Department of Biomedical Engineering, National Cheng Kung University, Taiwan.
Department of Anesthesiology, Taipei Medical University Hospital, Taiwan; Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan.
Complement Ther Med. 2016 Apr;25:34-8. doi: 10.1016/j.ctim.2015.12.012. Epub 2016 Jan 2.
Patients with cardiac arrhythmia were more likely to develop stroke than general population. The therapeutic effect of traditional Chinese medicine (TCM) on the risk of stroke in patients with cardiac arrhythmia was unknown. The aim of this study is to investigate the risk of stroke in patients with cardiac arrhythmia receiving TCM.
From the one million cohort of the Taiwan's National Health Insurance Research Database, we identified cohort of cardiac arrhythmia included 2029 patients who received TCM treatment in 2000-2004. The matching methods with propensity score was used to select 2029 appropriate control cohort for comparison. Incident events of stroke were identified during the follow-up period at the end of 2010. Cox proportional hazard model was used to calculate adjusted hazard ratios and 95% confidence intervals of stroke associated with TCM treatment.
During the follow-up period, patients with cardiac arrhythmia who underwent TCM treatment (11.4 per 1000 person-years) had a lower incidence of new-onset stroke than those without TCM treatment (17.7 per 1000 person-years), with an HR of 0.62 (95% CI=0.50-0.78). The association between TCM treatment and decreased new-onset stroke was both significant in women and men. The young patients aged 45-54 years who received TCM had the lowest risk of stroke (HR=0.48, 95% CI=0.27-0.87).
Receiving TCM treatment was associated with a lower risk of stroke in patients with cardiac arrhythmia. However, this study was limited by lack of information regarding lifestyles, biochemical profiles, the dose of herbal medicine, and acupuncture points used in treatments.
心律失常患者发生卒中的风险高于一般人群。中药(TCM)治疗心律失常患者卒中风险的疗效尚不清楚。本研究旨在探讨接受 TCM 治疗的心律失常患者发生卒中的风险。
我们从台湾全民健康保险研究数据库的 100 万队列中,确定了 2000-2004 年接受 TCM 治疗的心律失常队列,共包括 2029 例患者。采用倾向评分匹配方法为其匹配了 2029 例合适的对照组进行比较。在 2010 年底随访期间,确定卒中的首发事件。采用 Cox 比例风险模型计算 TCM 治疗与卒中相关的调整后风险比(HR)和 95%置信区间(CI)。
在随访期间,接受 TCM 治疗的心律失常患者(11.4/1000 人年)的新发卒中发生率低于未接受 TCM 治疗的患者(17.7/1000 人年),HR 为 0.62(95%CI=0.50-0.78)。TCM 治疗与新发卒中减少之间的关联在女性和男性中均具有统计学意义。接受 TCM 治疗的年轻患者(45-54 岁)发生卒中的风险最低(HR=0.48,95%CI=0.27-0.87)。
接受 TCM 治疗与心律失常患者发生卒中的风险降低相关。然而,本研究受到缺乏有关生活方式、生化特征、草药剂量和治疗中使用的针灸穴位等信息的限制。