少商和商阳穴刺血对老年重症社区获得性肺炎结局和预后的影响。

Effect of Bloodletting at Shaoshang and Shangyang Acupuncture Points on Outcome and Prognosis of Severe Community-Acquired Pneumonia in the Elderly.

机构信息

Emergency Department, DongCheng District Branch, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, BeiJing 100700, China.

Department of Intensive Care Unit, Tongzhou District Branch, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 101100, China.

出版信息

Dis Markers. 2021 Oct 26;2021:3295021. doi: 10.1155/2021/3295021. eCollection 2021.

DOI:10.1155/2021/3295021

PMID:34737837

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8563111/

Abstract

OBJECTIVES

The aim of this study was to explore, whether treatment with bloodletting at Shaoshang and Shangyang acupuncture points would affect therapy outcome and prognosis for severe community-acquired pneumonia (SCAP) in the elderly.

METHODS

A total of 62 patients, who met the diagnostic criteria for SCAP, were enrolled in the study and randomly divided into two groups, i.e., treatment group ( = 31) and control group ( = 31). All patients received a therapy according to the Chinese Clinical Practice and Expert Consensus of Emergency Severe Pneumonia from 2016. In addition to that, a bloodletting at Shaoshang (LU11) and Shangyang (LI1) acupuncture points was applied for the treatment group. This intervention was repeated for three times (ones daily), bloodletting a volume of 2-3 ml at each time point. Differences in a main index of clinical efficacy, body temperature (T), respiratory rate (RR), heart rate (Hr), white blood cell count (WBC), neutrophil percentage (N%), and C-reactive protein level (CRP) as well as different scores (CURB-65 score, SOFA score, and Apache II score) were compared between groups. Moreover, the 28-day mortality was compared between treatment and control group. The statistical methods involved in carrying out the current study include -test, Wilcoxon test, and chi-square test.

RESULTS

The clinical effective rate of the treatment group was 82.9%, which was significantly higher than the 17.1% in the control group ( < 0.05). After finishing the intervention, the treatment group showed significantly lower T (37.28 ± 0.54 vs. 37.82 ± 0.81), RR (20.06 ± 2.67 vs. 23.71 ± 6.85), Hr (81.71 ± 10.38 vs. 93.84 ± 15.39), CUBR-65 score (2.16 ± 0.74 vs. 3.03 ± 0.98), and SOFA score (5.84 ± 3.83 vs. 8.16 ± 4.2) compared to the control group ( < 0.05). The 28-day mortality rate of the treatment group was significantly lower than in the control group (12.9% vs. 45.2%, = 0.05).

CONCLUSIONS

Bloodletting at Shaoshang and Shangyang acupuncture points can support improving the clinical treatment efficacy for SCAP and reduce the 28-day mortality rate in the elderly.

摘要

目的

本研究旨在探讨少商和商阳穴刺络放血对老年重症社区获得性肺炎（SCAP）的疗效和预后是否有影响。

方法

本研究共纳入符合 SCAP 诊断标准的 62 例患者，随机分为治疗组（n=31）和对照组（n=31）。所有患者均按 2016 年中国重症肺炎临床实践专家共识进行治疗。此外，治疗组还进行了少商（LU11）和商阳（LI1）穴刺络放血治疗。每次治疗重复 3 次（每天 1 次），每次放血量为 2-3ml。比较两组主要疗效指标体温（T）、呼吸频率（RR）、心率（Hr）、白细胞计数（WBC）、中性粒细胞百分比（N%）、C 反应蛋白水平（CRP）及 CURB-65 评分、SOFA 评分、Apache II 评分的差异，比较两组 28 天病死率。统计学方法采用 t 检验、Wilcoxon 检验和卡方检验。

结果

治疗组的临床有效率为 82.9%，明显高于对照组的 17.1%（<0.05）。干预结束后，治疗组 T（37.28±0.54 比 37.82±0.81）、RR（20.06±2.67 比 23.71±6.85）、Hr（81.71±10.38 比 93.84±15.39）、CURB-65 评分（2.16±0.74 比 3.03±0.98）、SOFA 评分（5.84±3.83 比 8.16±4.2）明显低于对照组（<0.05）。治疗组 28 天病死率明显低于对照组（12.9%比 45.2%，=0.05）。