RESUMO
OBJECTIVE: To observe the clinical effect of acupuncture combined with Qingfei Qutan decoction for stroke-associated pneumonia (SAP) with phlegm-heat obstructing lung, and explore its possible mechanism. METHODS: 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 Qingfei Qutan decoction, 1 dose per day; the patients in the combination group were treated with acupuncture combined with Qingfei Qutan 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+3, CD+4, CD+8 and CD+4/CD+8) 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. RESULTS: After treatment, the CPIS scores, NLR, PCT, CRP and CD+8 in the each group were lower than those before treatment (P<0.05), while the levels of CD+3, CD+4, CD+4/CD+8 were higher than those before treatment (P<0.05). The above indexes in the combination group were better than those in the acupuncture group and the Chinese medication group (P<0.05), and the above indexes in the Chinese medication group were better than those in the acupuncture group (P<0.05). There was no significant difference in the clearance rate of pathogenic bacteria among three groups (P>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 (P<0.05). The cured and markedly effective rate in the Chinese medication group was higher than that in the acupuncture group (P<0.05). CONCLUSION: Acupuncture combined with Qingfei Qutan 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.
