目的 观察赤丹退黄颗粒联合酪酸梭菌活菌散治疗新生儿高胆红素血症的临床疗效。方法 选取2025年5月—2026年1月郑州市妇幼保健院收治的高胆红素血症新生儿82例，按临床实际用药将患儿分为对照组和治疗组，每组各41例。对照组温水冲服酪酸梭菌活菌散，1袋/次，3次/d。治疗组在对照组基础上温水冲服赤丹退黄颗粒，1 g（1/10袋）/次，3次/d。两组均连续治疗7 d。比较两组临床疗效、临床症状改善时间、胆红素和肝功能指标、血常规和炎症因子指标、免疫功能指标。结果 治疗后，治疗组总有效率为92.68%，高于对照组的总有效率82.93%，组间比较差异显著（P＜0.05）。治疗组腹胀好转时间、黄疸消失时间、胎便转黄时间均短于对照组（P＜0.05）。两组治疗后总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）、谷草转氨酶（AST）、谷氨酰转移酶（GGT）、碱性磷酸酶（ALP）均较治疗前下降（P＜0.05）；治疗组治疗后TBIL、DBIL、IBIL、AST、GGT、ALP低于对照组（P＜0.05）。两组治疗后白细胞计数（WBC）、中性粒细胞百分比（NEUT%）、血小板计数（PLT）、C反应蛋白（CRP）、降钙素原（PCT）水平均较治疗前下降（P＜0.05）；治疗组治疗后WBC、NEUT%、PLT、CRP、PCT水平低于对照组（P＜0.05）。两组治疗后CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺、免疫球蛋白G（IgG）、免疫球蛋白A（IgA）、免疫球蛋白M（IgM）均明显升高，CD8⁺明显降低（P＜0.05）；治疗组治疗后CD3⁺、CD4⁺、CD8⁺、CD4⁺/ CD8⁺、IgG、IgA、IgM高于对照组，CD8⁺低于对照组（P＜0.05）。结论 赤丹退黄颗粒联合酪酸梭菌活菌散治疗新生儿高胆红素血症的疗效确切，可加速临床症状消退，显著改善肝功能，降低胆红素水平，抑制炎症反应，增强免疫功能。

Objective To observe the clinical efficacy of Chidan Tuihuang Granules combined with Clostridium Butyricum Powder in treatment of neonatal hyperbilirubinemia.Methods A total of 82 neonates with neonatal hyperbilirubinemia admitted to Zhengzhou Maternal and Child Health Hospital from May 2025 to January 2026 were selected, and were divided into control group and treatment group according to actual clinical medication use, with 41 cases in each group. The control group took Clostridium Butyricum Powder in warm water, 1 bag/time, 3 times daily. The treatment group took Chidan Tuihuang Granules in warm water on the basis of the control group, 1 g (1/10 bag)/time, 3 times daily. Two groups were treated continuously for 7 days. The clinical efficacy, clinical symptom improvement time, bilirubin and liver function indicators, blood routine and inflammatory factor indicators, and immune function indicators were compared between two groups. Results After treatment, the total effective rate of the treatment group was 92.68%, which was higher than the total effective rate of 82.93% in the control group, and the difference between groups was significant (P < 0.05). The improvement time of abdominal distension, disappearance time of jaundice, and time for fetal stool to turn yellow in the treatment group were all shorter than those in the control group (P < 0.05). After treatment, the total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), aspartate aminotransferase (AST), glutamyl transferase (GGT), and alkaline phosphatase (ALP) in two groups decreased (P < 0.05). After treatment, the levels of TBIL, DBIL, IBIL, AST, GGT, and ALP in the treatment group were lower than those in the control group (P < 0.05). After treatment, the white blood cell count (WBC), neutrophil percentage (NEUT%), platelet count (PLT), C-reactive protein (CRP), and procalcitonin (PCT) levels in two groups decreased (P < 0.05). The levels of WBC, NEUT%, PLT, CRP, and PCT in the treatment group were lower than those in the control group after treatment (P < 0.05). After treatments, CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺, immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM) in two groups were significantly increased, while CD8⁺ was significantly decreased (P < 0.05). After treatment, the levels of CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺, IgG, IgA, and IgM in the treatment group were higher than those in the control group, while CD8 ⁺ was lower than that in the control group (P < 0.05). Conclusion Chidan Tuihuang Granules combined with Clostridium Butyricum Powder has a definite therapeutic effect on neonatal hyperbilirubinemia, can accelerate the resolution of clinical symptoms, significantly improve liver function, reduce bilirubin levels, inhibit inflammatory reactions, and enhance immune function.

R985

河南省医学科技攻关计划联合共建项目（LHGJ20250734）