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目的:观察用茵陈理中汤化裁而成的中药汤剂内服联合熏蒸对新生儿黄疸的治疗效果,并探讨其对患者血清胆红素及黄疸消退情况的影响。方法:选取2013年4月—2014年11月就诊于我院的寒湿阻滞型新生儿黄疸82例,按照随机数字表法分为对照组和观察组各41例。对照组患儿给予苯巴比妥片内服及蓝光照射治疗;观察组患儿则在此基础上联合给予由茵陈理中汤化裁而成的中药汤剂内服联合熏蒸,1剂/d,连续治疗7 d;治疗后观察患儿主要症状的缓解情况,计算临床治疗的有效率;检测患儿胆红素水平变化;记录胆红素降至正常的时间及黄疸消退时间、住院时间。结果:患儿经治疗后面目皮肤发黄、黄色晦黯、脘痞腹胀、便溏、乏力倦怠等主要症状有不同程度的改善,观察组患儿的改善尤其明显,其有效率90.2%明显高于对照组治疗的有效率70.7%,差异具有统计学意义(P<0.05);两组患儿的胆红素水平与治疗前相比有所降低,观察组患儿的降低幅度明显大于对照组患儿,差异具有统计学意义(P<0.05);观察组患儿胆红素降至正常的时间、黄疸消退时间及住院时间较对照组更短,差异具有统计学意义(P<0.05)。结论:茵陈理中汤化裁而成的中药汤剂长于温中化湿,其谨守患儿“寒湿困脾”的病机特点,内服联合熏蒸能显著改善新生儿黄疸的症状,利于胆红素水平的降低及黄疸的消退,有效缩短病程,疗效确切,凸显出中医药辨证论治儿科疾病的优势与特色,值得临床广泛推广运用。
OBJECTIVE: To observe the therapeutic effect of combined Chinese herbal decoction decoction made by Yinchen Li Zhong Tang on the neonatal jaundice and its effect on the regression of serum bilirubin and jaundice in patients. Methods: From April 2013 to November 2014, 82 cases of jaundiced neonates with cold block in our hospital were selected and divided into control group and observation group according to random number table. Children in the control group were treated with phenobarbital orally and blue light irradiation. On the basis of this, children in the observation group were treated with Chinese herbal decoction, 7 d. After treatment, observe the remission of the main symptoms in children, calculate the effective rate of clinical treatment; detect the change of bilirubin level in children; record the time of bilirubin drop to normal and jaundice subsided time and hospitalization time. Results: After treatment, the appearance of yellow skin, yellow darkness, swelling of abdominal swelling, loose stools, fatigue and other major symptoms in children with different degrees of improvement, especially in the observation group, the improvement rate of 90.2% was significantly higher In the control group, the effective rate was 70.7%, the difference was statistically significant (P <0.05). The bilirubin level in both groups was decreased compared with that before treatment, and the reduction rate in the observation group was significantly greater than that in the control group The difference was statistically significant (P <0.05). The bilirubin in observation group decreased to normal time, jaundice elimination time and hospitalization time were shorter than those in control group, with statistical significance (P <0.05). Conclusion: Yinchenlizhong decoction made of traditional Chinese medicine decoction longer than warm in the wet, its children with “cold dampness spleen” pathogenesis characteristics, oral administration of fumigation can significantly improve the symptoms of neonatal jaundice, which will benefit Bilirubin levels and jaundice subsided effectively shorten the course of the disease, curative effect is exact, highlights the advantages and characteristics of traditional Chinese medicine syndrome differentiation and treatment of pediatric diseases, it is worth widely clinical application.