Acyclovir Combined with Naloxone in the Treatment of Viral Encephalitis: A Meta-Analysis

BACKGROUND: The aim of this study was to systematically evaluate the efficacy and prognosis of acyclovir combined with naloxone in the treatment of patients with viral encephalitis (VE). METHODS: PubMed, Web of Science, Embase, CNKI, and WanFang Data were searched for relevant literature published between 2000 and 2021. Meta-analysis was performed using Stata16.0 software. The treatment group was treated with acyclovir combined with naloxone, and the control group was treated with acyclovir alone. RESULTS: A total of 12 studies with 986 participants were included. Compared with the control group, the treatment group could not only significantly improve the treatment response rate (OR = 5.53, 95% CI: 3.50, 8.74; P ≤ 0.001), but also reduce the incidence of adverse reactions (OR = 0.25, 95% CI: 0.17, 0.38; P ≤ 0.001). In addition, the combined treatment significantly inhibited the levels of inflammatory factors and neuron-specific enolase (NSE) in VE patients. The time for cerebrospinal fluid to return to normal (SMD = −2.73, 95% CI: −2.96, −2.51; P ≤ 0.001), as well as the disappearance time of meningeal irritation (SMD = −3.58, 95% CI: −4.96, −2.20; P ≤ 0.001), headache (SMD = −3.87, 95% CI: −5.84, −1.91; P ≤ 0.001), convulsion (SMD = −3.65, 95% CI: −4.56, −2.75; P < 0.001), tic (SMD = −4.083, 95% CI: −5.18, −2.98; P ≤ 0.001) and disturbance of consciousness (SMD = −4.96, 95% CI: −6.28, −3.63; P ≤ 0.001) in the treatment group were significantly shorter than those in the control group. CONCLUSION: A combination of acyclovir and naloxone can reduce the inflammatory response and shorter the time to symptom relief and disappearance, which is worthy of clinical promotion.