The Clinical Research Of Sijunzi Decoction On Feeding Intolerance In Premature Infants

Objective:To investigate the curative effects of si junzi decoction(SJZD) on feeding intolerance in premature infants.And to explore the effect of SJZD on serum gastrin(GAS) and plasma motilin(MOT) in premature infants with feeding intolerance. With a view to improve the clinical symptoms of spleen deficiency in preterm infants with feeding intolerance, and evaluate the safety of SJZD.Methods:According to the case study of prospective randomized controlled trial design of case study methods, were included in January 2009-December 2009 in Guangzhou University of Traditional Chinese Medicine subsidiary maternity Children's Hospital Neonatal Intensive Care Center,68 cases of premature infants with feeding intolerance, which were randomly divided into SJZD group and control group.Control group infants according to management guidelines for premature infants with conventional treatmen, during treatment of feeding intolerance, the control group were given 10 minutes of non-nutritive sucking before each feeding. Necessary, additional treatment with domperidone suspl 0.4ml/kg by peroral administration or nasal feeding once in every 8 hours a day,30 minutes before feeding. If the effect is not satisfactory, given the control group intravenous erythromycin 5 mg/kg for once a day, which applied the infusion with micro-infusion pump within one or two hours. The course of treatment lasted from 3 to 5 days. And the treatment group in the conventional management of premature infants at the same time, to oral SJZD of Chinese medicine, a small amount several times(1-3ml/times, Q3-4h/times), received treatment for a total of two weeks. The clinical symptoms (milk capacity, disgorging,gastric retention, abdominal distension, defecation information,etc.) were observed before and after treatment. Statistics the anemia rate at the end of the treatment;statistics parenteral nutrition time, weight increases and decreases before discharge;monitoring of liver function, kidney function, blood routine Urine routine and stool for routine. Detected the serum gastrin and plasma motilin levels of two groups before and after treatment. The gastrin and motilin in blood were detected by radioimmunoassay(RIA). Compared the result with statistical analysis.Result:The incidence rate of disgorging was direct correlation to conceptus age of premature infants, and the regularity of incidence rate of gastric retention,abdominal distension and constipation was opposite, the difference has statistically significant (P<0.05). The duration of feeding intolerance,the meam day age of total gastrointestinal feeding and the meam day age of rebound to birth weight in SJZD group were significantly shorter then control group (P<0.01). The average augmented milk and the weight gain in 7 days after the body weight stop decreased were significantly increased in SJZD group then control group, and the highest numerus of physiological losing of body weight in SJZD group was less then control group (P<0.05). Contrasted the contol group, the length of stay of the SJZD group was shorter (P<0.05). For the curative effect, the markedly effective rate of SJZD group was 52.9%, and the control group was 29.4%; the total efficiency rate of SJZD group was 97.1%, and the control group was 91.2%, the SJZD group were significantly higher than those in control group (P<0.05). The incidence of anemia of prematurity was 23.5% in SJZD group and 47.1% in control group, the difference was statistically significant (P<0.05). Contrasted the contol group, the length of stay of the SJZD group was shorter (P<0.05). The levels of serum gastrin and plasma motilin in two groups were significant increased after the treatment (P<0.01). The serum gastrin and plasma motilin levels between SJZD group and control group had no statistical meaning before treatment(P>0.05). After treatment, the levels of serum gastrin and plasma motilin in SJZD group were significantly higher than those in control group (P<0.05). The numerus of Hb,HCT and Ret had no statistical meaning between both SJZD group and control group before treatment (P>0.05). After treatment, The numerus of Hb,HCT and Ret in SJZD group were significantly higher than those in control group (P<0.05). The premature infants were fed without adverse effects of medical herbs.Conclusion:The curative effect of Sijunzi decoction on the spleen deficiency syndrome was significant. Sijunzi decoction can significantly treat feeding intolerance in premature infants effectively, improve digestion, increace milk, shorten the reached time of total gastrointestinal feeding, promote the weight gain, shorten the length of stay, improve the levels of serum gastrin and plasma motilin, improve the levels of Hb,HCT,Ret and reduce the incidence of anemia of prematurity. The medication is safe.