Objective To explore the efficacy of bi-level positive airway pressure ( BiPAP)ventilation plus plateau exhalation valve ( PEV) combined with respiratory stimulant for the treatment of pulmonary encephalopathy in patients with acute exacerbation of chronic obstructive pulmonary disease( AECOPD) . Methods 70 AECOPD patients with pulmonary encephalopathy were randomly divided into a control group and a treatment group. All patients received BiPAP ventilation and conventional therapyincluding antimicrobial, bronchodilation, and expectorant treatment. In the treatment group, the BiPAP ventilator was connected to PEV additionally, and naloxone and nikethamide were administered for 3 days.Clinical symptoms, blood gas analysis, vital signs, gas leakage conditions, and adverse reactions were recorded. Results Heart rate, respiratory rate, PaCO2 , and APACHEⅡ score were more significantly lower,the time to recover consciousness was shoter, meanwhile PaO2 , SaO2 , pH, and glasgow coma scale were significantly higher in the treatment group compared with the control group( all P lt; 0. 01) . Two cases in the treatment group and 5 cases in the control group received tracheal intubation and invasive ventilation due to treatment failure. Two elderly patients in the control group died in hospital. Conclusion Noninvasive positive pressure ventilation plus PEV combined with respiratory stimulant can significantly improve symptoms, shorten the time to recover consciousness, reduce the rate of endotracheal intubation, and improve hypoxemia and hypercapnia rapidly in AECOPD patients with pulmonary encephalopathy.
Objective To evaluate the effectiveness of Xingnaojing (XNJ) injection in the treatment of acute alcohol intoxication. Methods The Cochrane library (Issue 4, 2008), MEDLINE (1989 to 2008), WANFANG database (1991 to 2008), CBM (1991 to 2008), and CNKI (1991 to 2008) were searched. The quality of included studies was assessed according to the criteria recommended Cochrane Collaboration.Meta-analyses were performed using RevMan 4.2.2 software. Results Twenty seven trials, all published in China were included. The quality of these studies was low. Meta-analyses showed that normal treatment plus XNJ could significantly shorten action time [WMD= – 90.62 min, 95%CI (– 121.12, – 60.11)] and effective time [WMD= – 124.97 min, 95%CI (– 183.54, – 66.40)]. Normal treatment plus XNJ was similar with normal treatment plus naloxone in action time. No significant differences were observed in effective time between naloxone and XNJ. Conclusions It shows that XNJ injection plus western medical therapy is superior to western medical therapy. The curative efficacy of XNJ and Naloxone was similar.
Objective To assess the efficacy of naloxone for cardio-pulmonary-cerebral resuscitation (CPCR). Methods Randomized controlled trials (RCTs) involving naloxone for CPCR were identified from MEDLINE (1966 – Jun.2006), EMbase (1974 - Jun.2006), PubMed, The Cochrane Library (Issue2,2006), CBM(1978 - Jun.2006) and CNKI (1994 - Jun.2006). The quality of the trials was assessed by two reviewers independently. RevMan 4.2.7 software provided by the Cochrane Collaboration was used for statistical analysis. Results Ten RCTs were included. The quality of included RCTs was low. All the patients were in-patients or out-patients receiving CPCR due to cardial arrest at the age of 18-75 years. Meta-analysis indicated that the resuscitation rate in naloxone group was significantly higher than the placebo group (Plt;0.00001). And the recovery of the brain function in naloxone group was better than in the placebo group(Plt;0.00001) Conclusions Naloxone is effective for CPCR and it may ameliorate its prognosis. Because of the low quality of included trials and the small sample size, more RCTs are required to assess the efficacy of naloxone for CPCR.
Objective To assess the effect of naloxone in treating the disease of acute cerebral infarction. Methods Sixty patients of acute cerebral infarction were randomly divided into two groups. One group received routine therapy and the other routine therapy plus naloxone. Neuroprotective effect of naloxone were measured by using NIH stroke scale and Bathel-Index. Adverse effect of the drug was also observed. Results There were 27 patients (90%) improved with clinical manifestations in experiment group, and 20 patients (67%) improved in control group. There is a significant difference between the two groups (Plt;0.05).There is no adverse reactions of naxloxone observed. Conclusion Naloxone might protect the nervous cells and restore the function of the nervous system in patients with acute cerebral infraction.
ObjectiveTo objectively evaluate the effect and safety of naloxone for the treatment of moderate and severe neonatal hypoxia-ischemic encephalopathy (HIE). MethodsResearch articles published from inception to June 2015 on Cochrane library, PubMed, Web of science, Chinese Science and Technology Journal Full-text Database, Digital Full-text Journal Database and Chinese Journal Full-text Database were searched, which were relevant to naloxone in the treatment of moderate and severe neonatal HIE. And two authors extracted information via standardized data extraction form and assessed the quality of included studies independently. RevMan 5.2 software was used for Meta-analysis. ResultsAt last, 20 randomized controlled trials (involving 1 519 neonates; 783 in the treatment group and 736 in the control group) were included. The results of meta-analysis showed that the effect of naloxone for moderate and severe HIE was significantly superior to the control group[OR=5.07, 95%CI (3.61, 7.12), P < 0.000 01]. The neurobehavioral scores in neonates treated by naloxone after 5, 7, 10, and 14 days were higher than those in the control group[WMD=6.61 points, 95%CI (5.70, 7.51) points, P < 0.000 01; WMD=4.27 points, 95%CI (2.63, 5.91) points, P < 0.000 01; WMD=2.40 points, 95%CI (1.47, 3.34) points, P < 0.000 01; WMD=2.58 points, 95%CI (1.00, 4.16) points, P=0.001], respectively; while the neurobehavioral scores after 3-day treatment between the two groups had no statistically difference[WMD=0.00 points, 95%CI(-0.76, 0.77) points, P=0.99]. What's more, the disappeared time of clinical symptoms and signs (breathing improvement time, recovery time, convulsions disappearance time, and signs disappearance time) in naloxone group was superior to the control groups[WMD=-3.78 hours, 95%CI (-6.93, -0.64) hours, P=0.02; WMD=-9.66 hours, 95%CI (-14.25, -5.06) hours, P < 0.001; WMD=-2.81 hours, 95%CI (-5.28, -0.35) hours, P=0.03; WMD=-1.02 days, 95%CI (-1.84, -0.20) days, P=0.01], respectively. ConclusionsNaloxone has certain therapeutic on moderate and severe HIE. Further high-quality randomized controlled trials should be carried out to provide more reliable evidence.