基于Th1/TH2“漂移”及“触发”s TREM1、CD64观察针药结合治疗卒中相关性肺炎的临床研究

Clinical study of acupuncture combined with medicine in the treatment of stroke-related pneumonia based on Th1/Th2"drift"and"trigger"sTREM1 and CD64

目的:观察针药结合治疗卒中相关性肺炎(SAP)临床疗效及对Th1/TH2、s TREM1、CD64的影响。方法:将SAP患者按随机数字表法分为对照组和研究组,对照组给予一般处理及常规针刺治疗,研究组在对照组基础上加“化痰止咳针刺和益气化痰方口服”,治疗前后观察2组中医证候、欧洲卒中评分(ESS)、C反应蛋白(CRP)、白细胞计数(WBC)、降钙素原(PCT)变化。采用ELISA法检测血清γ干扰素(IFN-γ)、白介素(IL)-6、可溶性髓细胞表达触发受体1 (s TREM1)、人免疫球蛋白G Fc段受体Ⅰ(CD64)表达。结果:治疗后研究组中医证候积分、ESS及WBC、CRP、PCT均显著改善,且Th1/Th2、IFN-γ升高,IL-6、CD64、s TREM1显著降低,研究组在改善咳嗽、发热、WBC、CRP、ESS方面优于对照组,调节IFN-γ、CD64、s TREM1表达优于对照组。结论:针药结合可调节SAP患者Th1/TH2漂移,降低炎性指标,改善临床症状。

Objective:To observe the clinical efficacy of acupuncture combined with drugs in the treatment of strokeassociated pneumonia(SAP)and its effects on Th1/TH2,sTREM1,and CD64.Methods:SAP patients were randomly divided into control group and study group.The control group received general treatment and conventional acupuncture treatment.On the basis of the control group,the research group added"relieving sputum and cough acupuncture and Yiqi Huatan Recipe".Before and after treatment,TCM syndromes,European Stroke Score(ESS),C-reactive protein(CRP),white blood cell count(WBC),and procalcitonin(PCT)of the two groups were observed.Serum gamma interferon(IFN-γ),interleukin(IL)-6,soluble myeloid cell expression trigger receptor 1(sTREM1),and human immunoglobulin G Fc segment receptor I(CD64)were detected by ELISA.Result:After treatment,TCM syndrome scores,ESS and WBC,CRP,and PCT were significantly improved in the study group,and Th1/Th2,IFN-γincreased,IL-6,CD64,and sTREM1 were significantly decreased.The study group improved cough,fever,WBC,CRP,and ESS better than the control group;the expression of IFN-γ,CD64,and sTREM1 was better than that of the control group.Conclusion:Acupuncture combined with drugs can regulate Th1/TH2 drift in SAP patients,reduce inflammatory indicators and improve clinical symptoms.