College of Chinese Medicine, Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan.
Department of Acupuncture, China Medical University Hospital, Taichung, Taiwan.
J Altern Complement Med. 2019 Sep;25(9):946-956. doi: 10.1089/acm.2018.0496. Epub 2019 Jul 19.
Patients with Bell's palsy are more likely to develop stroke than the general population. The therapeutic effect of Traditional Chinese Medicine (TCM) on the risk of stroke in patients with Bell's palsy is unknown. We investigated the risk of stroke according to TCM use in Bell's palsy patients. Records obtained from Taiwan's National Health Insurance Research Database identified 9,863 patients with Bell's palsy, 238 of whom met study inclusion criteria and were categorized as TCM users ( = 119) or non-TCM users ( = 119). TCM treatment modalities and Chinese herbal medicine prescription patterns were analyzed. Cox proportional hazards regression analysis determined the risk of stroke. TCM users were at lower risk of stroke compared with non-TCM users (adjusted hazard ratio [aHR] 0.19; 95% confidence interval [CI], 0.06-0.59; < 0.004). In subgroup analyses, patients treated with both TCM and oral steroids were at significantly lower risk of stroke compared with those who used neither (aHR 0.05; 95% CI, 0.01-0.22; < 0.001). The risk of stroke was also lower among those treated with TCM only (aHR 0.25; 95% CI, 0.11-0.59; < 0.001) or oral steroids only (aHR 0.12; 95% CI, 0.03-0.39; < 0.01), compared with patients using neither. TCM therapy may lower the risk of stroke after Bell's palsy. However, the retrospective nature of this study and characteristics of the database limit these observational findings. Our results deserve further verification in large-scale prospective studies.
贝尔氏面瘫患者发生中风的风险高于普通人群。中药(TCM)治疗贝尔氏面瘫患者中风风险的疗效尚不清楚。我们研究了 TCM 使用与贝尔氏面瘫患者中风风险的相关性。 从台湾全民健康保险研究数据库中获取记录,共识别出 9863 例贝尔氏面瘫患者,其中 238 例符合纳入标准并分为 TCM 使用者( = 119)或非 TCM 使用者( = 119)。分析 TCM 治疗方式和中草药处方模式。Cox 比例风险回归分析确定中风风险。 与非 TCM 使用者相比,TCM 使用者中风风险较低(调整后的风险比[aHR]0.19;95%置信区间[CI],0.06-0.59; < 0.004)。在亚组分析中,与既不使用 TCM 也不使用口服类固醇的患者相比,同时使用 TCM 和口服类固醇的患者中风风险显著降低(aHR 0.05;95%CI,0.01-0.22; < 0.001)。仅使用 TCM(aHR 0.25;95%CI,0.11-0.59; < 0.001)或仅使用口服类固醇(aHR 0.12;95%CI,0.03-0.39; < 0.01)的患者,中风风险也低于既不使用 TCM 也不使用口服类固醇的患者。 TCM 疗法可能降低贝尔氏面瘫后的中风风险。然而,本研究的回顾性性质和数据库的特点限制了这些观察结果。我们的研究结果值得在大规模前瞻性研究中进一步验证。