针刺疗法联合穴位贴敷对急性呼吸衰竭机械通气患者血气分析指标、膈肌功能及炎症免疫指标的影响

摘要 目的：观察穴位贴敷、针刺疗法联合治疗对急性呼吸衰竭机械通气患者血气分析指标、膈肌功能及炎症免疫指标的影响。方法：选择2021年11月～2022年12月期间在安徽中医药大学附属六安医院接受治疗的92例急性呼吸衰竭机械通气患者，按照随机数字表法将患者分为对照组（常规治疗，46例）和研究组（对照组的基础上增加针刺疗法联合穴位贴敷治疗，46例）。对比两组血气分析指标、膈肌功能、炎症免疫指标及胃肠功能，同时记录两组并发症发生率。结果：研究组撤机前氧合指数（OI）、pH、动脉血氧分压（PaO2）高于对照组，动脉血二氧化碳分压（PaCO₂）低于对照组（P<0.05）。研究组撤机前右侧膈肌呼气末厚度（Tdi-ee）、吸气末厚度（Tdi-ei）、膈肌增厚分数（TFdi）低于对照组（P<0.05）。研究组撤机前超敏C反应蛋白（hs-CRP）、降钙素原（PCT）、白细胞计数（WBC）低于对照组，CD4⁺高于对照组（P<0.05）。研究组撤机前胃肠功能评分低于对照组（P<0.05）。两组并发症发生率组间对比无统计学差异（P>0.05）。结论：针刺疗法联合穴位贴敷在改善急性呼吸衰竭机械通气患者的血气分析指标、膈肌功能、炎症免疫指标中的应用价值较好。

Effect of Acupuncture Therapy Combined with Acupoint Application on Blood Gas Analysis Indicators, Diaphragm Function, and Inflammatory Immune Indicators in Mechanically Ventilated Patients with Acute Respiratory Failure

ABSTRACT Objective: To observe the effect of acupoint application and acupuncture therapy combined with treatment on blood gas analysis indicators, diaphragm function, and inflammatory immune indicators in patients with acute respiratory failure undergoing mechanical ventilation. Methods: 92 patients with acute respiratory failure who underwent mechanical ventilation at Lu''an Hospital Affiliated to Anhui University of Traditional Chinese Medicine from November 2021 to December 2022 were selected, and they were randomly divided into control group (46 cases for routine treatment) and study group (46 cases for acupuncture therapy combined with acupoint application treatment on the basis of the control group) by random number table method. The blood gas analysis indicators, diaphragm function, inflammatory immune indicators, and gastrointestinal function between the two groups were compared, and the incidence of complications between the two groups were recorded. Results: The oxygenation index (OI), pH, and arterial partial pressure of oxygen (PaO₂) before weaning in the study group were higher than those in the control group, while the arterial blood partial pressure of carbon dioxide (PaCO2) was lower than that in the control group (P<0.05). The right diaphragmatic end expiratory thickness (Tdi-ee), inspiratory end thickness (Tdi-ei), and diaphragmatic thickening fraction (TFdi) before weaning in the study group were lower than those in the control group(P<0.05). High sensitivity C-reactive protein (hs-CRP), calcitonin (PCT) and white blood cell count (WBC) before weaning in the study group were lower than those in the control group, and CD4⁺ was higher than that in the control group (P<0.05). The gastrointestinal function score of the study group before weaning was lower than that of the control group (P<0.05). There was no statistically significant difference in the incidence of complications between the two groups(P>0.05). Conclusion: Acupuncture therapy combined with acupoint application has good application value in improving blood gas analysis indicators, diaphragm function, and inflammatory immune indicators in patients with acute respiratory failure undergoing mechanical ventilation.