Wu Mei-Yao, Huang Ming-Cheng, Chiang Jen-Huai, Sun Mao-Feng, Lee Yu-Chen, Yen Hung-Rong
Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, 2 Yude Road, North District, Taichung, Taiwan.
Department of Chinese Medicine, China Medical University Hospital, 2 Yude Road, North District, Taichung, Taiwan.
Arthritis Res Ther. 2017 Feb 28;19(1):37. doi: 10.1186/s13075-017-1239-7.
The aim of this study was to understand whether acupuncture can decrease the risk of coronary heart disease (CHD) in patients with fibromyalgia.
Using data from the Taiwanese National Health Insurance Research Database, we performed a propensity score-matched cohort study to analyze patients with fibromyalgia diagnosed between 1 January 2000 and 31 December 2010. Patients who received acupuncture treatment, beginning with their initial date of fibromyalgia diagnosis and extending to 31 December 2010, were regarded as the acupuncture cohort. The no-acupuncture cohort comprised patients who never received acupuncture through 31 December 2010. A Cox regression model was used to adjust for age, sex, comorbidities, and drugs used. The HRs of the acupuncture and no-acupuncture cohorts were compared.
After performing a 1:1 propensity score match, 58,899 patients in both cohorts were identified. Baseline characteristics were similar in both cohorts. The cumulative incidence of CHD was significantly lower in the acupuncture cohort (log-rank test, p < 0.001). In the follow-up period, 4389 patients in the acupuncture cohort (17.44 per 1000 person-years) and 8133 patients in the no-acupuncture cohort (38.36 per 1000 person-years) developed CHD (adjusted HR 0.43, 95% CI 0.41-0.45). The beneficial effect of acupuncture on the incidence of CHD was independent of age, sex, comorbidities, and statins used.
Our study confirmed that acupuncture reduced the risk of CHD in patients with fibromyalgia in Taiwan. Further clinical and mechanistic studies are warranted.
本研究旨在了解针灸是否能降低纤维肌痛患者患冠心病(CHD)的风险。
利用台湾国民健康保险研究数据库的数据,我们进行了一项倾向评分匹配队列研究,以分析2000年1月1日至2010年12月31日期间诊断为纤维肌痛的患者。从纤维肌痛诊断初始日期开始至2010年12月31日接受针灸治疗的患者被视为针灸队列。非针灸队列包括截至2010年12月31日从未接受过针灸治疗的患者。使用Cox回归模型对年龄、性别、合并症和所用药物进行调整。比较针灸队列和非针灸队列的风险比(HRs)。
进行1:1倾向评分匹配后,两个队列中各识别出58899名患者。两个队列的基线特征相似。针灸队列中冠心病的累积发病率显著较低(对数秩检验,p < 0.001)。在随访期间,针灸队列中有4389名患者(每1000人年17.44例)发生冠心病,非针灸队列中有8133名患者(每1000人年38.36例)发生冠心病(调整后的HR为0.43,95%可信区间为0.41 - 0.45)。针灸对冠心病发病率的有益作用独立于年龄、性别、合并症和所用他汀类药物。
我们的研究证实,针灸降低了台湾纤维肌痛患者患冠心病的风险。有必要进行进一步的临床和机制研究。