含马兜铃酸草药的老年新使用者与痴呆症风险：台湾一项基于全国人口的研究
New Users of Herbal Medicine Containing Aristolochic Acids and the Risk of Dementia in the Elderly: A Nationwide, Population-Based Study in Taiwan.
作者信息
Chiou Yueh-Er, Chien Wu-Chien, Chung Chi-Hsiang, Chang Hsin-An, Kao Yu-Chen, Tsay Pei-Kwei, Tzeng Nian-Sheng
机构信息
Department of Nursing, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
出版信息
Neuropsychiatr Dis Treat. 2020 Jun 12;16:1493-1504. doi: 10.2147/NDT.S250659. eCollection 2020.
BACKGROUND
Herbal medicine containing aristolochic acids (HMCAA) was used for inflammatory and infectious diseases. This study aimed to investigate the association between the usage of HMCAA and the risk of dementia.
METHODS
A total of 199 new users of HMCAA were enrolled, along with 597 controls without the usage of HMCAA, at a ratio of 1:3 - matched by age, sex, and comorbidity, between 2000 and 2003 - from the National Health Research Institutes Database (NHRID) of Taiwan, which contains two million randomly sampled subjects, in this cohort study. We used Fine and Gray's survival analysis (competing with mortality) to compare the risk of developing dementia during a 15-year follow-up period (2000-2015).
RESULTS
In general, HMCAA was not significantly associated with dementia (adjusted subdistribution hazard ratio [SHR] = 0.861, 95% confidence interval [CI] = 0.484-1.532, = 0.611) for the HMCAA-cohort, although differential risk was observed among the groups at risk. The patients with usage of HMCAA aged ≧ 85 years were associated with a higher risk in dementia (adjusted SHR: 6.243, 95% CI=1.258-21.084, = 0.001), in comparison to those aged 50-54 years. Furthermore, the patients with usage of HMCAA that had cerebrovascular accidents were associated with an increased risk of dementia.
CONCLUSION
The usage of HMCAA was associated with the risk of developing dementia in the patients aged ≧ 85 years.
背景
含马兜铃酸的草药（HMCAA）曾用于治疗炎症和感染性疾病。本研究旨在调查HMCAA的使用与痴呆风险之间的关联。
方法
在这项队列研究中，于2000年至2003年期间，从台湾国家卫生研究院数据库（NHRID）中选取了199名HMCAA新使用者，以及597名未使用HMCAA的对照者，按1:3的比例进行年龄、性别和合并症匹配，该数据库包含两百万随机抽样对象。我们使用Fine和Gray生存分析（与死亡率竞争）来比较15年随访期（2000 - 2015年）内发生痴呆的风险。
结果
总体而言，对于HMCAA队列，HMCAA与痴呆无显著关联（调整后的亚分布风险比[SHR]=0.861，95%置信区间[CI]=0.484 - 1.532，P = 0.611），尽管在风险组中观察到了不同的风险。与50 - 54岁的使用者相比，年龄≧85岁的HMCAA使用者患痴呆的风险更高（调整后的SHR：6.243，95%CI = 1.258 - 21.084，P = 0.001）。此外，有脑血管意外的HMCAA使用者患痴呆的风险增加。
结论
年龄≧85岁的患者使用HMCAA与患痴呆的风险相关。
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