Acupuncture plus naloxone hydrochloride in the treatment of coma after surgery for cerebralhemorrhage: a randomized controlled trial / 针灸推拿医学（英文版）

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.