Naloxone plus enteral nutrition for gastrointestinal dysfunction in elderly cerebral infarction and peptic ulcer...

Cerebral infarction (CI) is a major subtype of ischemic stroke, with high incidence, recurrence rate, disability rate, and mortality rate in the elderly. Elderly CI patients are prone to peptic ulcer due to long-term use of antiplatelet drugs and stress factors, which further leads to gastrointestinal dysfunction, seriously affecting nutritional intake and rehabilitation. Naloxone, an opioid receptor antagonist, has neuroprotective potential, and enteral nutrition (EN) can improve gastrointestinal function. This study aims to explore the intervention effect of their combination.

To investigate the efficacy of naloxone combined with EN on gastrointestinal dysfunction in elderly patients with CI and peptic ulcer.

In this randomized controlled trial, 110 elderly patients with CI and peptic ulcer were equally assigned to a control group (receiving standard therapy combined with EN) or a combination group (receiving standard therapy, EN, and naloxone). The National Institute of Health Stroke Scale (NIHSS) scores, Barthel Index (BI), Chinese version of the MOS 36-Item Short Form Health Survey (SF-36) scores, gastrointestinal function scores, and serum levels of motilin (MTL), gastrin (GAS), and somatostatin (SS) were compared. Adverse reactions were also recorded.

Compared with the control group, the combination group had lower NIHSS scores (5.88 ± 1.07 vs 8.73 ± 1.14, P < 0.001) and gastrointestinal dysfunction scores (5.14 ± 1.27 vs 8.62 ± 1.31, P < 0.001), higher BI (87.36 ± 4.42 vs 72.29 ± 3.23, P < 0.001) and SF-36 scores (76.26 ± 3.85 vs 70.21 ± 3.66, P < 0.001), increased serum MTL (201.31 ± 12.35 ng/L vs 186.81 ± 11.18 ng/L, P < 0.001) and GAS levels (94.46 ± 9.64 pg/mL vs 103.15 ± 10.52 pg/mL, P < 0.001), and decreased SS levels (5.69 ± 1.25 pg/mL vs 8.31 ± 1.19 pg/mL, P < 0.001). No significant difference in the incidence of adverse reactions was found between the two groups.

The combination of naloxone and EN is a safe and efficacious therapeutic approach for ameliorating gastrointestinal dysfunction and promoting overall recovery in elderly individuals with CI and peptic ulcer.