Wang Ying, Mao Wei, Wu Hai-Yang, Zhang Li-da, Han Wei, Li Cheng-Long, Zhang Xin, Ji Hai-Sheng
Department of Encephalology, Second Affiliated Hospital of Anhui University of CM, Hefei 230000, China.
Graduate School of Anhui University of CM.
Zhongguo Zhen Jiu. 2022 Nov 12;42(11):1240-4. doi: 10.13703/j.0255-2930.20220208-k0003.
To observe the clinical effect of acupuncture combined with decoction for stroke-associated pneumonia (SAP) with phlegm-heat obstructing lung, and explore its possible mechanism.
Ninety-nine patients of SAP with phlegm-heat obstructing lung were randomly divided into a combination group (33 cases, 1 case dropped off), a Chinese medication group (33 cases, 1 case dropped off) and an acupuncture group (33 cases, 1 case dropped off). On the basis of routine basic treatment, the patients in the acupuncture group were treated with acupuncture at Tiantu (CV 22), Feishu (BL 13), Taiyuan (LU 9), Sanyinjiao (SP 6), etc., once a day, with an interval of 1 day after continuous 6-day treatment; the patients in the Chinese medication group were treated with decoction, 1 dose per day; the patients in the combination group were treated with acupuncture combined with decoction. Two weeks were taken as a course of treatment, and two courses of treatment were given. Before and after treatment, the clinical pulmonary infection score (CPIS), inflammatory indexes (neutrophil-to-lymphocyte ratio [NLR], procalcitonin [PCT], C-reactive protein [CRP]), cellular immune function (CD, CD, CD and CD/CD) were compared in the 3 groups. The clearance of pathogenic bacteria after treatment was observed in the 3 groups. The clinical efficacy of each group was evaluated.
After treatment, the CPIS scores, NLR, PCT, CRP and CD in the each group were lower than those before treatment (<0.05), while the levels of CD, CD, CD/CD were higher than those before treatment (<0.05). The above indexes in the combination group were better than those in the acupuncture group and the Chinese medication group (<0.05), and the above indexes in the Chinese medication group were better than those in the acupuncture group (<0.05). There was no significant difference in the clearance rate of pathogenic bacteria among three groups (>0.05). The cured and markedly effective rate was 65.6% (21/32) in the combination group, which was higher than 43.8% (14/32) in the Chinese medication group and 18.8% (6/32) in the acupuncture group (<0.05). The cured and markedly effective rate in the Chinese medication group was higher than that in the acupuncture group (<0.05).
Acupuncture combined with decoction could effectively improve the clinical symptoms of SAP patients with phlegm-heat obstructing lung, and the mechanism may be related to enhancing the cellular immune function and reducing the level of inflammatory reaction.
观察针刺联合 方治疗痰热壅肺型卒中相关性肺炎（SAP）的临床疗效，并探讨其可能机制。
将99例痰热壅肺型SAP患者随机分为联合组（33例，脱落1例）、中药组（33例，脱落1例）和针刺组（33例，脱落1例）。在常规基础治疗的基础上，针刺组患者取天突（CV 22）、肺俞（BL 13）、太渊（LU 9）、三阴交（SP 6）等穴位针刺治疗，每日1次，连续治疗6天后间隔1天；中药组患者服用 方，每日1剂；联合组患者采用针刺联合 方治疗。以2周为1个疗程，共给予2个疗程治疗。比较3组患者治疗前后的临床肺部感染评分（CPIS）、炎症指标（中性粒细胞与淋巴细胞比值[NLR]、降钙素原[PCT]、C反应蛋白[CRP]）、细胞免疫功能（CD 、CD 、CD 及CD /CD ）。观察3组患者治疗后病原菌清除情况。评价各组临床疗效。
治疗后，各组CPIS评分、NLR、PCT、CRP及CD 均低于治疗前（<0.05），而CD 、CD 、CD /CD 水平高于治疗前（<0.05）。联合组上述指标优于针刺组和中药组（<0.05），中药组上述指标优于针刺组（<0.05）。3组病原菌清除率比较，差异无统计学意义（>0.05）。联合组痊愈显效率为65.6%（21/32），高于中药组的43.8%（14/32）和针刺组的18.8%（6/32）（<0.05）。中药组痊愈显效率高于针刺组（<0.05）。
针刺联合 方能有效改善痰热壅肺型SAP患者的临床症状，其机制可能与增强细胞免疫功能、降低炎症反应水平有关。
