A Clinical Study On The Treatment Of Pulmonary Infection After Stroke Based On The Theory Of Liver Rising And Lung Falling

Objectiveto observed the clinical effect of acupuncture on pulmonary infection in patients with tracheotomy after stroke,which is based on the theory of liver rising and lung falling.On the one hand,the control time of infection was taken as the observation index to observe the effect of acupuncture on post-stroke bacterial pneumonia.On the other hand,the activity of diaphragm muscle was taken as the observation index to objectively evaluate the respiratory function of patients with tracheotomy after stroke,aiming to provide a new idea for the pulmonary rehabilitation of patients with post-stroke tracheotomy and indwolotomy.Methods72 patients diagnosed with pneumonia infected by pseudomonas aeruginosa with tracheotomy after stroke in the Second TCM Hospital Guangdong province were collected.SPSS 19.0 software was used to generate a table of random Numbers,which were then included into the control group and the observation group according to the random Numbers corresponding to the order of admission of patients by the physicians who were not involved in the treatment.The observation group included 36 patients,and the control group 36 patients.The control group received conventional treatment of western medicine,including active treatment of basic diseases and primary diseases,anti-infection treatment,mechanical assisted sputum excretion,etc.The treatment group received acupuncture treatment on the basis of the control group,which is based on the theory of liver rising and lung falling,The selected points were:chize,lieque,hegu,taichong,fengchi and jiaji(C3-C5)points,each time for 25 minutes,once a day,six times a week,a total of treatment for 3 weeks.Before and after treatment in the treatment of acquisition of the patient’s white blood cell count(WBC),neutrophil percentage(N%),C-reactiveprotein(CRP),procalcitonin(PCT)and clinical pulmonary infection score(CPIS),TCM symptom scores,GFC cough reflex scores,and antibiotic application data such as time,and using the M-TURBO diaphragm activity type ultrasonic measurement of two groups of patients.According to the TCM symptom score before and after treatment,the total effective rate of the two treatment schemes was obtained.According to the application time of antibiotics in the two groups,the effect of acupuncture guided by the theory of liver rising and lung falling" on pulmonary infection after stroke was evaluated.Results(1)before treatment,there were no significant differences in gender,age,albumin,course of disease and stroke type between the two groups,which were comparable(P>0.05).(2)after 3 weeks of treatment,the scores of CPIS,GFC cough reflex and respiratory symptoms in the two groups were significantly improved compared with those before treatment(P<0.01).In comparison between the two groups,all scores in the observation group were better than those in the control group,with significant difference(P<0.01).The differences before and after treatment were significant(P<0.05).(3)indicators of related infection:the white blood cell count(WBC),percentage of neutrophils(N%),c-reactive protein(CRP)and procalcitonin(PCT)of the two groups were significantly improved compared with those before treatment(P<0.01).Compared with the control group,the indexes of the observation group decreased significantly(P<0.01).The differences before and after treatment were significant(P<0.05).(4)diaphragm activity:after treatment,the diaphragm activity of the two groups increased compared with that before treatment(P<0.01).The increase in the observation group was greater than that in the control group(P<0.01).and the difference before and after treatment was significant(P<0.05).(5)efficacy evaluation:according to the TCM symptom score,the total effective rate after treatment was 91.4%in the observation group and 70.6%in the control group,and the overall efficacy of the observation group was better than that of the control group(P<0.05).In terms of infection window control time,the duration of antibiotic application in the observation group was significantly shorter than that in the control group(P<0.01).Conclusion(1)acupuncture therapy for stroke complicated with pulmonary infection,guided by the theory of liver rising and lung falling,can significantly reduce the inflammatory response of pulmonary infection,shorten the course of pulmonary infection,and reduce the application of antibiotics.(2)the theory of liver rising and lung falling can guide acupuncture to increase patients’diaphragm muscle activity,improve respiratory muscle strength,and increase intrathoracic pressure,so as to improve patients’ cough ability after tracheotomy,enhance airway clearance function,reduce aspiration,and thus reduce the incidence rate of SAP,which is worthy of clinical promotion and application.(3)the increased strength of the patient’s diaphragm and the improvement of cough reflex may be related to the acupuncture of tianding,fengchi and jiaji(C3-C5)points,and the stimulation of the respiratory center of the medulla oblongata and phrenic nerve.