- 期刊
Maternal Ingestion of Coptis and Its Effect on Neonatal Hyperbilirubinemia
母親服用黃速與新生兒高膽紅素血症的關係
摘要
在臺灣大部分孕婦在懷孕期間都服用過黃連，而且在她們的想法裏不認為黃連是一種藥，而只是一種日常服用物品。我們爲了瞭解黃連在中國新生兒高膽紅素血症中所佔的角色，而從事二個研究觀察，並將結果提出報告，以供大家參攷。第一部分爲自民國69年7月至70年6月一年中在臺北醫附設醫院出生的334位足月、體重在2,501至4,000gm之間，經由産道生産的健康新生兒，每天由腳跟採血測定其血清膽紅素值。依據母親在妊娠第三期間服用黃連15膠囊以上者與未服用者分爲二組，比較二者之間的差別。在服用組及未服用組其嬰兒血清膽紅素值分別爲：第1天4.48±1.67mg/dl及4.24±1.91mg/dl；第2天7.51±1.78mg/dl及7.32±1.79mg/dl；第3天9.59±2.40mg/dl及9.55±2.32mg/dl；第4天10.90±2.69mg/dl及10.74±2.61mg/dl；第5天10.37±3.04mg/dl及10.60±2.63mg/dl；高峯值11.68±2.47mg/dl及11.51±2.51mg/dl。每天及高峯血清膽紅素值二組間的差異皆無統計學上的意義。每峯血清膽紅素值大於15mg/dl者在服用組與未服用組分別爲7.5%(13/173)及5.0%(8/161)，二組間的差異亦無統計上的意義。第二部分爲自民國70年2月至6月間屬於未服用組中的63個嬰兒，將其臍帶血經由不同濃度的氯化小葉鹼(berberine chloride)或市面上所賣的黃連（製成膠囊，爲目前一般孕婦所服用者）作用3及12小時之後，測其溶血情形及紅血球脆性，並將其做成溶血百分比曲線。我們發現溶血曲線並不因葉物、濃度及作用時間而有改變，都在0.45%之氯化鈉溶液開始急速上昇，在0.2%氯化鈉溶液達近乎最高限。本研究觀察顯示，母親在懷孕期間服用黃連其嬰兒的血清膽紅素值及高膽紅素血症的發生率並未較未服用組高，但也沒有較低。經由活體外試驗，黃連也會增加紅血球的破壞。但根據肝臓灌流實驗顯示，小葉鹼主要由肝臟代謝，新生兒肝機能之不成熟也爲大家所公認，因此我們認爲將黃連給予新生兒服用，交不是一件適宜的事。
關鍵字
無資料並列摘要
In order to investigate the effect of coptis given to pregnant women on the hyperbilirubinemia of their newborns, 334 full term healthy Chinese newborn infants born at the Taipei Medical College Hospital were studied during the period of July 1980 to June 1981. The blood group incompatibility, G-6-PD deficiency, cephalhematoma, cesarean section infants of diabetic mothers, and intrauterine growth retardation wore excluded from the study. During the first 5 days of life serum bilirubin and peak serum bilirubin concentrations were slightly higher in the group of infants whose mothers took coptis during the third trimester of pregnancy than those whose mothers did not take coptis, but the difference was not statistically significant (P＞0.05), The fragility test of red blood cells was performed on the cord blood of 63 infants whom mothers did not take coptis during pregnant period. The cord blood teas incubated with different concentrations of coptis or berberine chloride for 3 or 12 hours, then the fragility test was performed. No ill effect of berberine chloride and coptis on the fragility of the blood cells was found. Our results sit suggested that intake of coptis once in a white during pregnancy (15 capsules or snore in the third trimester) did not increase the incidence and severity of neonatal hyperbilirubinemia, In vitro, coptis and berberine chloride did not affect the fragility of red blood cells, but these results do not indicate that coptis does not have ill effect on newborn infants.