茵陈五味汤对新生儿感染性黄疸的疗效及作用机制

目的:观察茵陈五味汤对新生儿感染性黄疸的疗效及作用机制,并观察其对hs-CRP和MCP-1基因表达的影响。方法:选取于2016年1月至2017年2月宝鸡市中医医院儿科收治的新生儿感染性黄疸患者的76例。通过随机分组法,分别将患者纳入观察组和对照组,每组38例,对照组:蓝光治疗联合头孢唑林钠;观察组:在对照组基础上,口服茵陈五味汤,疗程5 d。对患者进行疗效评定的同时采用经皮黄疸仪于患儿眉心处每日早晚各检测3次,分别取平均值作为患儿的经皮胆红素值(TCB)。治疗前后乳胶免疫比浊法检测血清hs CRP(超敏C反应蛋白),采用分立式全自动生化分析仪检测患儿治疗前后白细胞计数(WBC)。Taq Man荧光探针检测单核细胞趋化蛋白-1(MCP-1)基因表达情况。结果:1)2组治疗前后的疗效进行比较,观察组总有效率(97.37%)优于对照组(94.74%),但差异无统计学意义(P0.05)。2)治疗后2组经皮胆红素值均较治疗前明显下降,差异有统计学意义(P0.05),观察组该值下降程度明显优于对照组,差异有统计学意义(P0.05)。3)治疗前2组hs-CRP、WBC、MCP-1比较均差异无统计学意义(P0.05)。2组hs-CRP、WBC均较治疗前明显下降,差异有统计学意义(P0.05),治疗后观察组hs-CRP、WBC、MCP-1下降程度均明显优于对照组,差异有统计学意义(P0.05)。结论:茵陈五味汤能有效改善新生儿感染性黄疸,降低经皮胆红素值和WBC计数,其机制可能与sCRP、MCP-1下调有关。

Effect of Yinchen Wuwei Decoction on Neonatal Jaundice Infection and its Mechanism

To observe the effect of Yinchen Wuwei decoction on neonatal jaundice infection, and its effect on hs-CRP and MCP-1 gene expression.Methods:A total of 76 cases of neonatal infectious jaundice in our hospital from January 2016 to February 2017 were selected.The patients were randomly divided into treatment group and control group, with 38 cases in each group.Treatment for the control group:blue light treatment combined with cefazolin sodium; Treatment for the treatment group:on the basis of the control group, orally taken Yinchen decoction of five ingredients.After a course of 5 days, the clinical efficacy was assessed at the same time using transcutaneous jaundice meter between children eyebrows for 3 times in the morning and evening.The average value is taken as the children with transcutaneous bilirubin (TCB).Before and after treatment, the serum hsCRP (high sensitivity C reactive protein) was detected by latex immunoassay, and the white blood cell count (WBC) before and after treatment was detected by the automatic biochemical analyzer.The expression of monocyte chemoattractant protein-1 (MCP-1) gene was detected by TaqMan fluorescent probe.Results:1) The curative effect was compared between the two groups before and after treatment.The total effective rate of the treatment group (97.37%) was higher than that of the control group (94.74%), but there was no significant difference (P>0.05) .2) After treatment, the values of transcutaneous bilirubin in the two groups were significantly lower than those before treatment (P<0.05), the treatment group was significantly lower than the control group (P<0.05).3) There was no significant difference in hs-CRP, WBC and MCP-1 between the two groups before treatment (P>0.05).After treatment, hs-CRP and WBC of the two groups were significantly lower (P<0.05).After treatment, hs-CRP, WBC, MCP-1 decreased significantly, and it is more obvious in the observation group (P<0.05).Conclusion:Yinchenwuwei decoction can effectively relieve neonatal jaundice infection, reduce the percutaneous value and the count of WBC, the mechanism may be related to down-regulation of s-CRP and MCP-1.