일산화탄소 중독 후 지연성 뇌병증의 한약 치료 임상연구 동향

Abstract

Objectives: Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) is a severe neurological complication that emerges days to weeks after a pseudo-recovery period. Conventional treatments including hyperbaric oxygen therapy (HBO) have limited efficacy and potential side effects. Chinese herbal medicine (CHM) has demonstrated neuroprotective, antioxidant, and anti-inflammatory properties. However, domestic studies on CHM for DEACMP are limited, with only eight case reports published to date. No studies have provided clinical trends or high-quality evidence. Methods: We analyzed research trends in randomized controlled trials (RCTs) on CHM for DEACMP. A literature search was conducted in PubMed and CNKI for studies published from 2017 to 2024. RCTs evaluating CHM for DEACMP patients were included. Results: Eighteen RCTs involving 1,477 patients were included. The average number of participants per study was about 82. The average duration of coma was about 32 hours and the average delay period for DEACMP onset was about 22 days. Among four diagnostic criteria for DEACMP (CO poisoning history, pseudo-recovery period, CT/MRI findings, and clinical symptoms), six studies used all four criteria, while three studies used three criteria. Total effective rate and Mini-Mental State Examination were frequently used outcome measures. Most RCTs indicated that CHM combined with conventional treatments could improve cognitive function and neurological symptoms compared to conventional therapy alone. Conclusions: CHM has promising effects on DEACMP. It can improve cognitive function and recovery. Future studies should provide comprehensive evidence on CHM, evaluate combination therapies that reflect clinical settings, and include assessments of adverse effects.