The Clinical Observation Of Jian Pi And Li Dan Mixture For The Treatment Of Infants With Parenteral Nutrition Associated Cholestasis

ObjectiveObserving the curative effect for the treatment of 72 cases infants who got parenteral nutrition associated cholestasis by using JianPi and LiDan mixture cooperating with conventional western medicine therapy, and then exploring correlation mechanism and clinical advantages to infant of parenteral nutrition associated cholestasis with JianPi and LiDan mixture treatment.MethodsSince January 2012 until September 2014,72 cases infants with parenteral nutrition associated cholestasis were selected from Clinical departments(Combine traditional Chinese and western medicine department,Neonatal medicine,Neonatal surgery,Digestive internal medicine) of Children’s hospital in Wuhan. By the method of random number, they were divided into treatment group by integrating Chinese and Western medicines and control group who dealed with only conventional Western treatment with 36 cases in each group. The control group received routine treatment of Western medicine as glutathione with Ursodesoxycholic acid and etc, on the basis of which the treatment group was added JianPi and LiDanmixture treatment. And the course of each group was 2 weeks. Before and after therapy, observing the following indicators: the change of the children’s integral with clinical symptoms of traditional Chinese medicine, laboratory indexes, the adds of weight after remedy and jaundice degraded time. The laboratory indexes include serum direct bilirubin(DBIL), Gamma glutamyl enzyme(γ-GT), total bilirubin(TBIL), aspartate aminotransferase(AST), total bile acid(TBA),alkaline phosphatase(ALP),alanine aminotransferase(ALT),and ects, and then conducted integral and curative effect evaluation with statistical method. Before treatment,the two groups in gender, age, course of the treatment, birth weight,gestational age and duration of PN were comparabled no significant difference of statistics.ResultsCompared of traditional Chinese medicine syndrome integral of two groups before treatment, which were 25.34±2.46 and 26.12±3.26,there was no significant difference(P > 0.05); After treatment traditional Chinese medicine syndrome integral of treatment group was 12.05±3.25, compared with which of control group was 21.14±2.55, there was totally significant differences(P < 0.05);Each laboratory indicator(DBIL、γ-GT 、TBIL、AST、TBA、ALP、ALT)between the treatment group and the control group before treatment was not significant(P > 0.05); DBIL、TBIL and TBA of the treatment group decreased obviously after treatment and was a significant difference(P < 0.05) compared with the treatment group, while γ-GT、AST、ALP and AST of the treatment group compared with the control group, there was no significant difference(P >0.05); Before treatment the body weight in treatment group was3.01±1.04 and 3.28±1.35 in control group,compared which by statistical method was no significant difference(P > 0.05); The weight growth of the treatment group(0.85±1.33)compared with control group( 0.42±1.21) after treatment has a significant difference(P < 0.05);Compared the jaundice degraded time(28.40± 10.42/57.51 ± 16.32) of two groups, there was significant difference(P < 0.05). According to traditional Chinese medicine syndrome integral and curative effect of decision criteria:treatment group total effective rate and the efficiency rate was88.89% and 33.33% respectively, compared with the control group total effective rate was 66.67%, and show the efficiency of19.44%,has the significant difference(P < 0.05), with statistical significance.ConclusionThis topic research has shown that: JianPi and LiDan mixture with routine western medicine therapy PNAC of infant in improving traditional Chinese medicine clinical symptoms, reducing the laboratory indexes(TBIL, DBIL, TBA), increasing the weight and promoting jaundice degraded were better than pure routine western medicine therapy, and the curative effect of JianPi and LiDan mixture for treating parenteral nutrition associated cholestasis was also significant, considering concerned with the function of Chinese medicine like promoting bile excretion and gastrointestinal function, improving immunity, enhancing the body’s metabolism and promoting the role of the growth and development and ects, what is more, it had clinical obvious advantage with less adverse reaction, which suitable for clinical adoption.