穴位埋线联合西药治疗急性加重期慢性阻塞性肺疾病合并肺炎的临床研究

目的观察穴位埋线联合西药治疗急性加重期慢性阻塞性肺疾病（AECOPD）合并肺炎的临床疗效及对患者T淋巴细胞亚群的影响。方法将63例病例随机分为治疗组（31例）和对照组（32例），治疗组予以穴位埋线联合西医常规治疗，对照组予以单纯西医常规治疗。两组疗程均为14天，观察肺部感染控制（PIC）窗开启时间及辅助呼吸肌动用评分、呼吸困难评分（MMRC评分）、外周血中c反应蛋白（CRP）、T淋巴细胞亚群水平变化情况。结果①治疗组PIC窗开启所需时间为（7．20±1．19）天，对照组为（8．03±1．22）天，组间差异有统计学意义（P〈0．05）。②治疗前后组内比较，两组辅助呼吸肌动用评分、MMRC评分、CRP水平差异均有统计学意义（P〈0．01）；组间治疗后比较，两项评分及CRP水平差异亦有统计学意义（P〈0．05）。③治疗前后组内比较，治疗组CD3＋、CD4＋、CD8＋、CD4＋／CD8＋差异有统计学意义（P〈0．05，P〈0．01），对照组差异无统计学意义（P〉0．05）；组间治疗后比较，各项指标差异均有统计学意义（P〈0．05）。结论穴位埋线联合西药能缓解AECOPD合并肺炎患者呼吸肌疲劳、改善呼吸困难、缩短PIC窗开启时间，有助于控制肺部感染及急性发作，其机制可能与免疫调节有关。

Clinical effects of thread-embedding therapy combine with western medicine in treating AECOPD with concomitant pneumonia

Objective To observe the clinical efficacy of thread-embedding therapy with western medicine in the treatment of chronic obstructive pulmonary disease with acute exacerbation（AECOPD） with concomitant pneumonia, and its effect on T-lymphocyte subsets. Methods All patients with AECOPD were randomly divided into treatment group （31 cases） and control group （32 cases）. Treatment group was treated with thread-embedding therapy with western medicine, and control group was treated with western medicine only. Compare the opening time of pulmonary infection control window （ PIC window） between two groups and the score of the accessory respiratory muscle and MMRC in both groups before and after treatment, and detect peripheral blood CRP and T-lymphocyte subsets level before and after treatment. Results Compared with treatment before, two groups of accessory muscle use score, the MMRC score and CRP were significant differences （ P 〈 0.01 ） ; T-lymphocyte subsets levels of treatment group were of significant differences （ P 〈 0.05 ） , but the control group had no significant change （ P 〉 0.05 ）. Compared with the control group, the treatment group＇ s PIC window open time was significantly shortened （ P 〈 0.05 ） ; accessory muscle the use of ratings, MMRC score and CRP improved more significantly （P 〈 0.05） ; at the same time, the level of CD8 ＋ declined, CD3 ＋ , CD4 ＋ and CD4 ＋/CD8 ＋ ratio increased （ P 〈 0.05 ）. Conclusions Thread-embedding therapy with western medicine can shorten AECOPD patients＇ opening time of PIC window, reduce CRP levels and control pulmonary infection and its acute exacerbations, helpful to alleviate fatigue of breathing muscles and improve dyspnea. The mechanism of thread- embedding treatment may be associated with its immunomodulatory effects.