The clinical experience about treatment of refractory neonatal jaundice
                                            Written by Sunshufen    Translated by Hu Xiaohua
 
Neonatal jaundice pertains to “Taihuang” in TCM. The incidence is higher gradually, refractory neonatal jaundice is the severe case which onset is commonly in posthepatic obstructive jaundice，such as congenital choledochal cyst or stones, congenital biliary atresia, bile deposite, etc. This is severe jaundice, longer course, eliminating jaundice difficultly and poor prognosis, Serum bilirubin is more than 10 times of normal value, liver function is damaged severely. Anti-infection, enzyme induction, exchange transfusion and operation are used in western medicine which cost is very high and curative effect is not accurate. Many children is slow growth and development at the beginning, portal hypertension, hypersplenism and died of cachexia failure. Professor Peixueyi is a famous national TCM doctor. Who has deep accomplishments in refractory neonatal jaundice. The following is 2-case reports of Professor Peixueyi.

Case 1
Child patient 1，female, First visit on Dec.20, 2004
Being hospitalized for 5-week yellow sclera and skin. This child was full-term first delivery, 1-week yellow sclera and skin after birth and severe gradually, tawney urine, muddy color stool.
Examnination:
Middle-degree jaundice, distinct yellow, red rash on the face, yellow and greasy tongue fur, light purplish index finger veins, abdominal distension, liver was examined subcostal 3 cm, 4 cm xiphoid process with smooth surface, texture coarse. Lad test: serum total bilirubin was 729 U/L. Abdominal ultrasound reported congenital choledochal cyst, hepatomegaly.
Western medicine treatment:
Anti-inflammatory and protecting liver therapy, 1-week supporting treatment. Yellow sclera and skin did not improve obviously. Isotope technetium 99 scanning showed “congenital atresia of biliary tract ”. Exploratory laparotomy tested “choledochal cyst, hepatolithiasis ”, after surgery, symptoms improved obviously for a period of time, and recurrented one week later. Reexamination showed that liver function did not improve.
Syndrome differentiation in TCM: Jaundice of wetness-heat of liver and gallbladder, with blood stasis type.
TCM Treatment:
Clearing heat and removing dampness, activating blood and removing stasis to eliminate jaundice
Prescription:
Seeding of Virgate wermwood 16g, Jinqiancao herba 9g, fresh Lotus leaf 4g, Phellodendron 4g, Fresh Malt 9g, Salvia 9g, Japanese eupatorium 9g, Rice Paperiant Pith 4g. Decocted 15 min, extracted juice 90 ml. Alum 0.3g, Indigo pulverata levis 0.3g, Resina Draconis 0.3g and Amber 0.3g were made into powder and added into juice, 1 decoction per day (oral take 3 times separately per day, 30ml per time).
Took 1 week, facial rash disappeared, jaundice alleviated, grassy green stool. The same prescription was taken 2 weeks more, jaundice disappeared wholly, liver function and serum total bilirubin (16.90μmol/L), direct bilirubin (7.1μmol/L), alanine aminotransferase (58 U/L), alkaline phosphatase (191 U/L) recovered normally by reexamination, follow-up half of a year, no recurrence.
Comment:
The child is healthy, early onset, severe damp-heat, and shorter course. High dose seeding of virgate wermwood was used, in order to clear heat and remove dampness with the cholagogic action and eliminating jaundice. Jinqiancao herba, Rice Paperiant Pith, Phellodendron were used to clear heat and remove dampness; Japanese eupatorium was used to activate blood and remove stasis, Salvia was capable of removing blood stasis and producing blood. Fresh malt was used to strengthen spleen-stomach, fresh Lotus leaf was used to clear heat, remove dampness and treat facial rash; Alum, Indigo pulverata levis, Resina Draconis and Amber had the actions of dredging collaterals, small dosage (0.3g) did not damage vital qi. This compatibility can dispel pathogenic factors and strengthen healthy Qi to eliminate jaundice.