为对照组41例与试验组41例。2组均给予常规治疗及对症治疗,对照组给予茵栀黄颗粒3 g温开水或奶水送服,每日3次;试验组在对照组的基础上给予双歧杆菌三联活菌肠溶胶囊105 mg,每日2次。2组患儿均治疗7 d。治疗后,比较2组患儿血清胆红素、转铁蛋白、C反应蛋白、谷草转氨酶、谷丙转氨酶、碱性磷酸酶、总胆汁酸、总胆红素、直接胆红素水平及药物不良反应发生情况。结果治疗后,试验组总有效率为92.68%(38/41例),对照组为75.61%(31/41例),差异有统计学意义(P<0.05)。治疗后,试验组血清胆红素为(54.41±7.21)μmol·L~(-1),对照组为(121.54±14.54)μmol·L~(-1)(P<0.05)。试验组的C反应蛋白为(8.52±1.20)mg·L~(-1),对照组为(12.15±1.97)mg·L~(-1)(P<0.05)。试验组的谷草转氨酶为(35.88±5.26)mmol·L~(-1),谷丙转氨酶为(45.54±6.43)mmol·L~(-1),碱性磷酸酶为(138.92±20.15)mmol·L~(-1),对照组的谷草转氨酶为(45.25±6.13)mmol·L~(-1),谷丙转氨酶为(102.15±14.31)mmol·L~(-1),碱性磷酸酶为(172.21±28.51)mmol·L~(-1),2组差异有统计学意义(P<0.05)。试验组总胆汁酸为(10.45±1.51)μmol·L~(-1),总胆红素为(10.35±1.55)μmol·L~(-1),直接胆红素为(18.52±2.26)μmol·L~(-1),对照组总胆汁酸为(23.16±3.31)μmol·L~(-1),总胆红素为(57.14±8.35)μmol·L~(-1),直接胆红素为(62.81±9.07)μmol·L~(-1)(P<0.05)。试验组的转铁蛋白水平为(1.93±0.25)g·L~(-1),对照组转铁蛋白水平为(1.61±0.23)g·L~(-1)(P<0.05)。药物不良反应主要表现为头痛、恶心、皮疹,对照组药物不良反应发生率为12.20%(5/41例),试验组为7.32%(3/41例),差异无统计学意义(P>0.05)。结论茵栀黄颗粒联合三联活菌对新生儿黄疸有较好的临床疗效,药物安全性高。
Objective To observe the effect of Yinzhihuang granule combined with triple viable bacteria on serum total bile acid, transferrin and C-reactive protein in neonates with jaundice. Methods 82 neonates with jaundice were randomly divided into control group (n = 41) and experimental group (n = 41). 2 groups were given conventional treatment and symptomatic treatment, the control group was given Yinzhihuang granules 3 g warm water or milk served three times a day; the experimental group in the control group on the basis of bifidobacterium triple live Enteric-coated capsules 105 mg, 2 times a day. Both groups were treated for 7 days. After treatment, serum bilirubin, transferrin, C-reactive protein, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bile acid, total bilirubin, direct bilirubin and drug dysfunctions were compared between the two groups Reaction occurred. Results After treatment, the total effective rate was 92.68% (38/41) in the experimental group and 75.61% (31/41 cases) in the control group, the difference was statistically significant (P <0.05). After treatment, the level of serum bilirubin was (54.41 ± 7.21) μmol·L -1 in the test group and (121.54 ± 14.54) μmol·L -1 in the control group (P <0.05). The level of C-reactive protein in the experimental group was (8.52 ± 1.20) mg · L -1 and that in the control group was (12.15 ± 1.97) mg · L -1 (P <0.05). Aspartate aminotransferase (AST) of the test group was (35.88 ± 5.26) mmol·L -1, alanine aminotransferase was (45.54 ± 6.43) mmol·L -1, alkaline phosphatase was (138.92 ± 20.15) mmol·L -1 (-1) in the control group, and (45.25 ± 6.13) mmol·L -1 in the control group and (102.15 ± 14.31) mmol·L -1 in the control group, while the alkaline phosphatase was (172.21 ± 28.51) mmol·L -1, the difference between the two groups was statistically significant (P <0.05). Total bilirubin in test group was (10.45 ± 1.51) μmol·L -1, total bilirubin was (10.35 ± 1.55) μmol·L -1 and direct bilirubin was (18.52 ± 2.26) μmol The total bilirubin in the control group was (23.16 ± 3.31) μmol·L -1, the total bilirubin was (57.14 ± 8.35) μmol·L -1, the direct bilirubin (62.81 ± 9.07) μmol·L -1 (P <0.05). The level of transferrin in the test group was (1.93 ± 0.25) g · L -1, while the level of transferrin in the control group was (1.61 ± 0.23) g · L -1 (P <0.05). Adverse drug reactions were mainly headache, nausea and rash. The adverse drug reaction rate was 12.20% (5/41) in the control group and 7.32% (3/41) in the test group, with no significant difference (P> 0.05 ). Conclusion Yinzhihuang granules combined with triple viable bacteria have a good clinical effect on neonatal jaundice and have high drug safety.