茵栀黄口服液辅助治疗新生儿胆道闭锁21例疗效研究

目的 探讨茵栀黄口服液治疗胆道闭锁的临床疗效及安全性。方法 将42例胆道闭锁患儿随机分为对照组和治疗组,各21例。对照组采用肝门空肠吻合术（Kasai手术）及药物常规治疗,治疗组在此基础上于手术前后口服茵栀黄口服液。观察两组患儿的临床疗效,于治疗前后检测血生化指标和细胞因子水平,并记录药品不良反应;随访半年,观察胆管炎的发作情况及肝纤维化程度。结果 治疗后,治疗组总有效率为90.48%,明显高于对照组的71.43%（P〈0.05）;两组患儿治疗后血生化指标和细胞因子水平均较治疗前明显降低,且治疗组比对照组下降更显著（P〈0.05）;治疗组出现药品不良反应3例,症状均较轻微;随访半年,治疗组和对照组胆管炎发生率分别为9.52%和23.81%,肝纤维化异常率分别为9.52%和28.57%,但差异无统计学意义（P〉0.05）。结论 胆道闭锁新生儿在行Kasai手术及常规药物治疗的基础上,加用口服茵栀黄口服液,可显著提高临床疗效,调节患儿免疫功能,且不良反应较少,值得推广。

Clinical Efficacy of Yinzhihuang Oral Liquid in Treating Neonatal Biliary Atresia on 21 Cases

Objective To investigate the clinical efficacy and security of Yinzhihuang Oral Liquid in treating neonatal biliary atresia. Methods 42 cases of neonatal biliary atresia were randomly divided into the treatment group and the control group,21 cases in each group. The control group was treated with hepatic portal jejunal anastomosis （Kasai surgery） and routine medication therapy and on this basis the treatment group orally took Yinzhihuang Oral Liquid before operation. The clinical efficacy was observed in the two groups. Serum biochemical indexes and cytokine levels were examined before and after treatment. The drug adverse reactions were recorded. Follow- up lasted for half a year. The onset of cholangitis and liver fibrosis degree were observed. Results The total effective rate after treatment in the treatment group was 90.48% ,which was significantly higher than 71.43% in the control group （P 〈 0.05）;the levels of serum biochemical indexes and cytokines after treatment in the two groups were decreased compared with before treatment,but the decrease in the treatment group was more significant compared with the control group（P 〈 0. 05）;the treatment group had 3 cases of adverse reactions,the clinical symptoms were mild;in follow-up for half a year,the incidence rate of cholangitis in the treatment group and the control group were 9.52% and 23.81% respectively,the abnormal rate of hepatic fibrosis were 9.52% and 28.57% respectively, but the differences were not statistically significant （P 〉 0. 05）. Conclusion On the basis of performing Kasai surgery and the routine medication for treating neonatal biliary atresia, adding Yinzhihuang Oral Liquid can significantly increase the clinical efficacy and adjust the immune function with less adverse reactions,which is worth clinical promotion.