针刺联合肺康复治疗卒中相关性肺炎疗效观察

目的:观察针刺联合肺康复治疗卒中相关性肺炎的临床疗效。方法:选取2018年1月至2018年12月上海中医药大学附属第七人民医院神经内科及神经康复科住院治疗的卒中相关性肺炎患者60例,随机分为治疗组和对照组,每组30例。两组患者均给予常规脑卒中、肺炎规范化药物治疗和肺炎常规护理,对照组另给予针刺治疗,治疗组另给予针刺联合肺康复治疗。观察两组患者治疗前后中医证候积分、炎症指标(白细胞计数、C反应蛋白、降钙素原)、临床肺部感染评分变化情况,并比较两组临床疗效、4周生存率。结果:治疗组有效率为93.3%,对照组有效率为73.3%,治疗组高于对照组,差异有统计学意义(P<0.05);治疗14天后,两组患者发热、便秘证候积分比较,差异无统计学意义(P>0.05),治疗组咳嗽、咳痰、哮鸣、气短证候积分低于对照组,差异均有统计学意义(P<0.05);治疗14天后,治疗组白细胞计数、C反应蛋白低于对照组,差异有统计学意义(P<0.05);治疗14天后,治疗组临床肺部感染评分低于对照组,差异有统计学意义(P<0.05);治疗后4周随访,对照组死亡1例,生存率为96.67%,治疗组死亡0例,生存率为100.00%,两组生存率比较,差异无统计学意义(P>0.05)。结论:针刺联合肺康复治疗卒中相关性肺炎,能改善患者症状,提高临床疗效。

Curative Effect Observation of Acupuncture Combined with Lung Rehabilitation Therapy on Stroke-associated Pneumonia

Objective:To observe the clinical curative effect of acupuncture combined with lung rehabilitation therapy on stroke-associated pneumonia(SAP).Methods:A total of 60 patients with SAP treated in Department of Neurology and Neurorehabilitation of the Seventh People′s Hospital Affiliated to Shanghai University of CM from January 2018 to December 2018 were randomly divided into the treatment group and the control group,with 30 cases in each group.All the patients in the two groups were given routine stroke,standardized drug treatment of pneumonia and routine nursing of pneumonia.The patients in the control group were additionally given acupuncture treatment,and the ones in the treatment group were additionally given acupuncture combined with lung rehabilitation treatment.The changes of TCM syndrome score,inflammatory indexes(leukocyte count,C-reactive protein,procalcitonin)and clinical pulmonary infection score were observed before and after the treatment,and the clinical efficacies and 4-week survival rates of the two groups were compared.Results:The effective rate was 93.3%in the treatment group and 73.3%in the control group.The difference was statistically significant(P<0.05).After 14 days of treatment,there were no significant differences between the two groups in fever and constipation syndrome points(P>0.05).The scores of cough,expectoration,wheezing and shortness of breath syndrome in the treatment group were lower than those in the control group,and all the differences were statistically significant(P<0.05).After 14 days of treatment,the leukocyte count and C-reactive protein in the treatment group were lower than those in the control group,and all the differences were statistically significant(P<0.05);the clinical pulmonary infection score in the treatment group was lower than that in the control group,and the difference was statistically significant(P<0.05).According to the follow-up after 4 weeks′treatment,one case died in the control group,the survival rate was 96.67%,0 case died in the treatment group,the survival rate was 100.00%,there was no significant difference between the two groups(P>0.05).Conclusion:Acupuncture combined with lung rehabilitation therapy has a remarkable efficacy on SAP,can improve the symptoms of patients and enhance the clinical effect.