目的探讨痰热清注射液对重症胰腺炎合并肺部感染患者血氧水平、降钙素原(Procalcitonin,PCT)及高迁移率族蛋白B1(High Mobility Group Box-1,HMGB1)的影响。方法随机选择2018年1月-2019年1月在我院就诊的重症胰腺炎合并肺部感染患者84例,计算机分为对照组42例、观察组42例。对照组采取常规抗感染、胰腺分泌抑制、维持水和电解质平衡、营养支持,观察组在对照组基础上联用痰热清注射液。观察两组患者肺功能情况、HMGB1和PCT水平、血气指标、疗效指标、不良反应。结果两组治疗前FVC、FEV_(1)值比较无统计学差异(P>0.05),观察组治疗后FVC、FEV_(1)值高于对照组(P<0.05);治疗前PCT、HMGB1水平比较无差异(P>0.05),观察组治疗后PCT、HMGB1水平显著低于对照组;两组治疗前PO_(2)、PCO_(2)、SpO_(2)值比较无差异(P>0.05),观察组治疗后PO_(2)、SpO_(2)值高于对照组,PCO_(2)值低于对照组(P<0.05);两组患者治疗前血清淀粉酶、白细胞计数比较无差异(P>0.05),治疗后观察组血清淀粉酶、白细胞计数低于对照组(P<0.05);对照组不良反应发生率高于观察组,但比较差异无统计学意义(P>0.05)。结论痰热清注射液用于重症胰腺炎合并肺部感染患者的辅助治疗,能有效恢复患者肺功能,降低炎症因子PCT及HMGB1水平,增加抗感染效果,利于病情归转。
Objective To observe the effect of stimulating Yinttang （印堂 EX-HN 3） and Baihui（百会 GV 20） with electroacupuncture （EA） on blood oxygenation level of brain and explore the feasibility of measuring the therapeutic effect of acupuncture by applying near infra red spectrum （NIRS）. Methods Ten participants semi-randomly selected from 158 adults （random test sequence） were stimulated with EA at the acupoints of EX-HN 3 and GV 20. Verbal fluency task was conducted before and after acupuncture, and changes in blood oxygenation level of cerebral cortex were tested by applying NIRS. Quantitative data were processed with JMP 10.0.2 software, and changes in waveforms of blood oxygenation level of brain before and after treatment were compared by applying NIRS. Results ① The mean of reacting dose （integral value） of blood oxygenation level of cerebral cortex of the 158 adults in the verbal fluency task was 10.6 ± 1.1, and the mean of the whole reacting dose of blood oxygenation level of cerebral cortex at 1/2 period of time during the test （centroids value） was 46.8 ± 1.6. ② In the EA group, the mean of integral value and centroids value of 10 adults were 8.4 ± 5.1 and 54.7± 12.2 before EA while 9.8±3.5 and 41.2±6.7 after EA. The integral value and centroids value of the EA group were closer to the mean of all the subjects. Conclusion It was found by NIRS that the blood oxygenation level of cerebral cortex could be regulated in bi- directional way by stimulating EX-HN 3 and GV 20 with EA, and a further research on whether it directly related to EA is to be made.
