EEG patterns in critically ill comatose patients receiving complementary therapy with aromatic orifice-opening herbs: A preliminary retrospective observational study

Traditional Chinese aromatic orifice-opening herbs (AOOH) have historically been believed to promote consciousness recovery in coma patients. However, the electroencephalographic (EEG) physiological changes related to coma that are induced by AOOH remain unclear. This study investigates the impact of AOOH on EEG pattern in critically ill comatose patients. A retrospective analysis was performed on 74 comatose patients to investigate the effect of AOOH as a complementary therapy. Forty-four patients entered the AOOH group, and 30 patients entered the non-AOOH group. The study's primary outcome measure was the rhythmic and periodic patterns index. It includes the generalized periodic discharges index and the lateralized periodic discharges index, which together form the periodic discharges index. It also includes the generalized rhythmic delta activity index and the lateralized rhythmic delta activity index, which together form the rhythmic delta activity (RDA) index. Other outcome measures include the EEG background abnormality grade, the Glasgow Coma Scale score, and the seizure recurrence rate. The degree of Glasgow Coma Scale improved in both groups. However, it improved more in the AOOH add-on group than in the non-AOOH group (P < .01). Seizure recurrence rates were 60% and 34.1%, respectively, with a significant difference between the 2 groups (P < .05). AOOH add-on increases the chance of a less severe EEG background (P < .01). The periodic discharges index decreased significantly in the AOOH add-on group (P < .001) compared to the non-AOOH group (P < .05). Both groups showed a decrease in RDA index (P < .001 for the AOOH add-on group and P < .01 for the non-AOOH add-on group). However, no statistically significant differences were observed between the 2 groups regarding RDA index reduction. The reduction of lateralized periodic discharges and generalized rhythmic delta activity showed significant differences between the AOOH add-on group and the non-AOOH group (both P < .05). However, there were no differences when referring to generalized periodic discharges and lateralized rhythmic delta activity between the 2 groups (both P > .05). An add-on therapy with AOOH can modulate the EEG pattern, restore consciousness, and reduce seizures following comas. The advantages and mechanisms of traditional Chinese medicine will be gradually revealed in future.