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Published on: January 10, 2013
Electroacupuncture-Induced Phrenic Nerve Stimulation for Poststroke Pneumonia: A Propensity Score Matching Analysis
Bing-Feng Xing1, Xiao-Qiang Huang1, Hua Zhong2
1Department of Integrated Traditional Chinese and Western Medicine for Metabolic Diseases, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China, gdpu.edu.cn.
Background:
Poststroke pneumonia (PSP) is a common complication in bedridden patients with speech dysfunction, often leading to poor outcomes. This retrospective cohort study explores the clinical efficacy of electroacupuncture (EA) by stimulating the phrenic nerve to improve diaphragmatic activity and treat PSP.
Methods:
In this study, 88 hospitalized poststroke patients with pneumonia were divided into two groups. The nonexposure group received standard treatment, including respiratory rehabilitation, whereas the exposure group received additional EA therapy targeting the phrenic nerve. Propensity score matching (PSM) was applied, resulting in 22 patients in the exposure group and 29 in the nonexposure group. Both groups were treated for 2 weeks, during which Clinical Pulmonary Infection Score (CPIS) scores, white blood cell (WBC) count, C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT) levels were measured. In the exposure group, diaphragmatic activity and thickness were also assessed before, during, and after EA.
Results:
The exposure group showed significantly greater improvements compared with the nonexposure group in reducing CPIS scores (mean difference: -1.087; 95% confidence intervals (CIs): -1.68 to -0.494; p < 0.05) and improving inflammatory markers (WBC, CRP, IL-6, and PCT) (p < 0.05 for all comparisons). After PSM, CPIS scores demonstrated a larger absolute reduction in the exposure group compared with controls (-2.32 vs. -1.00), indicating a greater magnitude of clinical improvement. Within the exposure group, diaphragmatic activity improved significantly after 10 days of EA compared with baseline, with significant between-group differences (p < 0.05 for all comparisons). Quantitative assessment further showed that diaphragmatic excursion increased by approximately 0.32 cm following intervention (95% CIs: 0.18-0.46), suggesting enhanced diaphragmatic functional mobility.
Conclusion:
EA may enhance diaphragmatic activity through phrenic nerve stimulation, improving ventilation, sputum clearance, and regulating neuroimmune responses, contributing to the effective management of PSP.
Trial Registration:
International Traditional Medicine Clinical Trial Registry: ITMCTR2024000729.
