Hodge Lisa M, Creasy Caitlin, Carter KiahRae, Orlowski Ashley, Schander Artur, King Hollis H
J Am Osteopath Assoc. 2015 May;115(5):306-16. doi: 10.7556/jaoa.2015.061.
Lymphatic pump treatment (LPT) is a technique used by osteopathic physicians as an adjunct to antibiotics for patients with respiratory tract infections, and previous studies have demonstrated that LPT reduces bacterial load in the lungs of rats with pneumonia. Currently, it is unknown whether LPT affects drug effcacy.
To determine whether the combination of antibiotics and LPT would reduce bacterial load in the lungs of rats with acute pneumonia.
Rats were infected intranasally with 5×107 colony-forming units (CFU) of Streptococcus pneumoniae. At 24, 48, and 72 hours after infection, the rats received no therapy (control), 4 minutes of sham therapy, or 4 minutes of LPT, followed by subcutaneous injection of 40 mg/kg of levofoxacin or sterile phosphate-buffered saline. At 48, 72, and 96 hours after infection, the spleens and lungs were collected, and S pneumoniae CFU were enumerated. Blood was analyzed for a complete blood cell count and leukocyte differential count.
At 48 and 72 hours after infection, no statistically significant differences in pulmonary CFU were found between control, sham therapy, or LPT when phosphate-buffered saline was administered; however, the reduction in CFU was statistically significant in all rats given levofoxacin. The combination of sham therapy and levofoxacin decreased bacterial load at 72 and 96 hours after infection, and LPT and levofoxacin significantly reduced CFU compared with sham therapy and levofoxacin at both time points (P<.05). Colony-forming units were not detected in the spleens at any time. No statistically significant differences in hematologic findings between any treatment groups were found at any time point measured.
The results suggest that 3 applications of LPT induces an additional protective mechanism when combined with levofoxacin and support its use as an adjunctive therapy for the management of pneumonia; however, the mechanism responsible for this protection is unclear.
淋巴泵治疗(LPT)是整骨疗法医生用于辅助治疗呼吸道感染患者使用抗生素的一种技术,先前的研究表明,LPT可降低肺炎大鼠肺部的细菌载量。目前,尚不清楚LPT是否会影响药物疗效。
确定抗生素与LPT联合使用是否会降低急性肺炎大鼠肺部的细菌载量。
大鼠经鼻内接种5×10⁷ 肺炎链球菌菌落形成单位(CFU)。在感染后24、48和72小时,大鼠不接受治疗(对照组)、接受4分钟假治疗或4分钟LPT,随后皮下注射40mg/kg左氧氟沙星或无菌磷酸盐缓冲盐水。在感染后48、72和96小时,收集脾脏和肺脏,并对肺炎链球菌CFU进行计数。对血液进行全血细胞计数和白细胞分类计数分析。
在感染后48和72小时,给予磷酸盐缓冲盐水时,对照组、假治疗组或LPT组之间的肺部CFU无统计学显著差异;然而,所有给予左氧氟沙星的大鼠CFU的减少具有统计学显著性。假治疗与左氧氟沙星联合使用在感染后72和96小时降低了细菌载量,在两个时间点,LPT与左氧氟沙星联合使用相比假治疗与左氧氟沙星联合使用显著降低了CFU(P<0.05)。在任何时间脾脏中均未检测到菌落形成单位。在任何测量时间点,任何治疗组之间的血液学检查结果均无统计学显著差异。
结果表明,3次LPT应用与左氧氟沙星联合使用时可诱导额外的保护机制,并支持其作为肺炎管理的辅助治疗方法;然而,这种保护作用的机制尚不清楚。