茵陈蒿汤外洗联合布拉氏酵母菌散和光疗治疗新生儿高胆红素血症的临床研究

摘要 目的：探讨茵陈蒿汤外洗联合布拉氏酵母菌散和光疗治疗新生儿高胆红素血症的临床效果。方法：选取我院于2019年3月~2020年12月期间收治的新生儿高胆红素血症患儿97例。根据随机数字表法分为A组（48例）和B组（49例）。A组给予光疗治疗，B组在A组基础上采用茵陈蒿汤外洗联合布拉氏酵母菌散治疗。对比两组疗效、光疗总时间、住院总时间、不同时间点总胆红素（TBIL）及间接胆红素（IBIL）水平，分析两组患儿治疗72 h后的肠道菌群状况。结果：B组治疗后的临床总有效率高于A组（P<0.05）。B组的光疗总时间及住院总时间均短于A组（P<0.05）。两组治疗24 h后、治疗48 h后、治疗72 h后TBIL、DBIL水平呈下降趋势，且B组低于A组（P<0.05）。治疗72 h后B组肠道内拟杆菌属丰度高于A组（P<0.05），但大肠埃希菌属和葡萄球菌属丰度低于A组（P<0.05）。结论：茵陈蒿汤外洗联合布拉氏酵母菌散和光疗治疗新生儿高胆红素血症的疗效显著，可缩短光疗时间和住院时间，有效降低胆红素水平，调节患儿肠道菌群状况。

Clinical Study of Yinchenhao Decoction External Washing Combined with Saccharomyces Boulardii Sachets and Phototherapy in the Treatment of Neonatal Hyperbilirubinemia

ABSTRACT Objective: To investigate the clinical effect of Yinchenhao decoction external washing combined with Saccharomyces boulardii sachets and phototherapy in the treatment of neonatal hyperbilirubinemia. Methods: 97 cases of children with neonatal hyperbilirubinemia in our hospital from March 2019 to December 2020 were selected. According to random number table method, they were divided into group A (48 cases) and group B (49 cases). The group A was treated with phototherapy, and the group B was treated with Yinchenhao decoction external washing and Saccharomyces boulardii sachets on the basis of group A. The curative effect, total phototherapy time, total hospitalization time, total bilirubin (TBIL) and indirect bilirubin (IBIL) levels at different time points were compared between the two groups, and the intestinal flora of the two groups 72 h after treatment were analyzed. Results: The total effective rate of group B was higher than that of group A(P<0.05). The total phototherapy time and total hospitalization time of the group B were shorter than those of the group A(P<0.05). The levels of TBIL and DBIL in the two groups showed a downward trend at 24 h after treatment, 48 h after treatment and 72 h after treatment, and the group B was lower than the group A(P<0.05). 72 h after treatment, the abundance of pseudobacteroides in intestine of group B was higher than that of group A(P<0.05), but the abundance of Escherichia coli and Staphylococcus were lower than those of group A(P<0.05). Conclusion: Yinchenhao decoction external washing combined with Saccharomyces boulardii sachets and phototherapy in the treatment of neonatal hyperbilirubinemia has significant effect, which can shorten the total phototherapy time and total hospitalization time, effectively reduce the bilirubin level, and regulate the intestinal flora of children.