广州医科大学学报

目的:探讨纳洛酮(naloxone,NLX)和醒脑静(xingnaojing,XNJ)联合治疗急性酒精中毒的临床疗效。方法:把2003年1月-2005年12月收治的急性酒精中毒患者255例,随机分成3组,根据临床表现和Glasgow昏迷指数评分标准,再把每组患者分为轻度和重度两组。Ⅰ组87例给予NLX治疗;Ⅱ组85例给予XNJ治疗;Ⅲ组83例用Ⅰ组+Ⅱ组治疗。每组患者性别、年龄、病程及病情程度均无明显差异(P<0.05),具有可比性。三组均给予吸氧、输液,纠正酸碱及水电解质紊乱,重度中毒者给予洗胃,应用甘露醇。结果:①显效时间:轻度中毒Ⅰ组(30.55±6.52)min、Ⅱ组(31.62±5.53)min、Ⅲ组(25.50±3.56)min;重度中毒Ⅰ组(45.55±6.82)min、Ⅱ组(46.24±8.55)min、Ⅲ组(37.90±8.24)min;②治愈时间m in:轻度中毒Ⅰ组(110.64±14.44)min、Ⅱ组(115.08±16.26)min、Ⅲ组(92.66±15.38)min;重度中毒Ⅰ组(241.68±20.82)min、Ⅱ组(255.34±24.14)min、Ⅲ组(185.72±25.43)min;Ⅰ组轻、重度中毒组分别与Ⅱ组对应比较显效时间均有统计学意义(P<0.05),Ⅲ组轻、重度中毒组分别与Ⅰ、Ⅱ组对应比较显效时间均有显著的统计学意义(P<0.01)。Ⅰ组轻、重度中毒组分别与Ⅱ组对应比较治愈时间均有统计学意义(P<0.05),Ⅲ组轻、重度中毒组分别与Ⅰ、Ⅱ组对应比较治愈时间均有显著的统计学意义(P<0.01)。结论:NLX和XNJ等联合治疗急性酒精中毒疗效满意,特别是治疗重症酒精中毒具有明显的相加效果,且作用快,治疗显著,无任何不良反应,疗程缩短,值得临床推广。

Objective:To explore the clinical efficacy of Naloxone(NLX) and Xingnaojing(XNJ) for combined treatment of acute alcoholism.Methods: 255 patients with acute alcoholism registered to our hospital between January 2003 and December 2005 were randomized into three groups(Groups Ⅰ,Ⅱ and Ⅲ).Each group was further stratified into mild and severe subgroups based on clinical manifestation and Glasgow Coma Scale.NLX was given to Group Ⅰ(n=87),XNJ to Group Ⅱ(n=85),and NLX plus XNJ to Group Ⅲ(n=83).The three groups were comparable with regard to patient age,gender,duration and severity of alcoholism.In all groups,supportive treatment included oxygen therapy,intravenous irrigation,and correction of acid-base and electrolyte imbalance.In addition,those with severe alcoholism received gastric lavage and intravenous mannitol.Results: (1) Time to response of treatment was(30.55±6.52) min(Group Ⅰ),(31.62±5.53) min(Group Ⅱ) and(25.50±3.56)min(Group Ⅲ) among mild cases,compared with(45.55±6.82) min(Group I),(46.24±8.55) min(Group Ⅱ) and(37.90±8.24) min(Group Ⅲ) among severe cases.(2) Time to recovery was(110.64±14.44) min(Group Ⅰ),(115.08±16.26) min(Group Ⅱ) and(92.66±15.38) min(Group Ⅲ) among mild cases,compared with(241.68±20.82) min(Group Ⅰ),(255.34±24.14) min(Group Ⅱ) and(185.72±25.43)min(Group Ⅲ) among severe cases.Significant differences were found in time to response for both mild and severe cases in Group I when compared with their counterparts in Group Ⅱ(P<0.01),and for those in Group Ⅲ when compared withGroups Ⅰ and Ⅱ(P<0.05).Both mild and severe cases in Group Ⅲ also showed less time to recovery as compared with Groups I and Ⅱ(P<0.01).Conclusion: Combined NLX and XNJ therapy resulted in favorable outcomes in acute alcoholism,particular in severe cases where the therapy appeared synergistic and fast-acting,with no adverse effects and shorter course,and therefore may be useful in clinical practices.