| Objectives:(1)To objectively evaluate the clinical efficacy of herbal medicinal baths in the treatment of neonatal jaundice and their safety,using Meta-analysis.To provide evidence-based medical evidence for the clinical application of herbal baths in the treatment of neonatal jaundice.(2)To clinically observe the efficacy of Jin Chen lotion in the treatment of neonatal jaundice(damp-heat-depression evidence).Methods:(1)Meta-analysis part: Computer searches of Chinese databases such as China Knowledge Network(CNKI),Wanfang,Vipers(VIP),and China Biomedical Literature Service(CBM)were conducted to collect randomized controlled trials on the treatment of neonatal jaundice with herbal medicine baths in the past 20 years.Meta-analysis was performed using Rev Man 5.3 software.(2)Clinical observation part: 90 cases of children with damp-heat-depressed fetal yellowness attending the pediatric departments of the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine and the First People’s Hospital of Yunnan Province from October 2020 to October 2022,who met the observation conditions,were selected as observation subjects.A 2:1 control was used,30 cases in the observation group and 60 cases in the control group,and the observation group was given a herbal bath with Jin Chen lotion,while the control group was treated with blue light irradiation(the treatment cycle of the observation group was 6 days,and the light therapy was stopped when the transcutaneous bilirubin value of the control group was <85 μmol/L).The clinical efficacy of this study was comprehensively evaluated by observing the total clinical efficiency,transcutaneous bilirubin value,and total TCM evidence score after treatment.Results:(1)Meta-analysis section.(1)In the treatment of neonatal jaundice,herbal medicinal bath combined with conventional treatment had an advantage over conventional treatment alone in terms of total clinical efficiency [RR=4.90,95% CI(4.38,5.43),Z=18.24,P<0.00001].(2)In the treatment of neonatal jaundice,herbal medicated bath combined with conventional treatment had an advantage over conventional treatment alone in reducing serum total hemoglobin values [SMD=-13.97,95%CI(-14.63,-13.31),Z=41.68,P< 0.00001].(3)In the treatment of neonatal jaundice,herbal medicine bath combined with conventional treatment compared with conventional treatment alone There was an advantage in reducing the level of transcutaneous bilirubin values [SMD =-4.43,95% CI(-4.67,-4.19),Z =36.49,P<0.00001].(4)In the treatment of neonatal jaundice,herbal medicine bath combined with conventional Western medicine treatment significantly shortened the number of days of jaundice regression compared with conventional treatment alone [SMD=-1.86,95%CI(-1.97,-1.76),Z = 34.92,P<0.00001].(5)In the treatment of neonatal jaundice,herbal medicated bath combined with conventional treatment significantly shortened the number of hospital days compared with conventional treatment alone [SMD =-0.85,95%CI(-1.06,-0.65),Z = 8.03,P<0.00001].(6)In the treatment of neonatal jaundice,the incidence of adverse reactions was reduced with herbal medicine bath combined with conventional treatment compared with conventional treatment alone [RR = 0.39,95%CI(0.21,0.71),,Z = 3.03,P=0.002<0.05].(2)Clinical observation part:(1)The total clinical efficiency of the observation group was 86.6% when treated with Jin Chen lotion for 6 days,while the total clinical efficiency of the control group was 95%,and the total clinical efficiency of the observation group was lower than that of the control group(P < 0.05).(2)When mild jaundice(jaundice value of 5-10mg/dl),the total clinical efficiency of the observation group was 88.9%,and the total clinical efficiency of the control group was81.0%,the treatment effect of the observation group was better than that of the control group(P < 0.05);when moderate jaundice(jaundice value of 10-15mg/dl),the total efficiency of the observation group was 75.0%,and the total efficiency of the control group was 76.9%;when severe jaundice(jaundice value > 15mg/dl),the total effective rate was25% in the observation group and 80% in the control group,and the treatment effect of the control group was better than that of the observation group when the jaundice value was >10mg/dl(P<0.05).(3)After treatment,the transcutaneous bilirubin values of both groups were lower than those before treatment,and the efficacy of the observation group was lower than that of the control group,and the difference between the two groups was statistically significant(P <0.05).(4)After treatment,the total TCM evidence score decreased in both groups compared with that before treatment,and the treatment effect in the control group was better than that in the observation group,and the difference between the two groups was statistically significant(P < 0.05).Conclusions:(1)It was confirmed by Meta-analysis that,compared with conventional treatment alone,Chinese herbal medicine bath combined with conventional treatment in the treatment of neonatal jaundice had advantages in terms of total clinical efficiency,post-treatment serum total bilirubin values,transcutaneous bilirubin values,days to regression,days in hospital,and incidence of adverse effects compared with conventional treatment alone.However,due to the lack of standardized clinical research methods,the quality of the literature is generally low,and more high-quality double-blind controlled trials with large samples are needed for validation in the future.(2)The efficacy of Jin Chen lotion herbal bath in the treatment of damp-heat-depressed fetal yellowness is exact,and it can reduce transcutaneous bilirubin values.For children with mild jaundice in good general condition and exclusion bilirubin encephalopathy,Jin Chen lotion herbal bath can be preferred;for children with moderate to severe jaundice,light therapy is preferred,and the use of Jin Chen lotion herbal bath is recommended as a sequential therapy after light therapy when the jaundice value drops to 10 mg/dl after light therapy.Throughout the treatment process,no adverse reactions occurred,and the safety was high,which has positive significance for the treatment of neonatal jaundice and can be used as a clinical reference. |
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