Qin - Revision history

M.bennett at 07:56, 21 February 2022

2022-02-21T07:56:45Z

M.bennett at 07:50, 21 February 2022

2022-02-21T07:50:56Z

M.bennett: Created page with " '''Hyperbaric oxygen therapy improved cognitive and motor function i..."

2022-02-21T07:49:14Z

Created page with " '''Hyperbaric oxygen therapy improved cognitive and motor function i..."

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'''Hyperbaric oxygen therapy improved cognitive and motor function in patients with delayed encephalopathy after acute carbon monoxide poisoning'''

''' '''

'''Clinical bottom line'''

1.'''HBOT greatly improved motor function (ADL).

2. HBOT improved cognitive function (MoCA and MMSE)

 

----

'''Citation: '''Qin L, Meihua C, Dadong G, Li W, Jinglin W, Xiaoyu D, Mingjun B, Yong Z. Efficacy of Combined Xing Zhi-Yi Nao granules and Hyperbaric Oxygen Therapy for Cognition and Motor Dysfunction in Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning. Evidence-based Complementary and Alternative Medicine 2017; Article ID 1323297:1-6.

'''Lead author’s name and Email: '''L. Qin : liqin701015@163.com

'''Three-part clinical question (patients, intervention, outcome): '''In patients with delayed encephalopathy after acute COP, does the addition of hyperbaric oxygen therapy, compared to standard treatment alone, result in improved cognition and motor function?

 '''Search terms: '''Delayed encephalopathy, carbon monoxide, Chinese medicine

'''The study: '''Non-blinded non-concealed randomised controlled trial with intention-to-treat.

 '''The study patients: '''Patients between 18-75 years old, diagnosed with symptoms of DEACMP, 2-60 days from carbon monoxide exposure and presenting bilateral demyelination lesions on brain MRI. Those with significant co-morbidities or failed completion of follow-up plans were excluded.

'''Control group: '''(N = 19; 19 analysed): Nasal oxygen inhalation, injections of cytidine diphosphate choline and vitamin B, and management of fluids, blood glucose and blood pressure.

'''Experimental group: '''(N = 24; 24 analysed): As above, but also receiving HBOT daily for two months. 

 

'''The evidence'''

{| class="MsoTableGrid" style="border-collapse:collapse; border:solid black 1.0pt"
|-
| rowspan="2" style="width:169.85pt; border:solid black 1.0pt" width="226" | '''Measure'''
| colspan="2" style="width:78.0pt; border:solid black 1.0pt; border-left:none" width="104" | '''Control Group'''
| colspan="2" style="width:70.85pt; border:solid black 1.0pt; border-left:none" width="94" | '''HBOT Group'''
| rowspan="2" style="width:63.8pt; border:solid black 1.0pt; border-left:none" width="85" | '''Difference'''
| rowspan="2" style="width:68.3pt; border:solid black 1.0pt; border-left:none" width="91" | '''95% CI'''
|-
| style="width:49.65pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="66" | '''Mean'''
| style="width:1.0cm; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="38" | '''SD'''
| style="width:42.5pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="57" | '''Mean'''
| style="width:1.0cm; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="38" | '''SD'''
|- style="height:28.5pt"
| style="width:169.85pt; border:solid black 1.0pt; border-top:none" width="226" |
'''Activities of daily living scale at 2 months (0 worst to 100 best)'''

| style="width:49.65pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="66" | 23.0
| style="width:1.0cm; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="38" | 6.1
| style="width:42.5pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="57" | 60.5
| style="width:1.0cm; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="38" | 8.1
| style="width:63.8pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="85" | 37.5
| style="width:68.3pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="91" | 33.0 to 42.0
|-
| style="width:169.85pt; border:solid black 1.0pt; border-top:none" width="226" |
'''Montreal cognitive assessment scale''''''at 2 months (0 worst to 30 best)'''

| style="width:49.65pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="66" | 18.2
| style="width:1.0cm; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="38" | 3.6
| style="width:42.5pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="57" | 22.2
| style="width:1.0cm; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="38" | 2.7
| style="width:63.8pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="85" | 4.0
| style="width:68.3pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="91" | 2.1 to 5.9
|-
| style="width:169.85pt; border:solid black 1.0pt; border-top:none" width="226" |
'''Mini mental state examination at 2 months (0 worst to 30 best)'''

| style="width:49.65pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="66" | 18.1
| style="width:1.0cm; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="38" | 4.5
| style="width:42.5pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="57" | 22.4
| style="width:1.0cm; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="38" | 3.5
| style="width:63.8pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="85" | 4.3
| style="width:68.3pt; border-top:none; border-left:none; border-bottom:solid black 1.0pt; border-right:solid black 1.0pt" width="91" | 1.8 to 6.8
|}

 

'''Comments'''

#Details regarding HBOT dose not given in the paper.
#No blinding or allocation concealment and no indication of how the participants were randomised. Significant risk of bias.
#MoCA and MMSE scores in the treatment arms overall modestly improved but remain indicative of problematic cognitive dysfunction. ADL improvement clinically significant.
#Follow-up period was limited to two months. No long-term conclusions can be drawn.
#The authors included a third treatment arm which assessed HBOT with daily traditional Chinese medicine XingZhi-YiNao granules that were uniquely formulated for this study. This performed better than both the control and HBOT groups.

 

'''Appraised by: '''Bosco Tran bosco.tran@student.unsw.edu.au
'''Kill or update by:'''February 2025

@@ Line 10: / Line 10: @@
 <span style="line-height:107%"><span lang="EN-GB" style="font-size:14.0pt"><span style="line-height:107%">2. HBOT made a small improvement in cognitive function measures</span></span></span>
-<span style="line-height:107%">&nbsp;</span>
+<span style="line-height:107%">'''Citation: '''Qin L, Meihua C, Dadong G, Li W, Jinglin W, Xiaoyu D, Mingjun B, Yong Z. Efficacy of Combined Xing Zhi-Yi Nao granules and Hyperbaric Oxygen Therapy for Cognition and Motor Dysfunction in Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning. Evidence-based Complementary and Alternative Medicine 2017; Article ID 1323297:1-6.</span>
 ----
 <span style="line-height:107%">'''Lead author’s name and Email: '''L. Qin&nbsp;: liqin701015@163.com</span>
@@ Line 90: / Line 88: @@
 <span style="line-height:107%">&nbsp;</span>
-<span style="line-height:107%">'''Appraised by: '''Bosco Tran bosco.tran@student.unsw.edu.au</span> '''<span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:">Kill or update by:</span></span></span>'''<span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:">February 2025</span></span></span>
+<span style="line-height:107%">'''Appraised by: '''Bosco Tran bosco.tran@student.unsw.edu.au</span>

@@ Line 6: / Line 6: @@
 <span style="line-height:107%">'''<span lang="EN-GB" style="font-size:14.0pt"><span style="line-height:107%">Clinical bottom line</span></span>'''</span>
-<span style="line-height:107%"><span lang="EN-GB" style="font-size:14.0pt"><span style="line-height:107%">1.'''</span></span><span lang="EN-GB" style="font-size:14.0pt"><span style="line-height:107%">HBOT greatly improved motor function (ADL).</span></span></span>
+<span style="line-height:107%"><span lang="EN-GB" style="font-size:14.0pt"><span style="line-height:107%">1.HBOT resulted in a clinically importnat improvement in ADL</span></span></span>
-<span style="line-height:107%"><span lang="EN-GB" style="font-size:14.0pt"><span style="line-height:107%">2. HBOT improved cognitive function (MoCA and MMSE)</span></span></span>
+<span style="line-height:107%"><span lang="EN-GB" style="font-size:14.0pt"><span style="line-height:107%">2. HBOT made a small improvement in cognitive function measures</span></span></span>
 <span style="line-height:107%">&nbsp;</span>
@@ Line 16: / Line 16: @@
 <span style="line-height:107%">'''Citation: '''Qin L, Meihua C, Dadong G, Li W, Jinglin W, Xiaoyu D, Mingjun B, Yong Z. Efficacy of Combined Xing Zhi-Yi Nao granules and Hyperbaric Oxygen Therapy for Cognition and Motor Dysfunction in Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning. Evidence-based Complementary and Alternative Medicine 2017; Article ID 1323297:1-6.</span>
-<span style="line-height:107%">'''Lead author’s name and Email: '''L. Qin : liqin701015@163.com</span>
+<span style="line-height:107%">'''Lead author’s name and Email: '''L. Qin&nbsp;: liqin701015@163.com</span>
 <span style="line-height:107%">'''Three-part clinical question (patients, intervention, outcome): '''In patients with delayed encephalopathy after acute COP, does the addition of hyperbaric oxygen therapy, compared to standard treatment alone, result in improved cognition and motor function?</span>
@@ Line 90: / Line 90: @@
 <span style="line-height:107%">&nbsp;</span>
-<span style="line-height:107%">'''Appraised by: '''Bosco Tran bosco.tran@student.unsw.edu.au</span>
+<span style="line-height:107%">'''Appraised by: '''Bosco Tran bosco.tran@student.unsw.edu.au</span> '''<span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:">Kill or update by:</span></span></span>'''<span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:107%"><span style="font-family:">February 2025</span></span></span>