胸腺肽穴位注射对脓毒症患者T淋巴细胞亚群的影响研究

Study on the effect of acupoint injection of thymic peptide on T lymphocyte subsets in patients with sepsis

目的观察胸腺肽足三里穴位注射对脓毒症患者T淋巴细胞亚群等免疫指标的影响。方法选取2019年11月至2021年9月广州中医药大学顺德医院重症医学科收治的72例脓毒症患者作为研究对象,采用随机数字表法分为三组,分别为观察组、对照组A与对照组B,每组各24例。研究过程中每组脱落4例,最终完成观察者60例,每组各20例。三组患者均按照脓毒症指南给予规范治疗,除常规治疗外,观察组采用胸腺肽进行足三里穴位注射,对照组A采用生理盐水进行足三里穴位注射,对照组B采用胸腺肽皮下注射,均为每天一次,治疗7 d。比较三组患者治疗前后淋巴细胞计数(LY)、T淋巴细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)免疫指标的差异。结果观察组在治疗5、7 d后LY、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)指标均高于治疗前,差异有统计学意义(P<0.05);而对照组B在治疗7 d后上述指标明显升高,与治疗前比较,差异有统计学意义(P<0.05),对照组A治疗7 d后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)等指标高于治疗前(P<0.05);且观察组治疗5、7 d后上述指标均高于同期两组对照组,除治疗7 d后CD3^(+)指标外,其余指标差异均有统计学意义(P<0.05)。结论胸腺肽足三里穴位注射较皮下注射能更快速提高脓毒症患者T淋巴细胞亚群指标。

Objective To observe the effect of thymic peptide injection at Zusanli on T lymphocyte subsets and other immune indexes in patients with sepsis.Methods A total of 72 patients with sepsis admitted to the Department of Critical Care Medicine in Shunde Hospital Guangzhou University of Chinese Medicine from November 2019 to September 2021 were selected as study subjects and divided into the observation group,control group A and control group B according to the random number table method,with 24 patients in each group.During the study,4 cases were shed in each group,and 60 cases were completed,20 cases in each group.All three groups were given standardized treatment according to the sepsis guidelines.In addition to conventional treatment,the observation group was also injected with thymic peptide at Zusanli,control group A was injected with normal saline at Zusanli,and control group B was subcutaneously injected with thymic peptide.All patients in the three groups were injected once a day for 7 days.The differences in immune indexes such as lymphocyte count(LY),T lymphocyte subsets CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)before and after treatment were compared among the three groups.Results The indexes of LY,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group on Day 5 and Day 7 of treatment were higher than those before treatment,with statistically significant differences(P<0.05).However,the above indexes were seen to be significantly higher in control group B only after Day 7 of treatment,with statistically significant differences from those before treatment(P<0.05),and control group A had these indexes after Day 7 of treatment higher than those before treatment(P<0.05).In addition,the above indexes in the observation group after 5 and 7 days of treatment were higher than those in the two control groups in the same period,and all indexes showed statistically significant differences except for the CD3^(+)after 7 days of treatment(P<0.05).Conclusion Thymic peptide injection at Zusanli can more rapidly improve T lymphocyte subsets indexes in sepsis patients than subcutaneous injection.