Shih Chun-Chuan, Yeh Chun-Chieh, Hu Chaur-Jong, Lane Hsin-Long, Tsai Chin-Chuan, Chen Ta-Liang, Liao Chien-Chang
School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Ph.D. Program for Clinical Drug Discovery from Botanical Herbs, Taipei Medical University, Taipei, Taiwan.
BMJ Open. 2017 Jul 5;7(6):e013638. doi: 10.1136/bmjopen-2016-013638.
To investigate the risk of dementia in patients with stroke who did and did not receive acupuncture treatment.
Retrospective cohort study.
This study was based on Taiwan's National Health Insurance Research Database that included patients with stroke hospitalised between 1 January 2000 and 31 December 2004.
We identified 11 220 patients aged 50 years and older with newly diagnosed stroke hospitalisation.
We compared the incident dementia during the follow-up period until the end of 2009 in patients with stroke who did and did not receive acupuncture. The adjusted HRs and 95% CIs of dementia associated with acupuncture were calculated in multivariate Cox proportional hazard regressions.
Acupuncture treatment was associated with a decreased risk of dementia with multivariate adjustment (HR, 0.73; 95% CI 0.66 to 0.80), and the association was significant in both sexes and every age group, as well as in groups with ischaemic stroke, with fewer medical conditions and those hospitalised after stroke. Patients with stroke received acupuncture treatment, and conventional rehabilitation was associated with a significantly reduced risk of poststroke dementia (HR, 0.64; 95% CI 0.56 to 0.74).
This study raises the possibility that patients with non-haemorrhagic stroke who received acupuncture had a reduced risk of dementia. The results suggest the need for prospective sham-controlled and randomised trials to establish the efficacy of acupuncture in preventing dementia.
研究接受和未接受针灸治疗的中风患者患痴呆症的风险。
回顾性队列研究。
本研究基于台湾国民健康保险研究数据库,该数据库纳入了2000年1月1日至2004年12月31日期间住院的中风患者。
我们确定了11220名年龄在50岁及以上、新诊断为中风住院的患者。
我们比较了在随访期至2009年底期间,接受和未接受针灸治疗的中风患者发生痴呆症的情况。在多变量Cox比例风险回归中计算与针灸相关的痴呆症的调整后风险比(HR)和95%置信区间(CI)。
经多变量调整后,针灸治疗与痴呆症风险降低相关(HR,0.73;95%CI 0.66至0.80),且在男女各年龄组、缺血性中风组、合并疾病较少的组以及中风后住院的组中,这种关联均显著。接受针灸治疗的中风患者以及接受传统康复治疗的患者发生中风后痴呆症的风险显著降低(HR,0.64;95%CI 0.56至0.74)。
本研究提出了接受针灸治疗的非出血性中风患者患痴呆症风险降低的可能性。结果表明需要进行前瞻性假对照随机试验,以确定针灸预防痴呆症的疗效。