俞募穴针刺对脑瘫伴反复呼吸道感染患儿血清免疫指标及肺功能的影响

Effect of Acupuncture at Back-shu Acupoints and Front-mu Acupoints on Serum Immune Indicators and Pulmonary Function in Children with Repeated Respiratory Tract Infection and Cerebral Palsy

目的:探讨针刺背俞穴、腹募穴对脑瘫患儿反复呼吸道感染疗效分析,观察其对患儿肺功能、血清免疫指标的影响,探讨其可能的作用机制。方法:按照随机数字表将脑瘫合并反复呼吸道感染的112例住院患儿随机分为观察组和对照组,每组各56例。所有患儿治疗前均根据实际情况进行相应的对症治疗,对照组给予玉屏风颗粒,每次1/3袋,每天3次,口服。观察组在此基础上进行背俞穴、腹募穴针刺治疗。观察两组患儿肺功能、血清免疫指标变化,并评价疗效。结果:观察组有效率为92.86%,对照组有效率为76.79%,观察组治疗效果优于对照组(P<0.05);治疗前两组血清免疫球蛋白含量、T淋巴细胞亚群和肺功能指标比较,差异无统计学意义(P>0.05),治疗后两组血清免疫球蛋白A(immunoglobulin A,IgA)、IgG、IgM含量均有显著提高(P<0.05),表明两种疗法均能提高患儿血清免疫球蛋白含量;且观察组显著高于对照组(P<0.05);治疗后两组CD4^+、CD4^+/CD8^+升高,CD8^+下降,差异有统计学意义(P<0.05),且观察组CD4^+、CD4^+/CD8^+高于对照组,CD8^+低于对照组(P<0.05),说明两种疗法均能显著提高T淋巴细胞亚群,且观察组优于对照组(P<0.05);治疗后两组用力肺活量(forced vital capacity,FVC)、1秒用力呼气容积(forced expiratory volume in one second,FEV1)、最大呼气流量(peak expiratory flow,PEF)水平显著升高(P<0.05),说明两组均能有效提高患儿肺功能;治疗后观察组显著高于对照组(P<0.05),说明针刺俞募穴+玉屏风颗粒治疗对肺功能的影响优于单独玉屏风颗粒治疗。结论:针刺俞募穴辅助治疗脑瘫患儿反复呼吸道感染疗效显著,能显著提高患儿免疫功能和肺功能。

Objective: To explore the therapeutic effect of acupuncture at Back-shu and abdomen-mu points on recurrent respiratory tract infections in children with cerebral palsy,observe the effect of acupuncture at Back-shu and abdomen-mu points on pulmonary function and serum immune indexes,and explore its possible mechanism. Methods: 112 hospitalized children with cerebral palsy and recurrent respiratory tract infections in the Children’s Cerebral Palsy Diagnosis and Rehabilitation Center of our hospital from October 2017 to October 2018 were randomly divided into observation group and control group,56 cases in each group. All the children were given symptomatic treatment according to the actual situation before treatment. The control group was given Yupingfeng Granules 1/3 bag/time,3 times·d-1 orally. The observation group was treated with acupuncture at Back-shu and abdomenmu points on this basis. The changes of pulmonary function and serum immune indexes were observed and the curative effect was evaluated. Results: The total effective rate was 92. 86% in the observation group and 76. 79% in the control group. Statistical test showed that the effect of the observation group was better than that of the control group (P < 0. 05). There was no significant difference in serum immunoglobulin content,T lymphocyte subsets and lung function between the two groups before treatment (P >0. 05). After treatment,the serum IgA,IgG and IgM levels of the two groups were significantly increased. The t-test of samples in the two groups showed that both groups could increase the serum immunoglobulin content of the children,and the observation group was significantly higher than the control group (P < 0. 05). The independent sample t-test between the two groups showed that both groups could increase the content of immunoglobulin. The effect of Cishu Mu Point + Yupingfeng Granule on immunoglobulin was better than that of Yupingfeng alone. After treatment,CD4^+,CD4^+/CD8^+ increased and CD8 decreased in the two groups. By paired sample t test,P < 0. 05,CD4^+,CD4^+/CD8^+ in the observation group was higher than that in the control group,and CD8^+ was lower than that in the control group. By independent sample t test between the two groups (P < 0. 05),it showed that both groups could significantly improve T lymphocyte subsets,and the treatment of Shu Mu Point + Yupingfeng Granule was better than that of the single point. Duyu Pingfeng Granule;After treatment,the levels of FVC,FEV1 and PEF in the two groups increased significantly,and the paired sample t test showed that both groups could effectively improve the pulmonary function of children. After treatment,the observation group was significantly higher than the control group. Independent sample t test showed that the effect of acupuncture at Shumu point + Yupingfeng Granule on lung function was better than that of single Yupingfeng Granule treatment (P< 0. 05). Conclusion: Acupuncture at Shumu acupoint is effective in treating recurrent respiratory tract infections in children with cerebral palsy,and can significantly improve the immune function and pulmonary function of children with cerebral palsy.