泻肺涤痰饮联合针灸对急性脑梗死继发肺部感染患者外周血PCT、NLR水平的影响

Effects of Xiefei Ditan Decoction combined with Acupuncture on Peripheral Blood PCT and NLR in Patients with Acute Cerebral Infarction Secondary to Pulmonary Infection

目的:探讨泻肺涤痰饮联合针灸对急性脑梗死(ACI)继发肺部感染患者外周血降钙素原(PCT)、中性粒细胞/淋巴细胞比值(NLR)水平的影响。方法:选取2018年1月~2021年3月在本医院收治的110例ACI继发肺部感染患者,采用简单随机分组将患者分为观察组(n=55)和对照组(n=55)。观察组给予泻肺涤痰饮联合针灸治疗,对照组给予针灸治疗,均治疗2周。治疗前后,比较观察组和对照组中医证候积分、治疗疗效、神经功能缺损情况(NIHSS)和日常生活能力(ADL),检测两组ACI继发肺部感染患者外周血PCT、NLR和NSE水平,并记录不良反应发生情况。结果:治疗后,观察组总有效率为94.54%,高于对照组总有效率76.36%(P<0.05);治疗后,观察组ACI肺部感染患者体温变化、咳痰量、气喘、咳嗽等中医证候积分均降低,且观察组各指标优于对照组(P<0.05);治疗后,观察组和对照组NIHSS评分均降低,ADL评分均升高(P<0.05)。治疗后,观察组外周血PCT、NLR、NSE水平明显低于对照组(P<0.05)。观察组ACI患者不良反应发生率为7.14%,包括2例恶心呕吐、2例腹泻和1例皮疹患者,与对照组不良反应发生率(18.18%)相比无明显差异(P<0.05)。结论:泻肺涤痰饮联合针灸治疗ACI继发肺部感染患者能有效缓解肺部感染症状,改善神经功能,降低外周血PCT、NLR水平,提高疗效。

Objective:To explore the effects of Xiefei Ditan Decoction combined with acupuncture on levels of peripheral blood procalcitonin(PCT)and neutrophil/lymphocyte ratio(NLR)in patients with lung infection secondary to acute cerebral in-farction(ACI).Methods:A total of 11Opatients with lung infection secondary to ACI admitted to the hospital were enrolled be-tween January 2018and March 2021.They were divided into observation group(n=55)and control group(n=55)by using ran-dom number table and double-blind methods.The observation group was treated with Xiefei Ditan Decoction and acupuncture,while control group was treated'with acupuncture for 2weeks.Before and after treatment,scores of TCM syndromes,curative effect,scores of National Institutes of Health Stroke Scale(NIHSS)and activity of daily living scale(ADL)between the two groups were compared.The levels of peripheral blood PCT,NLR and NSE in both groups were detected.And the occurrence of adverse reactions was recorded.Results:After treatment,total response rate in observation group was higher than that in control group(90.91%vs 76.36%)(P<0.05).After treatment,scores of TCM syndromes(changes of body temperature,expectoration volume,wheezing,cough)in observation group were decreased,which were better than those in control group(P<0.05).After treatment,NIHSS scores were decreased,and ADL scores were increased in both groups(P<0.05).After treatment,levels of peripheral blood PCT,NLR and NSE in observation group were significantly lower than those in control group(P<0.05).The incidence of adverse reactions in observation group was 7.14%(2cases with nausea and vomiting,2cases with diarrhea and lcase with skin rash),which was not significantly different from the incidence of adverse reactions in the control group(18.18%)(P<0.05).Conclusion:Xiefei Ditan Decoction combined with acupuncture can effectively relieve lung infection,improve nerve function,reduce levels of peripheral blood PCT and NLR,and improve curative effect in patients with lung infection secondary to ACI.