茵栀黄口服液与白蛋白联合方案对新生儿病理性黄疸胆红素、炎症因子、免疫指标及相关因子的影响
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摘要
目的:探究茵栀黄口服液与白蛋白联合方案对新生儿病理性黄疸胆红素、炎症因子、免疫指标及相关因子的影响。方法:选择我院收治的患病理性黄疸新生儿134例,随机为对照组(n=67)及观察组(n=67),对照组给予白蛋白治疗,观察组在对照组基础上联合茵栀黄口服液治疗,对比分析两组治疗前后胆红素、炎症因子、免疫指标、甲胎蛋白(AFP)及转铁蛋白(TRF)水平的变化情况。结果:治疗后,两组TBIL、DBIL、IBIL水平均较治疗前显著降低(P<0.05),且观察组TBIL、DBIL、IBIL水平显著低于对照组(P<0.05);两组CRP、IL-6水平均较治疗前显著降低(P<0.05),且观察组CRP、IL-6水平显著低于对照组(P<0.05);两组CD4~+、CD4~+/CD8~+水平均较治疗前显著升高(P<0.05),而CD8~+较治疗前显著降低,且观察组CD4~+、CD4~+/CD8~+水平显著高于对照组(P<0.05),CD8~+水平显著低于对照组(P<0.05);两组AFP水平较治疗前均显著降低(P<0.05),而TRF水平较治疗前均显著升高(P<0.05),且观察组AFP水平显著低于对照组(P<0.05),TRF水平显著高于对照组(P<0.05)。结论:茵栀黄口服液与白蛋白联合方案可有效降低新生儿黄疸胆红素水平,抑制其炎症反应,增强细胞免疫功能及改善AFP、TRF表达水平,具有临床推广意义。
Objective:To explore the effects of Yinzhihuang oral liquid and albumin on bilirubin,inflammatory factors,immune indexes and related factors in neonatal pathologic jaundice.Methods:134 neonates with pathologic jaundice admitted to our hospital from May 2017 to April 2018 were randomly selected as the control group(n=67)and the observation group(n=67),the control group was treated with albumin,the observation group was treated with Yinzhihuang Oral Liquid on the basis of the control group.The bilirubin,inflammatory factors,immune indicators,alpha-fetoprotein(AFP)and transferrin(TRF)were compared and analysed before and after treatment.Results:After treatment,the levels of TBIL,DBIL and IBIL in both groups were significantly lower than those before treatment(P<0.05),and the levels of TBIL,DBIL and IBIL in observation group were significantly lower than those in control group;the levels of CRP and IL-6 in both groups were significantly lower than those before treatment(P<0.05),and the levels of CRP and IL-6 in observation group were significantly lower than those in control group(P<0.05);the levels of CD4~+,CD4~+/CD8~+in both groups were significantly higher than those before treatment(P<0.05),while the levels of CD8~+was significantly lower than that before treatment,the levels of CD4~+,CD4~+/CD8~+in observation group were significantly higher than those in control group(P<0.05),and the level of CD8~+was significantly lower than that in control group(P<0.05);the levels of AFP in both groups were significantly lower than before treatment(P<0.05),while the levels of TRF were significantly higher than before treatment(P<0.05),and the levels of AFP in observation group were significantly lower than those in control group(P<0.05),the levels of TRF were significantly higher than those in control group(P<0.05).Conclusions:The combination of Yinzhihuang oral liquid and albumin can effectively reduce the bilirubin level in neonatal jaundice,inhibit its inflammatory reaction,enhance the cellular immune function and improve the expression of AFP and TRF,which is of clinical significance.
Objective:To explore the effects of Yinzhihuang oral liquid and albumin on bilirubin,inflammatory factors,immune indexes and related factors in neonatal pathologic jaundice.Methods:134 neonates with pathologic jaundice admitted to our hospital from May 2017 to April 2018 were randomly selected as the control group(n=67)and the observation group(n=67),the control group was treated with albumin,the observation group was treated with Yinzhihuang Oral Liquid on the basis of the control group.The bilirubin,inflammatory factors,immune indicators,alpha-fetoprotein(AFP)and transferrin(TRF)were compared and analysed before and after treatment.Results:After treatment,the levels of TBIL,DBIL and IBIL in both groups were significantly lower than those before treatment(P<0.05),and the levels of TBIL,DBIL and IBIL in observation group were significantly lower than those in control group;the levels of CRP and IL-6 in both groups were significantly lower than those before treatment(P<0.05),and the levels of CRP and IL-6 in observation group were significantly lower than those in control group(P<0.05);the levels of CD4~+,CD4~+/CD8~+in both groups were significantly higher than those before treatment(P<0.05),while the levels of CD8~+was significantly lower than that before treatment,the levels of CD4~+,CD4~+/CD8~+in observation group were significantly higher than those in control group(P<0.05),and the level of CD8~+was significantly lower than that in control group(P<0.05);the levels of AFP in both groups were significantly lower than before treatment(P<0.05),while the levels of TRF were significantly higher than before treatment(P<0.05),and the levels of AFP in observation group were significantly lower than those in control group(P<0.05),the levels of TRF were significantly higher than those in control group(P<0.05).Conclusions:The combination of Yinzhihuang oral liquid and albumin can effectively reduce the bilirubin level in neonatal jaundice,inhibit its inflammatory reaction,enhance the cellular immune function and improve the expression of AFP and TRF,which is of clinical significance.
引文
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2万勇峰,朱建宏.四种方案治疗新生儿黄疸的疗效及对相关生化指标的影响[J].湖南师范大学学报(医学版),2017,14(4):133-137.
3陈爱萍,李志飞.茵栀黄口服液、丹参注射液联合蓝光照射治疗新生儿ABO溶血性黄疸的临床疗效分析[J].中华中医药学刊,2017,35(6):1587-1589.
4逯军,凌瑶君.蓝光联合益生菌口服治疗早产儿黄疸临床观察[J].山东医药,2017,57(9):77-79.
5罗嫚丽,曹文芳,刘豫军,等.布拉氏酵母菌联合茵栀黄口服液治疗新生儿黄疸临床观察[J].山东医药,2016,56(8):79-80.
6罗菁,卢洪萍.茵栀黄口服液联合培菲康对新生儿黄疸的疗效及对T细胞亚群的影响[J].中华全科医学,2017,15(3):463-465.
7魏克伦,王玉山.关于新生儿病理性黄疸诊断标准的讨论[J].中华儿科杂志,2009,47(1):17.
8 Basiri-Moghadam M,Basiri-Moghadam K,Kianmehr M,et al.The effect of massage on neonatal jaundice in stable preterm newborn infants:a randomized controlled trial[J].J Pak Med Assoc,2015,65(6):602-606.
9 Ogunlesi TA,Abdul AR.Maternal knowledge and careseeking behaviors for newborn jaundice in Sagamu,Southwest Nigeria[J].Niger J Clin Pract,2015,18(1):33-40.
10 Amos RC,Jacob H,Leith W.Jaundice in newborn babies under 28days:NICE guideline 2016(CG98)[J].Archives of disease in childhood-Education&practice edition,2017,102(4):207-209.
11唐春梅.新生儿黄疸蓝光治疗效果及不良反应探讨[J].中外医学研究,2015,13(33):138-140.
12董孝云,师淑锋,张璋.白蛋白联合蓝光照射治疗新生儿黄疸疗效及临床指标观察[J].中国卫生标准管理,2016,7(3):93-94.
13朱继孝,李雪溦,钟国跃,等.栀子柏皮汤及其拆方对中医阳黄证黄疸大鼠退黄作用的研究[J].中药新药与临床药理,2015,26(1):25-30.
14王玉蛟,王立新.中医防治新生儿黄疸的研究进展[J].中国医药科学,2016,6(01):26-30,34.
15 Vodret S,Bortolussi G,Ja2prováJ,et al.Inflammatory signature of cerebellar neurodegeneration during neonatal hyperbilirubinemia in Ugt1-/-mouse model[J].JNeuroinflamm,2017,14(1):64.
16刘艳薇,董淑红,魏锋,等.新生儿黄疸血清白细胞介素及红细胞免疫检测的临床价值[J].广东医学,2017,38(20):3155-3157.
17 Evansgilbert T.Chikungunya and neonatal immunity:fatal vertically transmitted chikungunya infection[J].Am J Trop Med Hyg,2017,96(4):913-915.
18 Restori KH,Srinivasa BT,Ward BJ,et al.Neonatal immunity,respiratory virus infections,and the development of asthma[J].Front Immunol,2018,9:1249.
19 Rees JC,Rossio JL,Wilson HE,et al.Cellular immunity in neoplasia.Antigen and mitogen responses in patients with bronchiogenic carcinoma.[J].Cancer,2015,36(6):2010-2015.
20 Hu Z,Zou Q,Su B.Regulation of T cell immunity by cellular metabolism[J].Front Med,2018,13(2):1-10.
21张振琪,瞿晓青,高羽迪.茵陈丹芍汤治疗妊娠期肝内胆汁淤积症的临床疗效及其对Th1/Th2平衡的影响[J].浙江中医杂志,2017,52(9):634-635.
22严雪龙,孟爱平,濮社班.金银花抗炎免疫活性研究进展[J].中国野生植物资源,2016,35(2):41-44.
23 Kuzdan C,Can G.The umbilical cord alpha-fetoprotein levels for predicting hyperbilirubinemia in term neonates[J].J Matern-fetal Neo M,2014,27(3):265-269.
24 Takeda A,Ishiwatari S,Okada S.Influence of transferrin on manganese uptake in rat brain[J].J Neurosci Res,2015,59(4):542-552.
2万勇峰,朱建宏.四种方案治疗新生儿黄疸的疗效及对相关生化指标的影响[J].湖南师范大学学报(医学版),2017,14(4):133-137.
3陈爱萍,李志飞.茵栀黄口服液、丹参注射液联合蓝光照射治疗新生儿ABO溶血性黄疸的临床疗效分析[J].中华中医药学刊,2017,35(6):1587-1589.
4逯军,凌瑶君.蓝光联合益生菌口服治疗早产儿黄疸临床观察[J].山东医药,2017,57(9):77-79.
5罗嫚丽,曹文芳,刘豫军,等.布拉氏酵母菌联合茵栀黄口服液治疗新生儿黄疸临床观察[J].山东医药,2016,56(8):79-80.
6罗菁,卢洪萍.茵栀黄口服液联合培菲康对新生儿黄疸的疗效及对T细胞亚群的影响[J].中华全科医学,2017,15(3):463-465.
7魏克伦,王玉山.关于新生儿病理性黄疸诊断标准的讨论[J].中华儿科杂志,2009,47(1):17.
8 Basiri-Moghadam M,Basiri-Moghadam K,Kianmehr M,et al.The effect of massage on neonatal jaundice in stable preterm newborn infants:a randomized controlled trial[J].J Pak Med Assoc,2015,65(6):602-606.
9 Ogunlesi TA,Abdul AR.Maternal knowledge and careseeking behaviors for newborn jaundice in Sagamu,Southwest Nigeria[J].Niger J Clin Pract,2015,18(1):33-40.
10 Amos RC,Jacob H,Leith W.Jaundice in newborn babies under 28days:NICE guideline 2016(CG98)[J].Archives of disease in childhood-Education&practice edition,2017,102(4):207-209.
11唐春梅.新生儿黄疸蓝光治疗效果及不良反应探讨[J].中外医学研究,2015,13(33):138-140.
12董孝云,师淑锋,张璋.白蛋白联合蓝光照射治疗新生儿黄疸疗效及临床指标观察[J].中国卫生标准管理,2016,7(3):93-94.
13朱继孝,李雪溦,钟国跃,等.栀子柏皮汤及其拆方对中医阳黄证黄疸大鼠退黄作用的研究[J].中药新药与临床药理,2015,26(1):25-30.
14王玉蛟,王立新.中医防治新生儿黄疸的研究进展[J].中国医药科学,2016,6(01):26-30,34.
15 Vodret S,Bortolussi G,Ja2prováJ,et al.Inflammatory signature of cerebellar neurodegeneration during neonatal hyperbilirubinemia in Ugt1-/-mouse model[J].JNeuroinflamm,2017,14(1):64.
16刘艳薇,董淑红,魏锋,等.新生儿黄疸血清白细胞介素及红细胞免疫检测的临床价值[J].广东医学,2017,38(20):3155-3157.
17 Evansgilbert T.Chikungunya and neonatal immunity:fatal vertically transmitted chikungunya infection[J].Am J Trop Med Hyg,2017,96(4):913-915.
18 Restori KH,Srinivasa BT,Ward BJ,et al.Neonatal immunity,respiratory virus infections,and the development of asthma[J].Front Immunol,2018,9:1249.
19 Rees JC,Rossio JL,Wilson HE,et al.Cellular immunity in neoplasia.Antigen and mitogen responses in patients with bronchiogenic carcinoma.[J].Cancer,2015,36(6):2010-2015.
20 Hu Z,Zou Q,Su B.Regulation of T cell immunity by cellular metabolism[J].Front Med,2018,13(2):1-10.
21张振琪,瞿晓青,高羽迪.茵陈丹芍汤治疗妊娠期肝内胆汁淤积症的临床疗效及其对Th1/Th2平衡的影响[J].浙江中医杂志,2017,52(9):634-635.
22严雪龙,孟爱平,濮社班.金银花抗炎免疫活性研究进展[J].中国野生植物资源,2016,35(2):41-44.
23 Kuzdan C,Can G.The umbilical cord alpha-fetoprotein levels for predicting hyperbilirubinemia in term neonates[J].J Matern-fetal Neo M,2014,27(3):265-269.
24 Takeda A,Ishiwatari S,Okada S.Influence of transferrin on manganese uptake in rat brain[J].J Neurosci Res,2015,59(4):542-552.