针灸联合肺康复训练对卒中性肺炎患者肺功能及外周血炎症因子的影响

Effects of acupuncture and moxibustion and lung rehabilitation training on pulmonary function and peripheral blood inflammatory factors in patients with stroke-associated pneumonia

目的探究针灸联合肺康复训练对卒中性肺炎患者肺功能及外周血炎症因子的影响。方法选取2021年1月至2022年8月期间在榆林市第一医院康复医学科治疗的100例卒中性肺炎患者进行研究,按照随机数表法分为对照组和研究组各50例。对照组患者采用常规肺康复训练,研究组患者采用针灸联合肺康复训练,两组患者均进行康复治疗14 d。治疗后比较两组患者的治疗效果,以及康复治疗前后的肺功能指标[用力肺活量(FVC)、第一秒用力呼气容积(FEV_(1))、呼气峰流速(PEF)、平均最大呼气流量(MMEF)],外周血炎症因子[C-反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)]水平和肺炎症状消退时间(咳嗽消失时间、咳痰消失时间、湿啰音消失时间)。结果研究组患者的临床治疗总有效率为98.00%,明显高于对照组的82.00%,差异有统计学意义(P<0.05);治疗前,两组患者的FVC、FEV_(1)、PEF、MMEF水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的FVC、FEV_(1)、PEF、MMEF水平均明显升高,且研究组患者的FVC、FEV_(1)、PEF、MMEF水平分别为(3.94±0.42)L、(3.05±0.45)L、(3.72±0.91)L/s、(0.92±0.11)L/s,明显高于对照组的(3.15±0.45)L、(2.43±0.42)L、(2.87±0.78)L/s、(0.77±0.10)L/s,差异均有统计学意义(P<0.05);治疗前,两组患者的CRP、PCT、WBC水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的CRP、PCT、WBC水平均明显降低,且研究组患者的CRP、PCT、WBC水平分别为(8.09±1.28)mg/L、(0.36±0.05)ng/L、(7.54±1.32)×10^(3)/L,明显低于对照组的(18.93±1.41)mg/L、(0.78±0.12)ng/L、(9.38±1.52)×10^(3)/L,差异均有统计学意义(P<0.05);研究组患者的咳嗽消失时间、咳痰消失时间、湿啰音消失时间分别为(7.56±1.58)d、(8.06±1.34)d、(8.16±1.16)d,明显短于对照组的(10.52±1.54)d、(11.12±2.42)d、(12.69±2.68)d,差异均有统计学意义(P<0.05)。结论针灸联合肺康复训练治疗卒中性肺炎能有效改善患者的肺功能及外周血炎症因子指标,治疗效果好,具有临床应用价值。

Objective To explore the effect of acupuncture and moxibustion combined with lung rehabilitation training on pulmonary function and peripheral blood inflammatory factors in patients with stroke-associated pneumonia.Methods One hundred patients with stroke-associated pneumonia who were treated in the Department of Rehabilita-tion Medicine,Yulin First Hospital from January 2021 to August 2022 were selected amd randomly divided into a con-trol group and a study group,with 50 patients in each group.The patients in the control group received routine lung reha-bilitation training,and the patients in the study group received acupuncture and moxibustion combined with lung rehabil-itation training.Both groups were treated for 14 days.After treatment,the therapeutic effects of the two groups were compared,as well as the pulmonary function indexes before and after treatment[forced vital capacity(FVC),forced ex-piratory volume in the first second(FEV_(1)),peak expiratory flow rate(PEF),and mean maximum expiratory flow(MMEF)],the levels of peripheral blood inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC)],and time for the disappearance of pneumonia symptoms(cough disappearance time,sputum disappearance time,wet rale disappearance time).Results The total effective rate of clinical treatment in the study group was 98.00%,significantly higher than 82.00%in the control group(P<0.05).Before treatment,there was no statis-tically significant difference in the levels of FVC,FEV_(1),PEF,and MMEF between the two groups(P>0.05);after treat-ment,the levels of FVC,FEV_(1),PEF,and MMEF in both groups of patients significantly increased,and the levels in the study group were(3.94±0.42)L,(3.05±0.45)L,(3.72±0.91)L/s,and(0.92±0.11)L/s,which were significantly higher than(3.15±0.45)L,(2.43±0.42)L,(2.87±0.78)L/s,and(0.77±0.10)L/s in the control group(P<0.05).Before treatment,there was no statistically significant difference in the levels of CRP,PCT,and WBC between the two groups(P>0.05);after treatment,the levels in both groups were significantly reduced,and the levels in the study group were(8.09±1.28)mg/L,(0.36±0.05)ng/L,and(7.54±1.32)×10^(3)/L,which were significantly lower than(18.93±1.41)mg/L,(0.78±0.12)ng/L,and(9.38±1.52)×10^(3)/L in the control group;the differences were statistically significant differences(P<0.05).The cough dis-appearance time,sputum disappearance time,and wet rale disappearance time of the study group were(7.56±1.58)d,(8.06±1.34)d,and(8.16±1.16)d,respectively,which were significantly shorter than(10.52±1.54)d,(11.12±2.42)d,and(12.69±2.68)d in the control group(P<0.05).Conclusion Acupuncture and moxibustion combined with lung rehabili-tation training can effectively improve the lung function and peripheral blood inflammatory factor indicators of patients with stroke-associated pneumonia,with good therapeutic effect and clinical application value.