针刺联合体外膈肌起搏对脑卒中相关性肺炎患者免疫功能和炎性因子的影响

Effect of acupuncture combined with extracorporeal diaphragm pacing on the immune function and inflammatory factors in stroke-associated pneumonia

【目的】分析针刺联合体外膈肌起搏对脑卒中相关性肺炎患者免疫功能和炎性因子的影响。【方法】将收治60例卒中相关性肺炎的患者随机分为A组和B组,每组30例。在常规治疗基础上A组加用针刺联合体外膈肌起搏,B组加用体外膈肌起搏。比较两组患者治疗前后血清免疫球蛋白IgG、IgM、IgA和炎性因子白细胞计数(white blood cell count,WBC)、超敏c反应蛋白(hypersensitivity c-reactive protein,hs-CRP)、降钙素原(procalcitonin,PCT)水平的变化,呼吸功能评估及疗效观察。【结果】治疗前两组患者血清免疫球蛋白与炎性因子比较无明显差异(P>0.05);治疗7、15 d后A、B组的血清IgG、IgM、IgA水平均明显高于本组治疗前(P<0.05),且A组的血清IgG、IgM、IgA水平均明显高于B组(P<0.05)。治疗7、15 d后A、B的血清WBC、CRP和PCT水平均明显低于本组治疗前(P<0.05),在治疗15 d后A组的WBC、hs-CRP、PCT均低于B组(P<0.05)。治疗15 d后,两组患者用力肺活量及第1秒用力肺活量均明显高于本组治疗前(P<0.05)。治疗15 d后,A组患者的最大发声时间较治疗前明显升高(P<0.05),高于B组,但差异无统计学意义(P>0.05)。A组总治疗有效率为83.3%(25/30),显著高于B组的66.7%(20/30)(P<0.05)。【结论】针刺联合体外膈肌起搏对大面积梗死性脑卒中后肺炎患者的免疫功能具有促进作用,能显著促进患者免疫球蛋白表达,降低炎性指标,提高临床疗效。

【Objective】To explore the effect of acupuncture combined with extracorporeal diaphragm pacing on the immune function and inflammatory factors in stroke-associated pneumonia.【Methods】A total of 60 cases with stroke-associated pneumonia were randomly divided into group A and group B,30 cases in each group.On the basis of conventional treatment,the patients in the group A were treated with acupuncture combined with extracorporeal diaphragm pacing,and those in the group B were treated with extracorporeal diaphragm pacing alone.The levels of immunoglobulin(IgG,IgM and IgA)and serum inflammatory factors including white blood cell count,hypersensitivity c-reactive protein(hs-CRP),procalcitonin(PCT),were compared between the two groups before and after treatment.The respiratory function was evaluated and the treatment was observed.【Results】Before the treatment,there was no significant difference in immunoglobulin levels between the two groups(P>0.05).After 7 days and 15 days of treatment,the levels of IgG,IgM and IgA in both groups were significantly higher than those before the treatment(P<0.05),and the levels of IgG,IgM and IgA in the group A were significantly higher than those in the group B(P<0.05).After 7 days and 15 days of treatment,the levels of serum WBC,hs-CRP and PCT in both groups were significantly lower than those before the treatment(P<0.05).After 15 days of treatment,the levels of serum WBC,hs-CRP and PCT in the group A were significantly lower than those in the group B(P<0.05).After 15 days of treatment,forced vital capacity(FVC)and forced expiratory volume in one second(FEV1)in both groups were significantly higher than those before the treatment(P<0.05).After 15 days of treatment,the maximum phoation time(MPT)in the group A was significantly higher than that before the treatment(P<0.05),and higher than that in the group B,but the difference was not statistically significant(P>0.05).The total effective rate of the treatment in the group A was 83.3%(25/30),significantly higher than that in the group B 66.7%(20/30)(P<0.05).【Conclusion】Acupuncture combined with extracorporeal diaphragm pacing for stroke-associated pneumonia can effectively improve the patients’immune globulin levels and inflammatory factors,as well as promote the prognosis of patients.