茵栀黄口服液治疗足月新生儿黄疸的疗效观察
摘要
新生儿黄疸是我国大部分新生儿病室内最主要的收治疾病之一,主要发生于早期新生儿,分为生理性黄疸和病理性黄疸两种。生理性黄疸一般状态良好,一般不需要干预治疗,可自行消退。但约5%～10%的黄疸患儿是需干预治疗的病理性黄疸,如处理不当,严重时可引起胆红素脑病,除可造成神经系统损害外,严重的可引起死亡,故应及时查明病因,并进行积极有效的治疗。目前临床上主要采用综合治疗方法,具体包括:光疗、抗感染、控制溶血等病因治疗,必要时给予碱化血液、白蛋白治疗预防胆红素脑病,达换血指征者予换血治疗。其中又以蓝光照射治疗最为常用,效果显著,但副作用亦较明显。为了减少蓝光照射的副作用,可选择加用口服药缩短光疗时间,但临床上可应用的口服药极少。茵栀黄口服液是根据古方茵陈蒿汤,经长期的临床应用及剂型改革研究才研制而成。鉴于基础医学研究的迅速发展以及对中药制剂研究的高度重视,人们对该制剂的研究日趋活跃。本研究旨在研究茵栀黄口服液的退黄、利胆效果,为临床治疗新生儿黄疸提供一种途径。
本文选择了2010年1月至2011年1月于我科诊治的293例诊断新生儿黄疸的足月患儿,均给予综合治疗,治疗组在综合治疗基础上加用茵栀黄口服液。其中治疗组组125例,对照组组168例。对本研究组中的患儿的胎龄(GA)、性别、出生体重(BW)、起病年龄、治疗年龄、大便颜色及性状改变、是否呕吐、腹胀及腹泻、肝功总胆红素(TBIL)、直接胆红素(TBIL)、黄疸消退时间、光疗时间等因素进行记录、统计学分析。比较2组疗效及治疗后1天、3天、5天总胆红素下降值,并对治疗组中早期、晚期新生儿的黄疸的疗效进行对比。其中大便改变、应用药物第3天及第5天胆红素下降值、黄疸消退时间、光疗时间两组比较,P<0.05,有统计学意义。
综上得出结论:1.茵栀黄口服液对足月新生儿黄疸的治疗效果确切,可明显减少光疗时间及黄疸消退时间,提高胆红素下降速度。2.茵栀黄口服液起作用时间在用药后的3-5天。3.茵栀黄口服液治疗足月早期新生儿与足月晚期新生儿的黄疸的药效是相同的。4.茵栀黄口服液治疗足月新生儿黄疸不良反应轻微,主要有排稀便、褐色便及大便次数增多等,停药后很快消失,不需要特殊处置。可以作为临床上治疗足月新生儿黄疸的药物之一。
Term Neonatal Jaundice is the most common symptoms, also is the main neonatal illness in China. It ofen happens in early newborns. Jaundice can be divided into physiological and pathological jaundice., Newborns suffer from physiological jaundice are in usually good condition,and it can be spontaneous regression without intervention. About 5 to 10% of children suffering from pathologic jaundice needs intervention and treatment.It can be very serious if we do not handle it or mishandle, causing bilirubin encephalopathy, or death seriously.So we should find out the etiology timely, and promote positive effective treatment. The clinical treatment methods are as follows: phototherapy, anti-infection, control hemolysis and so on. Albumin treatment or alkalifying blood can be used to prevent bilirubin encephalopathy.Blood exchange transfusion can also be used when necessary. Blu-ray radiation therapy is the most commonly used blu-ray radiation therapy treatment, the effect is remarkable, but side effects are also obvious. We can add oral liquid to reduce the side effects of blu-ray illuminate,but oral liquid is rare on clinical. Yin zhi huang Oral liquid is developed by the ChenHao soup, concerning the clinical application to rotogravure in long-term study. Researchs on it become more frequentely in view of the rapid development of basic medical research to study. This study aims to study the abilities of Yin zhi huang Oral liquid torefund yellow,and abate jaundice.
This article chooses 293 cases of neonatal jaundice children treated in our department from the January 2010 in January 2011.We gave them full comprehensive treatment, the treatment group combined with Yin zhi huang Oral liquid. Therapeutic one 125 cases, compared with 168 patients. Record and analysis statisticsly children's tire on age (GA), sex, birth weight (BW), onset age, treatment age, defecate color and character change, whether vomiting and abdominal distension and diarrhea, liver meritorious service is total bilirubin (TBIL), direct bilirubin (TBIL), icteric subsidise time, phototherapy time in this group. Compare two groups curative effect and treatment 1 day, three days, five days total bilirubin decline in value, along with groups treated early and late the curative effect of neonatal jaundice contrast. Comparisons among two groups of the defecate change ,the drop data of bilirubin using drugs 3 days and 5 days, icteric subsidise time, phototherapy time is P < 0.05, with a statistical significance.
In conclusion:1. Yin zhi huang Oral liquid have better effect on the therapy of newborns jaundice exactly, it can shorten the time of jaundice subsidise, blu-ray irradiation, It can also improve the speed of bilirubin decreasing. 2. Yin zhi huang Oral liquid can be effective between 3 to 5 days . 3. There are less discrepancies between neonatal jaundice of early newborns and late ones by Yin zhi huang Oral liquid treatment. 4. The adverse reactions of Yin zhi huang Oral liquid treatment on term newborns jaundice were minimal, and mainly have looser stools, brown will and the number of defecating increase.It can disappear very quickly after discontinuation. Furthermore, other adverse reaction were rare,so it can be used as a theropy to crease jaundice.
本文选择了2010年1月至2011年1月于我科诊治的293例诊断新生儿黄疸的足月患儿,均给予综合治疗,治疗组在综合治疗基础上加用茵栀黄口服液。其中治疗组组125例,对照组组168例。对本研究组中的患儿的胎龄(GA)、性别、出生体重(BW)、起病年龄、治疗年龄、大便颜色及性状改变、是否呕吐、腹胀及腹泻、肝功总胆红素(TBIL)、直接胆红素(TBIL)、黄疸消退时间、光疗时间等因素进行记录、统计学分析。比较2组疗效及治疗后1天、3天、5天总胆红素下降值,并对治疗组中早期、晚期新生儿的黄疸的疗效进行对比。其中大便改变、应用药物第3天及第5天胆红素下降值、黄疸消退时间、光疗时间两组比较,P<0.05,有统计学意义。
综上得出结论:1.茵栀黄口服液对足月新生儿黄疸的治疗效果确切,可明显减少光疗时间及黄疸消退时间,提高胆红素下降速度。2.茵栀黄口服液起作用时间在用药后的3-5天。3.茵栀黄口服液治疗足月早期新生儿与足月晚期新生儿的黄疸的药效是相同的。4.茵栀黄口服液治疗足月新生儿黄疸不良反应轻微,主要有排稀便、褐色便及大便次数增多等,停药后很快消失,不需要特殊处置。可以作为临床上治疗足月新生儿黄疸的药物之一。
Term Neonatal Jaundice is the most common symptoms, also is the main neonatal illness in China. It ofen happens in early newborns. Jaundice can be divided into physiological and pathological jaundice., Newborns suffer from physiological jaundice are in usually good condition,and it can be spontaneous regression without intervention. About 5 to 10% of children suffering from pathologic jaundice needs intervention and treatment.It can be very serious if we do not handle it or mishandle, causing bilirubin encephalopathy, or death seriously.So we should find out the etiology timely, and promote positive effective treatment. The clinical treatment methods are as follows: phototherapy, anti-infection, control hemolysis and so on. Albumin treatment or alkalifying blood can be used to prevent bilirubin encephalopathy.Blood exchange transfusion can also be used when necessary. Blu-ray radiation therapy is the most commonly used blu-ray radiation therapy treatment, the effect is remarkable, but side effects are also obvious. We can add oral liquid to reduce the side effects of blu-ray illuminate,but oral liquid is rare on clinical. Yin zhi huang Oral liquid is developed by the ChenHao soup, concerning the clinical application to rotogravure in long-term study. Researchs on it become more frequentely in view of the rapid development of basic medical research to study. This study aims to study the abilities of Yin zhi huang Oral liquid torefund yellow,and abate jaundice.
This article chooses 293 cases of neonatal jaundice children treated in our department from the January 2010 in January 2011.We gave them full comprehensive treatment, the treatment group combined with Yin zhi huang Oral liquid. Therapeutic one 125 cases, compared with 168 patients. Record and analysis statisticsly children's tire on age (GA), sex, birth weight (BW), onset age, treatment age, defecate color and character change, whether vomiting and abdominal distension and diarrhea, liver meritorious service is total bilirubin (TBIL), direct bilirubin (TBIL), icteric subsidise time, phototherapy time in this group. Compare two groups curative effect and treatment 1 day, three days, five days total bilirubin decline in value, along with groups treated early and late the curative effect of neonatal jaundice contrast. Comparisons among two groups of the defecate change ,the drop data of bilirubin using drugs 3 days and 5 days, icteric subsidise time, phototherapy time is P < 0.05, with a statistical significance.
In conclusion:1. Yin zhi huang Oral liquid have better effect on the therapy of newborns jaundice exactly, it can shorten the time of jaundice subsidise, blu-ray irradiation, It can also improve the speed of bilirubin decreasing. 2. Yin zhi huang Oral liquid can be effective between 3 to 5 days . 3. There are less discrepancies between neonatal jaundice of early newborns and late ones by Yin zhi huang Oral liquid treatment. 4. The adverse reactions of Yin zhi huang Oral liquid treatment on term newborns jaundice were minimal, and mainly have looser stools, brown will and the number of defecating increase.It can disappear very quickly after discontinuation. Furthermore, other adverse reaction were rare,so it can be used as a theropy to crease jaundice.
引文
[1]薛辛东.儿科学第6版[M].北京:人民卫生出版社, 2003:134.
[2]梁玉美,陈霞静.新生儿高胆红素血症病因分析及预防策略[J].右江医学,2007,35 (5): 1003-1383.
[3]Setia S,Villaveces A,Dhillon P,etal.Neonatal jaundice in Asian, white,and mixed-race infants[J].Arch Pediatr Adolesc Med.2002,156:276-279.
[4]刘汉嘉,韩雪芳,谢鹤,等.628例新生儿高胆红素血症临床分析[J].广东医学,2003,24(6):621-622.
[5]Bhutani VK,Donn SM,Johnson LH.Risk management of severe neona- tal hyperbilirubinemia to prevent kernicterus Clin Perinatol,2005,32: 125-139.
[6]吴晓翠,陈新.新生儿黄疸[M].北京:人民军医出社,2001:156-157.
[7]Ostrow JD,Pascolo L,Shapiro SM,et al.New concepts in bilirubin encephalopathy.Eur J C lin Invest, 2003, 33: 988-997.
[8]Shapiro SM.Definition of the clinical spectrum of kernicterus and bilirubin-induced neurologic dysfunction(BIND). J Perinatol, 2005, 25: 54-59.
[9]金汉珍,黄德氓,官希吉.实用新生儿学第2版[M].北京:人民卫生出版社,1997:256.
[10]Cremer RJ,Peyrrman PW,Richards DH.Influence of light on the hypebrilirubinaemia of infants.Lnaeet,1958,1: l094-1097.
[11]王永明,徐天鹤,华子瑜.新生儿期胆红素的神经细胞毒性及影响因素[J].国外医学:妇幼保健分册, 2004, 15(3):140-141.
[12]Fanaroff AA,Martin RJ,Neonatal jaundice.Neonatal-perinatal Medie- ine (Diseases of the Fetus and Inafnt).Jemrnay, 1998:137.
[13]中华医学会中华儿科杂志编辑委员会,中华医学会儿科学分会新生儿学组.全国新生儿黄疸与感染学术研讨会纪要(附新生儿黄疸干预推荐方案).中华儿科杂志, 2001,39(3):184-187.
[14]Seidmna DS,Moise J,Egraz Z,et al.A new blue light-emitting Phototherapy device:A prospective randomized controlled study.J pediatr, 2000; 136:773-774.
[15]Rosenstein BS,Dueore JM(1983)Indution on DNA strand breaks in normal human fibroblasts exposed to monochromatic ultraviolet and visible wavelengths in the 240-546 nm range. Photoehem Photobiol 38; 51-55.
[16]刘兴国.新生儿黄疸的治疗;药物疗法.见:金汉珍,黄德氓,官希吉,主编实用新生儿学.第2版.北京:人民卫生出版社1997:256.
[17]Kevin-Ives N.Neonatal juandice:Clinical management of the jaundiced inafnt.In:Rennie JM,Roberton NRC, ets.Textbook of neonatology 3rded. Edinbugrh:Churehill Livingatone, 1999, 726.
[18]Caldera R,Mayaier M, SenderA,etal.The effcet of human albumin in assoeciation with intensive Phototherapy in the mnagaement of neonatal jaundice.Arch Fr Pediatr,1993, 50(5): 399.
[19]Hosono S, Ohno T ,Kimoto H,et al. Eeffet of albumin infusion therapy on total and Unbound bilirubin values in term infants with intensive Phototherapy. Pediatr Int, 2001,43(1):8.
[20]Rubo J,Wahn V.High-dose intravenous immunoglobulin in Rh haemolytic disease [J]. Lnaect, 1991: 337(8746): 91442.
[21]李玲摘.静脉大剂量γ-球蛋白治疗血型不合引起的新生儿免疫溶血性黄疸.新生儿科杂志,1993,8(4):187.
[22]Sato K,Hara T,KondoT,et al. High-dose intravenous immunoglobulin therapy for Neonatal immune haemolytic jaundice due to blood group income- patibility.AetaPaediatrSeand. 1991: 80: 163-166.
[23]Rubo J,Albreeht K,Lasch,Petal.High dose intravenous immunoGlo- bulin therapy for hyperbilirubinemia caused by Rh haemolytic disease. Jpediatr,1992:121:93-97.
[24]Voto Ls,Sexer H,Ferreiro G,et al.Neonatal administration of high dose intravenous immunoglobulin in Rhesus haemolytic disease.J perinat Med,1995; 23:443-51.
[25]Dgaoglu T,Ovali F,Samnaci N,et al.High-dose intravenous immunoglobulin therapy for Rhesus haemolytic disease.J Int Med Res.1995, 23: 264-271.
[26]赵芳,张晓春,李怀玉,等.静注球蛋自治疗新生儿ABO溶血病的疗效[J].实用儿科临床杂志,2002,17(3):207-208.
[27]王继杰,李敏.静脉滴注丙种球蛋白治疗新生儿ABO溶血病的疗效观察[J].临床儿科杂志,2002, 20(4):235-236.
[28]杨彩云,吴明昌,王慧欣,等.静脉注射不同剂量丙种球蛋白治疗重症新生儿ABO溶血病48例疗效观察[J].中华围产医学杂志,2001; 6(1): 28-31.
[29]金汉珍,黄德眠,官希吉.实用新生儿学第3版[M],北京:人民卫生出版社,2003: 309-312.
[30]李锐钦,邓皓辉,邝玉子等.外周动静脉同步换血换血量与胆红素水平关系的研究[J].中国实用儿科杂志, 2001: 16(11): 660-662.
[31]杨玲竹,吏惠蓉,邵宝亭,等.Rh新生儿溶血病21例分析[J].实用妇产科杂志, 2001; 17(4): 231-232.
[32]陈白励.新生儿快速连续同步换血法[J].中国实用妇科和产科杂志,2001;17(10);589-591.
[33]李小敏.外周静脉加脐静脉同步换血治疗新生儿高胆红素血症39例报告[J].中国儿童保健杂志,2002; 6.
[34]钟丹妮,刘悠南,刘义,等.广西新生儿胆红素-尿普二磷酸葡萄糖醛酸转移酶基因Gly7IA突变的研究[J].中华儿科杂志,2002:40(to): 579-581.
[35]Silva RF,Rodrigues CM,Brites D.Bilirubin-induced apoptosis incultured rat neural cells is aggravated by chenodeoxycholic acid but prebvented by Ursodeoxyeholic acid[J].J Hepatol,2001,34(3):402-408.
[36]张莉英,鲁金玲.茵栀黄佐治新生儿高胆红素血症临床观察[J].新生儿科杂志,2001,16( 2):80-81.
[37]国家药典委员会.临床用药须知(中药卷)[S]. 2005年版.北京:人民卫生出版社,2005:96.
[38]刘圣,陈礼明.清热中药现代药理与临床[M]. 1版.合肥:安徽科学技术出版社,1999:40-278.
[39]张春莲,曹树军.茵栀黄白汤防治新生儿黄疸123例分析[J].中医杂志,2000, 41(2): 102.
[40]张慎枢.茵栀黄注射液的抗菌作用及临床疗效[J].中成药研究,1986; (5) : 29.
[41]韦翠芬.茵栀黄注射液佐治新生儿高胆红素血症疗效观察[J].右江医学杂志, 2008,36(1):123.
[42]李柏谦,张平,孙志滔.清开灵注射液对新生儿高胆红素血症的治疗观察[J].实用医学杂志,2001, 17( 10): 1005.
[43]王佩珍,顾锦耀.茵栀黄注射液的不良反应[J].中国新药于临床杂志, 1998, 11( 6) : 391.
[44]金汉珍,黄德珉,宫希吉.实用新生儿学[M]. 3版.北京:人民卫生出版社,2008: 266- 268.
[45]Andreula CF.Simonetti L,DeSantis F,et al.Minimally invasive Oxygen ozone therapy for lumbar discherniation[J].AJNR,2003,24(5): 996-1000.
[46]Mishra S, Agarwal R, Deorari AK, et al. Jaundice in the newborns[J]. Indian J Pediatr, 2008, 75(2): 157- 163.
[47]唐卉,李慕军,杨晓娅,等.脐血胆红素早期预测新生儿病理性黄疸的价值[J].广西医学,2001, 23(8): 729- 730.
[48]毛健,富建华,陈丽英,等.重度高胆红素血症新生儿苍白球磁共振成像特征及其临床意义[J].中华儿科杂志,2007, 45(1):24- 29.
[49]Ahlfors CE,Parker AE.Unbound bilirubin concentration is associ- ated with abnormal automated auditory brainstem response for jaundiced newborns[J]. Pediatrics,2008,121(5):976- 978.
[50]Moerschel SK,Cianciaruso LB,Tracy LR.A practical approach to neonatal jaundice[J]. Am Fam Physician, 2008, 77(9):1255- 1262.
[51]孙丽丽,武广云,尹立岩.经皮胆红素测定在新生儿黄疽筛查中的应用[J].中国厂矿医学,2004,17(2): 111.
[52]甄宇峰,沈娜君.对新生儿黄疸胆红素测定方法的探讨[J].中国社区医师·医学专业半月刊,2008, 01: 92-93.
[53]刘兴国.新生儿黄疸的治疗;药物疗法.见:金汉珍,黄德氓,官希吉,主编实用新生儿学.第2版.北京:人民卫生出版社. 1997:256.
[54]Cremer RJ,Peyrrman PW,Richards DH.Influence of light on the hypebrilirubinaemia of infants.Lnaeet,1958, l:1094-1097.
[55]王永明,徐天鹤,华子瑜.新生儿期胆红素的神经细胞毒性及影响因素[J].国外医学:妇幼保健分册, 2004, 15(3): 140-141.
[56]Fnaar of fAAMartinRJ Neonatal jaundice Neonatal perinatal Medieine(DiseasesoftheFetusnadInafnt). Jemrnay,1998:1371.
[57]中华医学会中华儿科杂志编辑委员会,中华医学会儿科学分会新生儿学组.全国新生儿黄疸与感染学术研讨会纪要(附新生儿黄疸干预推荐方案).中华儿科杂志. 2001, 39(3): 184-187.
[58]边俊梅,王瑢,张水堂.孕妇静滴催产素对新生儿黄疸的影响[J].中国优生与遗传杂志, 2000, 8(2):87.
[59]仝玉丽.抚触对新生儿黄疸的影响[J].中国妇幼保健,2006,21(14):1907- 1909.
[60]张莉英,鲁金玲.茵栀黄佐治新生儿高胆红素血症临床观察[J].新生儿科杂志, 2001, 16(2) : 80-81.
[61]刘岚,绍皙.新生儿病理性黄疸及治疗方法研究进展[J].国际儿科学杂志, 2006,33(6): 429-431.
[62]韦翠芬.茵栀黄注射液佐治新生儿高胆红素血症疗效观察[J].右江医学杂志,2008, 36(1): 123.
[63]李柏谦,张平,孙志滔.清开灵注射液对新生儿高胆红素血症的治疗观察[J].实用医学杂志,2001, 17(10): 1005.
[64]韦毅.茵栀黄治疗新生儿病理性黄疸临床观察[J].现代中西医结合杂志, 2009 , 18 (32): 3956-3957.
[65]张慎枢.茵栀黄注射液的抗菌作用及临床疗效[J].中成药研究,1986; (5) : 29.
[2]梁玉美,陈霞静.新生儿高胆红素血症病因分析及预防策略[J].右江医学,2007,35 (5): 1003-1383.
[3]Setia S,Villaveces A,Dhillon P,etal.Neonatal jaundice in Asian, white,and mixed-race infants[J].Arch Pediatr Adolesc Med.2002,156:276-279.
[4]刘汉嘉,韩雪芳,谢鹤,等.628例新生儿高胆红素血症临床分析[J].广东医学,2003,24(6):621-622.
[5]Bhutani VK,Donn SM,Johnson LH.Risk management of severe neona- tal hyperbilirubinemia to prevent kernicterus Clin Perinatol,2005,32: 125-139.
[6]吴晓翠,陈新.新生儿黄疸[M].北京:人民军医出社,2001:156-157.
[7]Ostrow JD,Pascolo L,Shapiro SM,et al.New concepts in bilirubin encephalopathy.Eur J C lin Invest, 2003, 33: 988-997.
[8]Shapiro SM.Definition of the clinical spectrum of kernicterus and bilirubin-induced neurologic dysfunction(BIND). J Perinatol, 2005, 25: 54-59.
[9]金汉珍,黄德氓,官希吉.实用新生儿学第2版[M].北京:人民卫生出版社,1997:256.
[10]Cremer RJ,Peyrrman PW,Richards DH.Influence of light on the hypebrilirubinaemia of infants.Lnaeet,1958,1: l094-1097.
[11]王永明,徐天鹤,华子瑜.新生儿期胆红素的神经细胞毒性及影响因素[J].国外医学:妇幼保健分册, 2004, 15(3):140-141.
[12]Fanaroff AA,Martin RJ,Neonatal jaundice.Neonatal-perinatal Medie- ine (Diseases of the Fetus and Inafnt).Jemrnay, 1998:137.
[13]中华医学会中华儿科杂志编辑委员会,中华医学会儿科学分会新生儿学组.全国新生儿黄疸与感染学术研讨会纪要(附新生儿黄疸干预推荐方案).中华儿科杂志, 2001,39(3):184-187.
[14]Seidmna DS,Moise J,Egraz Z,et al.A new blue light-emitting Phototherapy device:A prospective randomized controlled study.J pediatr, 2000; 136:773-774.
[15]Rosenstein BS,Dueore JM(1983)Indution on DNA strand breaks in normal human fibroblasts exposed to monochromatic ultraviolet and visible wavelengths in the 240-546 nm range. Photoehem Photobiol 38; 51-55.
[16]刘兴国.新生儿黄疸的治疗;药物疗法.见:金汉珍,黄德氓,官希吉,主编实用新生儿学.第2版.北京:人民卫生出版社1997:256.
[17]Kevin-Ives N.Neonatal juandice:Clinical management of the jaundiced inafnt.In:Rennie JM,Roberton NRC, ets.Textbook of neonatology 3rded. Edinbugrh:Churehill Livingatone, 1999, 726.
[18]Caldera R,Mayaier M, SenderA,etal.The effcet of human albumin in assoeciation with intensive Phototherapy in the mnagaement of neonatal jaundice.Arch Fr Pediatr,1993, 50(5): 399.
[19]Hosono S, Ohno T ,Kimoto H,et al. Eeffet of albumin infusion therapy on total and Unbound bilirubin values in term infants with intensive Phototherapy. Pediatr Int, 2001,43(1):8.
[20]Rubo J,Wahn V.High-dose intravenous immunoglobulin in Rh haemolytic disease [J]. Lnaect, 1991: 337(8746): 91442.
[21]李玲摘.静脉大剂量γ-球蛋白治疗血型不合引起的新生儿免疫溶血性黄疸.新生儿科杂志,1993,8(4):187.
[22]Sato K,Hara T,KondoT,et al. High-dose intravenous immunoglobulin therapy for Neonatal immune haemolytic jaundice due to blood group income- patibility.AetaPaediatrSeand. 1991: 80: 163-166.
[23]Rubo J,Albreeht K,Lasch,Petal.High dose intravenous immunoGlo- bulin therapy for hyperbilirubinemia caused by Rh haemolytic disease. Jpediatr,1992:121:93-97.
[24]Voto Ls,Sexer H,Ferreiro G,et al.Neonatal administration of high dose intravenous immunoglobulin in Rhesus haemolytic disease.J perinat Med,1995; 23:443-51.
[25]Dgaoglu T,Ovali F,Samnaci N,et al.High-dose intravenous immunoglobulin therapy for Rhesus haemolytic disease.J Int Med Res.1995, 23: 264-271.
[26]赵芳,张晓春,李怀玉,等.静注球蛋自治疗新生儿ABO溶血病的疗效[J].实用儿科临床杂志,2002,17(3):207-208.
[27]王继杰,李敏.静脉滴注丙种球蛋白治疗新生儿ABO溶血病的疗效观察[J].临床儿科杂志,2002, 20(4):235-236.
[28]杨彩云,吴明昌,王慧欣,等.静脉注射不同剂量丙种球蛋白治疗重症新生儿ABO溶血病48例疗效观察[J].中华围产医学杂志,2001; 6(1): 28-31.
[29]金汉珍,黄德眠,官希吉.实用新生儿学第3版[M],北京:人民卫生出版社,2003: 309-312.
[30]李锐钦,邓皓辉,邝玉子等.外周动静脉同步换血换血量与胆红素水平关系的研究[J].中国实用儿科杂志, 2001: 16(11): 660-662.
[31]杨玲竹,吏惠蓉,邵宝亭,等.Rh新生儿溶血病21例分析[J].实用妇产科杂志, 2001; 17(4): 231-232.
[32]陈白励.新生儿快速连续同步换血法[J].中国实用妇科和产科杂志,2001;17(10);589-591.
[33]李小敏.外周静脉加脐静脉同步换血治疗新生儿高胆红素血症39例报告[J].中国儿童保健杂志,2002; 6.
[34]钟丹妮,刘悠南,刘义,等.广西新生儿胆红素-尿普二磷酸葡萄糖醛酸转移酶基因Gly7IA突变的研究[J].中华儿科杂志,2002:40(to): 579-581.
[35]Silva RF,Rodrigues CM,Brites D.Bilirubin-induced apoptosis incultured rat neural cells is aggravated by chenodeoxycholic acid but prebvented by Ursodeoxyeholic acid[J].J Hepatol,2001,34(3):402-408.
[36]张莉英,鲁金玲.茵栀黄佐治新生儿高胆红素血症临床观察[J].新生儿科杂志,2001,16( 2):80-81.
[37]国家药典委员会.临床用药须知(中药卷)[S]. 2005年版.北京:人民卫生出版社,2005:96.
[38]刘圣,陈礼明.清热中药现代药理与临床[M]. 1版.合肥:安徽科学技术出版社,1999:40-278.
[39]张春莲,曹树军.茵栀黄白汤防治新生儿黄疸123例分析[J].中医杂志,2000, 41(2): 102.
[40]张慎枢.茵栀黄注射液的抗菌作用及临床疗效[J].中成药研究,1986; (5) : 29.
[41]韦翠芬.茵栀黄注射液佐治新生儿高胆红素血症疗效观察[J].右江医学杂志, 2008,36(1):123.
[42]李柏谦,张平,孙志滔.清开灵注射液对新生儿高胆红素血症的治疗观察[J].实用医学杂志,2001, 17( 10): 1005.
[43]王佩珍,顾锦耀.茵栀黄注射液的不良反应[J].中国新药于临床杂志, 1998, 11( 6) : 391.
[44]金汉珍,黄德珉,宫希吉.实用新生儿学[M]. 3版.北京:人民卫生出版社,2008: 266- 268.
[45]Andreula CF.Simonetti L,DeSantis F,et al.Minimally invasive Oxygen ozone therapy for lumbar discherniation[J].AJNR,2003,24(5): 996-1000.
[46]Mishra S, Agarwal R, Deorari AK, et al. Jaundice in the newborns[J]. Indian J Pediatr, 2008, 75(2): 157- 163.
[47]唐卉,李慕军,杨晓娅,等.脐血胆红素早期预测新生儿病理性黄疸的价值[J].广西医学,2001, 23(8): 729- 730.
[48]毛健,富建华,陈丽英,等.重度高胆红素血症新生儿苍白球磁共振成像特征及其临床意义[J].中华儿科杂志,2007, 45(1):24- 29.
[49]Ahlfors CE,Parker AE.Unbound bilirubin concentration is associ- ated with abnormal automated auditory brainstem response for jaundiced newborns[J]. Pediatrics,2008,121(5):976- 978.
[50]Moerschel SK,Cianciaruso LB,Tracy LR.A practical approach to neonatal jaundice[J]. Am Fam Physician, 2008, 77(9):1255- 1262.
[51]孙丽丽,武广云,尹立岩.经皮胆红素测定在新生儿黄疽筛查中的应用[J].中国厂矿医学,2004,17(2): 111.
[52]甄宇峰,沈娜君.对新生儿黄疸胆红素测定方法的探讨[J].中国社区医师·医学专业半月刊,2008, 01: 92-93.
[53]刘兴国.新生儿黄疸的治疗;药物疗法.见:金汉珍,黄德氓,官希吉,主编实用新生儿学.第2版.北京:人民卫生出版社. 1997:256.
[54]Cremer RJ,Peyrrman PW,Richards DH.Influence of light on the hypebrilirubinaemia of infants.Lnaeet,1958, l:1094-1097.
[55]王永明,徐天鹤,华子瑜.新生儿期胆红素的神经细胞毒性及影响因素[J].国外医学:妇幼保健分册, 2004, 15(3): 140-141.
[56]Fnaar of fAAMartinRJ Neonatal jaundice Neonatal perinatal Medieine(DiseasesoftheFetusnadInafnt). Jemrnay,1998:1371.
[57]中华医学会中华儿科杂志编辑委员会,中华医学会儿科学分会新生儿学组.全国新生儿黄疸与感染学术研讨会纪要(附新生儿黄疸干预推荐方案).中华儿科杂志. 2001, 39(3): 184-187.
[58]边俊梅,王瑢,张水堂.孕妇静滴催产素对新生儿黄疸的影响[J].中国优生与遗传杂志, 2000, 8(2):87.
[59]仝玉丽.抚触对新生儿黄疸的影响[J].中国妇幼保健,2006,21(14):1907- 1909.
[60]张莉英,鲁金玲.茵栀黄佐治新生儿高胆红素血症临床观察[J].新生儿科杂志, 2001, 16(2) : 80-81.
[61]刘岚,绍皙.新生儿病理性黄疸及治疗方法研究进展[J].国际儿科学杂志, 2006,33(6): 429-431.
[62]韦翠芬.茵栀黄注射液佐治新生儿高胆红素血症疗效观察[J].右江医学杂志,2008, 36(1): 123.
[63]李柏谦,张平,孙志滔.清开灵注射液对新生儿高胆红素血症的治疗观察[J].实用医学杂志,2001, 17(10): 1005.
[64]韦毅.茵栀黄治疗新生儿病理性黄疸临床观察[J].现代中西医结合杂志, 2009 , 18 (32): 3956-3957.
[65]张慎枢.茵栀黄注射液的抗菌作用及临床疗效[J].中成药研究,1986; (5) : 29.