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Acupuncture plus naloxone hydrochloride in the treatment of coma after surgery for cerebral hemorrhage: a randomized controlled trial

针刺联合盐酸纳洛酮治疗脑出血术后昏迷的随机对照研究

  • Clinical Study
  • Published:
Journal of Acupuncture and Tuina Science Aims and scope Submit manuscript

Abstract

Objective

To observe the efficacy of acupuncture combined with naloxone hydrochloride in the treatment of coma after surgery for cerebral hemorrhage and to explore its possible mechanism of action.

Methods

Seventy-two patients were divided into a control group and an observation group according to the random number table method, with 36 cases in each group. The control group was treated with intravenous naloxone hydrochloride, and the observation group received additional acupuncture treatment. After 1 month of treatment, the awakening rate, Glasgow coma scale (GCS) score, cerebral edema volume, mean velocity (Vm) of the middle cerebral artery, and cerebrospinal fluid Caspase-3, and macrophage migration inhibitory factor (MIF) levels were compared between the two groups.

Results

During the study, there were 2 cases of shedding in the control group and 34 remaining valid cases; 1 case of shedding in the observation group and 35 remaining valid cases. After treatment, the awakening rate was higher in the observation group than in the control group (P<0.05); the GCS score increased in both groups compared with that before treatment (P<0.05), and was higher in the observation group than in the control group (P<0.05); the volume of cerebral edema decreased in both groups (P<0.05), and was smaller in the observation group than in the control group (P<0.05); the middle cerebral artery Vm increased in both groups (P<0.05), and was higher in the observation group than in the control group (P<0.05); the cerebrospinal fluid Caspase-3 and MIF levels decreased significantly in both groups (P<0.05) and were lower in the observation group than in the control group (P<0.05).

Conclusion

Acupuncture combined with naloxone hydrochloride for the treatment of coma after surgery for cerebral hemorrhage can promote patients’ awakening, improve the degree of coma, reduce the volume of cerebral edema, and enhance cerebral blood flow velocity, producing a better effect than naloxone hydrochloride used alone; it may be related to its reduction of cerebrospinal fluid Caspase-3 and MIF levels.

【摘要】

目的

观察针刺联合盐酸纳洛酮治疗脑出血术后昏迷的疗效并探讨其可能机制。

方法

将72例患者按随机数字表法分为对照组和观察组, 每组36例。对照组予静脉滴注盐酸纳洛酮治疗, 观察组在此基础上加用针刺治疗。治疗1个月后比较两组苏醒率、格拉斯哥昏迷量表(GCS)评分、脑水肿体积、大脑中动脉平均血流速度(Vm)、脑脊液Caspase-3、巨噬细胞移动抑制因子(MIF)水平。

结果

研究过程中对照组脱落2例, 剩余有效样本34例; 观察组脱落1例, 剩余有效样本35例。治疗后观察组苏醒率高于对照组(P<0.05); 两组GCS评分均较治疗前增加(P<0.05), 观察组高于对照组(P<0.05); 两组脑水肿体积均减小(P<0.05), 观察组小于对照组(P<0.05); 两组大脑中动脉Vm均增加(P<0.05),观察组高于对照组(P<0.05); 两组脑脊液Caspase-3和MIF水平明显降低(P<0.05), 且观察组低于对照组(P<0.05)。

结论

针刺联合盐酸纳洛酮治疗脑出血术后昏迷可促进患者苏醒, 改善昏迷程度, 减少脑水肿体积, 提升脑血流速度, 疗效优于盐酸纳洛酮单独使用, 可能与其降低脑脊液Caspase-3和MIF水平有关。

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References

  1. DIENER H C, HANKEY G J. Primary and secondary prevention of ischemic stroke and cerebral hemorrhage: JACC Focus Seminar. J Am Coll Cardiol, 2020, 75(15): 1804–1818.

    Article  PubMed  Google Scholar 

  2. WANG Y, JIN H, GONG S, YANG X W, SUN X, XU M T, LIU Y, WANG S M, SONG W L, TAO Y Q. Efficacy analysis of robot-assisted minimally invasive surgery for small-volume spontaneous thalamic hemorrhage. World Neurosurg, 2019, 131: e543–e549.

    Article  PubMed  Google Scholar 

  3. PANDEY A S, DAOU B J, CHAUDHARY N, XI G H. A combination of deferoxamine mesylate and minimally invasive surgery with hematoma lysis for evacuation of intracerebral hemorrhage. J Cereb Blood Flow Metab, 2020, 40(2): 456–458.

    Article  PubMed  Google Scholar 

  4. BOULOS L J, BEN HAMIDA S, BAILLY J, MAITRA M, EHRLICH A T, GAVÉRIAUX-RUFF C, DARCQ E, KIEFFER B L. Mu opioid receptors in the medial habenula contribute to naloxone aversion. Neuropsychopharmacology, 2020, 45(2): 247–255.

    Article  CAS  PubMed  Google Scholar 

  5. LI L B, NIE S L, DONG Z M, NING H F. Clinical efficacy and CT perfusion of puerarin combined with naloxone in the treatment of traumatic cerebral infarction. Pak J Pharm Sci, 2020, 33(1): 423–428.

    Google Scholar 

  6. LI D, CHEN Q X, ZOU W, SUN X W, YU X P, DAI X H, TENG W. Acupuncture promotes functional recovery after cerebral hemorrhage by upregulating neurotrophic factor expression. Neural Regen Res, 2020, 15(8): 1510–1517.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Chinese Neuroscience Society, Chinese Neurosurgical Society. Key diagnostic points for cerebrovascular diseases. Linchuang He Shiyan Yixue Zazhi, 2013, 12(7): 559.

    Google Scholar 

  8. LIU Q G, HU L. Science of Meridians and Acupoints. Beijing: China Press of Traditional Chinese Medicine, 2012.

    Google Scholar 

  9. BRAINE M E, COOK N. The Glasgow coma scale and evidence-informed practice: a critical review of where we are and where we need to be. J Clin Nurs, 2017, 26(1–2): 280–293.

    Article  PubMed  Google Scholar 

  10. Digiorgio A M, WITTENBERG B A, CRUTCHER CL 2nd, KENNAMER B, GREENE C S, VELANDER A J, WILSON J D, TENDER G C, CULICCHIA F, HUNT J P. The impact of drug and alcohol intoxication on Glasgow coma scale assessment in patients with traumatic brain injury. World Neurosurg, 2020, 135: e664–e670.

    Article  PubMed  Google Scholar 

  11. WANG X B, MA J. Effect of Xiezhuo Xingshen Chinese medicine combined with ginkgo-diyidamolum injection on hypertensive cerebral hemorrhage after minimally invasive drainage and on IL-6, TNF-α, MMP-9. Xiandai Zhongxiyi Jiehe Zazhi, 2017, 26(31): 28–30.

    Google Scholar 

  12. YAN X G, WANG Y F, XU J L. Clinical efficacy of early right median nerve electrical stimulation for patients with hypertensive cerebral hemorrhage. Jilin Yixue, 2020, 41(9): 2094–2096.

    Google Scholar 

  13. MOULLAALI T J, WANG X, MARTIN R H, SHIPES V B, ROBINSON T G, CHALMERS J, SUAREZ J I, QURESHI A I, PALESCH Y Y, ANDERSON C S. Blood pressure control and clinical outcomes in acute intracerebral hemorrhage: a preplanned pooled analysis of individual participant data. Lancet Neurol, 2019, 18(9): 857–864.

    Article  PubMed  Google Scholar 

  14. ZHANG N. Effectiveness of closed versus open aspiration in patients with cerebral hemorrhage coma on ventilator-assisted ventilation. Yixue Lilun Yu Shijian, 2020, 33(15): 2555–2557.

    Google Scholar 

  15. XUE Y. Efficacy of Xingnaojing injection combined with gangliosides in the treatment of comatose patients after cerebral hemorrhage. Shanxi Yiyao Zazhi, 2020, 49(8): 997–999.

    Google Scholar 

  16. XU X Z. The efficacy of combining modified Tianma Gouteng decoction with Xingnaojing injection in the treatment of postoperative hypertensive cerebral hemorrhage. Zhejiang Zhongyi Zazhi, 2020, 55(8): 573.

    Google Scholar 

  17. WANG J, XIE Y, CHEN Y S. Analysis of the relationship between traditional Chinese medicine syndrome differ classification of hypertensive cerebral hemorrhage and serum MMP-9, Hcy, and GCS score. Sichuan Zhongyi, 2020, 38(9): 56–58.

    Google Scholar 

  18. CUI H Y, ZHAO D X, WANG R N, SUN X Z. Research progress of traditional Chinese medicine treating cerebral hemorrhage. Zhonghua Zhongyiyao Xuekan, 2020, 38(2): 81–83.

    Google Scholar 

  19. LINDER M, TSCHERNIG T. Vasculogenic mimicry: possible role of effector Caspase-3, Caspase-6 and Caspase-7. Ann Anat, 2016, 204(1): 114–117.

    Article  PubMed  Google Scholar 

  20. ZHU J, LI T Y, LU M X, MO S Y, FENG J J, LU Q C, LU W L. Study on effect of rosuvastatin on the expression of C-IAP-1 and Caspase-3 in rats after intracerebral hemorrhage. Youjiang Yixue, 2017, 45(3): 280–284.

    Google Scholar 

  21. DENG X N, WANG X Y, YU H Y, CHEN S M, ZHANG Y Y, DU X J, GAO W. Changes of plasma macrophage migration inhibitory factor level in patients with acute myocardial infarction and its clinical significance. Zhongguo Xinxueguan Zazhi, 2018, 23(2): 104–109.

    Google Scholar 

  22. JIANG L X, LIANG Y, CHEN W W, WANG J L, LI X, SUN Y M, XUE M Z. Expression and significance of serum NO, IGF-1, MIF levels in acute intracerebral hemorrhage. Zhongguo Yiyao Daobao, 2016, 13(1): 64–67.

    CAS  Google Scholar 

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Acknowledgments

There was no project fund support for this study.

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Authors and Affiliations

  1. The First People’s Hospital of Huzhou, Zhejiang Province, Huzhou, 313000, China

    Min Chen  (陈敏), Shuangshuang Wu  (吴双双) & Peiying Tang  (汤佩英)

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  1. Min Chen  (陈敏)
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  2. Shuangshuang Wu  (吴双双)
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  3. Peiying Tang  (汤佩英)
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Corresponding author

Correspondence to Peiying Tang  (汤佩英).

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First Author

CHEN Min, bachelor, nurse

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There is no potential conflict of interest in this article.

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Informed consent was obtained from guardians of all individual participants.

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Chen, M., Wu, S. & Tang, P. Acupuncture plus naloxone hydrochloride in the treatment of coma after surgery for cerebral hemorrhage: a randomized controlled trial. J. Acupunct. Tuina. Sci. 20, 134–138 (2022). https://doi.org/10.1007/s11726-022-1304-x

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  • DOI: https://doi.org/10.1007/s11726-022-1304-x

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