中西医结合防治ABO新生儿溶血症

作者	单位
姜梅	中日友好医院
钱美伦	北京协和医院妇产科
何萃华	北京协和医院妇产科
徐蕴华	北京协和医院妇产科
李大维	中日友好医院
张苏平	北京协和医院儿科

摘要点击次数: 1504

全文下载次数: 945

中文摘要:

本文报道了用中西医结合的方法对既往有严重 ABO 新生儿溶血症妊娠或分娩史的孕妇及新生儿进行中药、蓝光照射、白蛋白、血浆等预防用药及治疗(孕妇自17周起服中药至分娩,新生儿娩出后即服预防性中药3天)。结果:服药前后新生儿溶血症的发病率由78.6%下降为26.3%(P<0.005);患儿病死率由56.8%下降为0%(P<0.001)。提示中西医结合防治本病,可明显降低发病率和病死率;即使发病,病情也轻;经长期随诊无后遗症发生。

英文摘要:

Both Chinese herbal medicine and Western medicine were administered for prevention and treatment of the neonatal hemolytic disease by giving the herbal medicine of promoting the blood circulation and relieving the staffs as well as regulating the Qi(气)prescription composed of Leonurus heterophyllus,Ligusticum wallichii,Paeonia alba,Angelica sinensis and Saussurea lappa,making in pills to 35 pregnant women who had the history of delivering the"yellow baby"previously.It was given from 17th weeks of pregnancy up to the delivery.As for the blood group of the mothers,34 of them were group"O",only one belonged to group"A". The titer of their serum anti-A(B)IgG were>1:64.Meanwhile,the blood group of the fetuses were different from their mothers.Changes of the serum anti-A(B)IgG titer were followed monthly during the medication. 38 newborns were delivered by 35 mothers with one pair of twin,2 mothers delivered twice.Cord blood bilirubin,anti-A(B)IgG titer,hemoglobin,blood group of the newborns were examined immediately after delivery.Another group of herbal medicine with the effect of clearing up the heat and removing the dampness such as Artemisia scoparia,Gardenia jasminoides,Scutellaria baicalensis,while several kinds of Western medicine of liver protection as luminal,glucurolactone,prednisone were administered orally just after the birth for three days for prophylaxis.Meanwhile,the changes of symptoms and signs as well as laboratory findings of the newborns especially serum bilirubin were followed closely.The principles and methods of oombined treatment according to the severity of disorders were demonstrated.Intravenous infusion of Chinese herbal medicine for clearing up the heat and removing the dampness,and supplemented with Rhubarb, photo-therapy,albumin infusion,exchange transfusion etc.were given.Comparison of the morbidity and mortality between the two groups of newborns before and after the combined therapy who were delivered by tile same group of mothers showed the morbidity rates were 78.6% and 26.3%;mortality rates 56.8% and 0% respectively,which were significant statistically.The severity of the disturbance of the newborn patients after the medication,9 of them were mild,only one was rather severe with the bilirubin peak value of 22.3 mg/dl and was cured by exchange transfusion.There were no sequelae in the medication group after long-period follow-up.The mechanism of the pathogenesis was discussed from both the TCM and the WM point of view.Immunological test on mature mice were done after taking drugs.The titer of anti-A(B) IgG were decreased dramatically especially in the herbal group.Human serum immunological inhibition test and agglutinin absorption test demonstrated some drugs among the blood circulation promoter and stasis reliever,as well as heat and dampness remover served as immunological inhibitor,thus,offering the theoretical basis of the treatment for this disease. Now working in China-J apan Friendship Hospital

关闭