Chuang Sun-Fa, Shih Chun-Chuan, Yeh Chun-Chieh, Lane Hsin-Long, Tsai Chin-Chuan, Chen Ta-Liang, Lin Jaung-Geng, Chen Tainsong, Liao Chien-Chang
Department of Biomedical Engineering, National Cheng Kung University, 1 University Road, Tainan City, 701, Taiwan.
School of Chinese Medicine for Post-Baccalaureate, I-Shou University, 8 Yida Road, Kaohsiung City, 824, Taiwan.
BMC Complement Altern Med. 2015 Sep 9;15:318. doi: 10.1186/s12906-015-0828-8.
Whether acupuncture protects stroke patients from acute myocardial infarction (AMI) has not been studied previously. The purpose of this study was to investigate the risk of AMI among stroke patients receiving acupuncture treatment.
Taiwan's National Health Insurance Research Database was used to conduct a retrospective cohort study of 23475 stroke patients aged 40-79 years receiving acupuncture treatment and 46950 propensity score-matched stroke patients not receiving acupuncture treatment who served as controls from 2000 to 2004. Both stroke cohorts were followed until the end of 2009 and were adjusted for immortal time to measure the incidence and adjusted hazard ratios (HRs) with 95 % confidence intervals (CIs) for new-onset AMI in multivariate Cox proportional hazard models.
Stroke patients who received acupuncture treatment (9.2 per 1000 person-years) exhibited a lower incidence of AMI compared with those who did not receive acupuncture treatment (10.8 per 1000 person-years), with an HR of 0.86 (95 % CI, 0.80-0.93) after adjusting for age, sex, low income, coexisting medical conditions and medications. The relationship between acupuncture treatment and AMI risk was investigated in female stroke patients (HR, 0.85; 95 % CI, 0.76-0.95), male stroke patients (HR, 0.87; 95 % CI, 0.80-0.95), patients from 50 to 59 years of age (HR, 0.75; 95 % CI, 0.63-0.90), patients from 60 to 69 years of age (HR, 0.85; 95 % CI, 0.75-0.95), patients suffering from ischemic stroke (HR, 0.87; 95 % CI, 0.79-0.95), and patients suffering from hemorrhagic stroke (HR, 0.62; 95 % CI, 0.44-0.88).
We raised the possibility that acupuncture may be effective in lowering the risk of AMI in stroke patients aged 50-69 in this study, which was limited by a lack of information regarding stroke severity and acupuncture points. Our results suggest that prospective randomized trials are needed to establish the efficacy of acupuncture in preventing AMI.
此前尚未研究针刺疗法能否保护中风患者预防急性心肌梗死（AMI）。本研究旨在调查接受针刺治疗的中风患者发生AMI的风险。
利用台湾地区全民健康保险研究数据库，对2000年至2004年期间年龄在40 - 79岁、接受针刺治疗的23475例中风患者以及46950例倾向得分匹配的未接受针刺治疗的中风患者（作为对照）进行回顾性队列研究。对两个中风队列随访至2009年底，并对不朽时间进行调整，以测量多变量Cox比例风险模型中新发AMI的发病率和调整后的风险比（HR）及95%置信区间（CI）。
接受针刺治疗的中风患者（每1000人年9.2例）发生AMI的发病率低于未接受针刺治疗的患者（每1000人年10.8例），在调整年龄、性别、低收入、并存疾病和药物治疗因素后，HR为0.86（95%CI，0.80 - 0.93）。在女性中风患者（HR，0.85；95%CI，0.76 - 0.95）、男性中风患者（HR，0.87；95%CI，0.80 - 0.95）、50至59岁患者（HR，0.75；95%CI，0.63 - 0.90）、60至69岁患者（HR，0.85；95%CI，0.75 - 0.95）、缺血性中风患者（HR，0.87；95%CI，0.79 - 0.95）和出血性中风患者（HR，0.62；95%CI，0.44 - 0.88）中均研究了针刺治疗与AMI风险之间的关系。
本研究提出针刺疗法可能有效降低50 - 69岁中风患者发生AMI风险的可能性，但本研究受限于缺乏中风严重程度和针刺穴位的相关信息。我们的结果表明，需要进行前瞻性随机试验来确定针刺疗法预防AMI的疗效。
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