阳中隐阴针刺手法针灸治疗对卒中相关性肺炎患者动脉血气指标及肠道菌群B/E值的影响

Effect of Yang Zhong Yin Yin acupuncture on arterial blood gas analysis parameters and B/E values of intestinal flora in patients with stroke-associated pneumonia

  • 摘要:
    目的 分析卒中相关性肺炎患者应用阳中隐阴针刺手法针灸治疗的效果, 以期为该病治疗方案的合理制定提供参考依据。
    方法 采用随机数字表法将2020年11月-2023年11月华中农业大学医院收治的卒中相关性肺炎患者98例分为对照和试验组, 各49例。对照组给予常规西医治疗, 试验组在此基础上给予阳中隐阴针刺手法针灸治疗, 两组均持续治疗14 d。比较两组疗效(治疗14 d后)、症状控制情况及临床相关评分、炎症相关指标、动脉血气指标、肠道菌群双歧杆菌与大肠埃希菌比值(B/E) 值(治疗前和治疗14 d后)。
    结果 试验组治疗14 d后的总有效率(87.76%) 较对照组(71.43%) 更高(P =0.045); 试验组肺部啰音消失、咳嗽缓解及退热时间(5.01±0.78)d、(3.69±0.54)d、(3.99 ±0.62)d 短于对照组(5.97 ±1.04)d、(6.01 ±1.15)d、(6.13 ±1.25)d (P < 0.05); 较治疗前, 两组治疗14 d后的临床肺部感染评分(CPIS)、美国国立卫生研究院卒中量表(NIHSS)、急性生理与慢性健康评分Ⅱ (APACHE Ⅱ) 评分、血清前肾上腺髓质素(pro-ADM)、降钙素原(PCT)、白细胞(WBC)、C-反应蛋白(CRP)、全血中性粒细胞/淋巴细胞比值(NLR) 水平及动脉血二氧化碳分压(PaCO2) 降低(P < 0.05); 动脉血氧饱和度(SaO2)、动脉血氧分压(PaO2) 及肠道菌群B/E值升高(P < 0.05)。
    结论 阳中隐阴针刺手法针灸治疗卒中相关性肺炎患者可减轻机体感染程度和炎症, 改善患者神经功能和动脉血气, 并可调节B/E值, 改善患者肠道菌群, 进而可控制患者症状, 促进其预后的改善, 进一步提高疗效。

     

    Abstract:
    OBJECTIVE To analyze the effect of the technique of Yang Zhong Yin Yin acupuncture on patients with stroke-associated pneumonia and to provide references for developing rational therapeutic strategies for stroke-associated pneumonia.
    METHODS Ninety-eight cases of patients with stroke-associated pneumonia admitted to Huazhong Agricultural University Hospital from Nov. 2020 to Nov. 2023 were included and randomly divided into the experimental and control group by a table of random numbers with 49 cases in each group. They received Yang Zhong Yin Yin acupuncture plus conventional western therapy (the experimental group) or conventional western therapy alone (the control group)for 14 d. The efficacy (after 14 d of treatment), symptom control and clinical relevant scores, inflammation indicators, arterial blood gas analysis parameters, and intestinal flora Bifidobacterium/Escherichia coli (B/E) (before and after 14 d of treatment) of the two groups were compared.
    RESULTS The experimental group got high total effective rate (87.76%) when compared with the control group (71.43%) (P=0.045). The times of disappearance of lung rales, cough relief and fever reduction in the experimental group 5.01±0.78) d, (3.69±0.54) d, and (3.99±0.62) d were shorter than those in the control group (5.97±1.04) d, (6.01±1.15) d, and (6.13±1.25) d (P < 0.05). Compared with the pretreatment, the scores of clinical pulmonary infection score (CPIS), national institutes of health stroke scale (NIHSS) and acute physiology and chronic health score Ⅱ (APACHE Ⅱ), levels of serum pro-adrenomedullin (pro-ADM), procalcitonin (PCT), white blood cells (WBC), C-reactive protein (CRP), whole blood granulocyte/lymphocyte ratio (NLR) and arterial partial pressure of carbon dioxide (PaCO2) of the two groups after 14 d of treatment decreased (P < 0.05); arterial oxygen saturation (SaO2), arterial partial pressure of oxygen (PaO2) and B/E values increased (P < 0.05).
    CONCLUSION Yang Zhong Yin Yin acupuncture treatment for patients with stroke-associated pneumonia infection can reduce the infection and inflammation, improve patients′ neurological function and arterial blood gases and regulate the B/E value to balance the intestinal flora of the patients, which can control the symptoms of the patients, improve their prognosis and further enhance the efficacy of the treatment.

     

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