Influence of acupuncture combined with rehabilitation on arterial blood gas of, respiratory of and prognosis of elderly patients with pulmonary infection after stroke

doi:10.3877/cma.j.issn.1674-1358.2019.04.013

Abstract

Abstract:

Objective

To investigate the effect of acupuncture combined with rehabilitation therapy on arterial blood gas index, respiratory index and prognosis of elderly patients with pulmonary infection after stroke.

Methods

From April 2015 to August 2017, a total of 74 cases with pulmonary infection after stroke were treated in Danyang Traditional Chinese Medicine Hospital. They were divided into western medicine treatment group (37 cases) and western medicine + traditional Chinese Medicine treatment (TCM) group (37 cases) by random digital table method. The effective rate, arterial blood gas index, respiratory index, acute physiological and chronic health score (APACHE Ⅱ), procalcitonin (PCT), C-reactive protein (CRP) and count of white blood cell (WBC) before and after treatment were compared between the two groups, respectively.

Results

Before treatment, the partial pressure of blood oxygen (PaO₂) (t = 0.414, P = 0.340), oxygen saturation (SaO₂) (t = 0.837, P = 0.203), partial pressure of carbon dioxide (PaCO₂) (t = 0.517, P = 0.304), count of WBC (t = 0.071, P = 0.943), the oxygen partial pressure of alveolar artery (t = 0.399, P = 0.346), respiratory index (t = 0.440, P = 0.331) and APACHE Ⅱ score (t = 0.474, P = 0.318) between patients in two groups were all with significant differences. The effective rate of TCM treatment group was significantly higher than that of western medicine treatment group (91.89% vs. 70.27%; χ² = 5.638, P = 0.018). The levels of PaO₂ (t = 33.824, P < 0.001) and SaO₂ (t = 2.701, P = 0.004) in western medicine treatment group were significantly higher than those in the western medicine treatment group, while the levels of PaCO₂ (t = 20.196, P < 0.001), count of WBC (t = 2.380, P = 0.020), alveolar arterial oxygen partial pressure difference (t = 18.923, P < 0.001), respiratory index (t = 5.302, P < 0.001), APACHE Ⅱ score (t = 4.450, P < 0.001), PCT (t = 5.625, P < 0.001) and CRP (t = 5.625, P < 0.001) in western medicine treatment group were significantly lower than those in western medicine treatment group, all with significant differences.

Conclusions

Acupuncture combined with rehabilitation could effectively improve the curative effect of elderly patients with pulmonary infection after stroke, improve their arterial blood gas index, alveolar arterial oxygen partial pressure difference and respiratory indexes, decrease the APACHE Ⅱ score and inflammatory reaction of patients with respiratory infection.

Key words: Acupuncture, Rehabilitation therapy, Stroke, Pulmonary infection, Arterial blood gas index, Respiratory index

Qi Cheng. Influence of acupuncture combined with rehabilitation on arterial blood gas of, respiratory of and prognosis of elderly patients with pulmonary infection after stroke[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(04): 334-339.

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References 22

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组别	例数	男/女（例）	平均年龄（ ± s，岁）	病程（d）	脑卒中分型[例（%）]
组别	例数	男/女（例）	平均年龄（ ± s，岁）	病程（d）	出血性	缺血性
西药治疗组	37	22/15	67.42 ± 5.38	10.25 ± 1.44	11（29.73）	26（70.27）
西药+中医治疗组	37	19/18	68.05 ± 5.03	10.47 ± 1.52	15（40.54）	22（59.46）
统计量	?	χ² = 0.492	t = 0.501	t = 0.639	χ² = 0.949	χ² = 0.949
P值	?	0.483	0.309	0.262	0.330	0.330

组别	例数	男/女（例）	平均年龄（ ± s，岁）	病程（d）	脑卒中分型[例（%）]
组别	例数	男/女（例）	平均年龄（ ± s，岁）	病程（d）	出血性	缺血性
西药治疗组	37	22/15	67.42 ± 5.38	10.25 ± 1.44	11（29.73）	26（70.27）
西药+中医治疗组	37	19/18	68.05 ± 5.03	10.47 ± 1.52	15（40.54）	22（59.46）
统计量	?	χ² = 0.492	t = 0.501	t = 0.639	χ² = 0.949	χ² = 0.949
P值	?	0.483	0.309	0.262	0.330	0.330

组别	例数	痊愈[例（%）]	显效[例（%）]	有效[例（%）]	无效[例（%）]	有效率（%）
西药治疗组	37	8（21.62）	12（32.43）	6（16.22）	11（29.73）	70.27
西药+中医治疗组	37	10（27.02）	13（35.14）	11（29.73）	3（8.11）	91.89
χ²值	?	0.294	0.060	1.909	5.638	15.235
P值	?	0.588	0.806	0.167	0.018	< 0.001

组别	例数	痊愈[例（%）]	显效[例（%）]	有效[例（%）]	无效[例（%）]	有效率（%）
西药治疗组	37	8（21.62）	12（32.43）	6（16.22）	11（29.73）	70.27
西药+中医治疗组	37	10（27.02）	13（35.14）	11（29.73）	3（8.11）	91.89
χ²值	?	0.294	0.060	1.909	5.638	15.235
P值	?	0.588	0.806	0.167	0.018	< 0.001

指标		西药治疗组（37例）	西药+中医治疗组（37例）	t值	P值
PaO₂（mmHg）		?	?	?	?
?	治疗前	49.86 ± 1.74	50.03 ± 1.79	0.414	0.340
?	治疗后	55.41 ± 2.04	71.73 ± 2.11	33.824	< 0.001
?	t值	12.591	46.405	?	?
?	P值	< 0.001	< 0.001	?	?
SaO₂（%）		?	?	?	?
?	治疗前	0.76 ± 0.22	0.72 ± 0.19	0.837	0.203
?	治疗后	0.80 ± 0.25	0.97 ± 0.29*	2.701	0.004
?	t值	0.731	4.386	?	?
?	P值	0.467	< 0.001	?	?
PaCO₂（mmHg）		?	?	?	?
?	治疗前	64.78 ± 1.89	65.01 ± 1.94	0.517	0.304
?	治疗后	62.27 ± 1.83	53.84 ± 1.76	20.196	< 0.001
?	t值	5.804	25.939	?	?
?	P值	< 0.001	< 0.001	?	?
肺泡动脉氧分压差（mmHg）		?	?	?	?
?	治疗前	19.03 ± 1.27	19.15 ± 1.32	0.399	0.346
?	治疗后	16.75 ± 1.22	11.47 ± 1.18	18.923	< 0.001
?	t值	7.875	26.385	?	?
?	P值	< 0.001	< 0.001	?	?
呼吸指数		?	?	?	?
?	治疗前	0.38 ± 0.18	0.40 ± 0.21	0.440	0.331
?	治疗后	0.31 ± 0.16	0.15 ± 0.09	5.302	< 0.001
?	t值	1.768	6.656	?	?
?	P值	0.081	< 0.001	?	?
急性生理评分		?	?	?	?
?	治疗前	15.18 ± 1.94	15.60 ± 2.12	0.889	0.377
?	治疗后	11.11 ± 1.84	8.06 ± 1.04	8.778	< 0.001
?	t值	9.259	19.423	?	?
?	P值	< 0.001	< 0.001	?	?
慢性健康评分		?	?	?	?
?	治疗前	11.14 ± 1.86	11.07 ± 1.79	0.165	0.870
?	治疗后	10.08 ± 1.67	7.49 ± 1.22	7.618	< 0.001
?	t值	2.579	10.053	?	?
?	P值	0.012	< 0.001	?	?
APACHE Ⅱ评分		?	?	?	?
?	治疗前	28.47 ± 6.13	29.15 ± 6.20	0.474	0.318
?	治疗后	21.03 ± 5.58	15.42 ± 5.26	4.450	< 0.001
?	t值	5.460	10.272	?	?
?	P值	< 0.001	< 0.001	?	?
PCT（mg/L）		?	?	?	?
?	治疗前	1.81 ± 0.79	1.76 ± 0.77	0.276	0.784
?	治疗后	0.84 ± 0.41	0.52 ± 0.33	3.698	0.000
?	t值	6.629	9.004	?	?
?	P值	< 0.001	< 0.001	?	?
CRP（mg/ L）		?	?	?	?
?	治疗前	85.09 ± 13.18	84.17 ± 13.06	0.302	0.764
?	治疗后	57.26 ± 10.25	44.19 ± 9.73	5.625	< 0.001
?	t值	10.139	14.932	?	?
?	P值	< 0.001	< 0.001	?	?
WBC（× 10⁹/L）		?	?	?	?
?	治疗前	9.37 ± 4.22	9.44 ± 4.23	0.071	0.943
?	治疗后	8.15 ± 3.70	6.28 ± 2.95	2.380	0.020
?	t值	1.322	3.710	?	?
?	P值	0.190	< 0.001	?	?

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