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针刺降低了台湾纤维肌痛患者的中风风险:一项全国性匹配队列研究。

Acupuncture decreased the risk of stroke among patients with fibromyalgia in Taiwan: A nationwide matched cohort study.

机构信息

Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.

School of Chinese Medicine, College of Chinese Medicine, Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan.

出版信息

PLoS One. 2020 Oct 1;15(10):e0239703. doi: 10.1371/journal.pone.0239703. eCollection 2020.

Abstract

BACKGROUND

The aim of this study was to investigate the effectiveness of acupuncture in decreasing the risk of stroke in patients with fibromyalgia.

METHODS

We enrolled patients who was newly diagnosed as having fibromyalgia between 1 January, 2000 and 31 December, 2010 from the Taiwanese National Health Insurance Research Database. The claim data for both the acupuncture cohort and non-acupuncture cohort were assessed from the index date to 31 December, 2013. A Cox regression model adjusted for age, sex, comorbidities, and drugs use was used to compare the hazard ratios of the two cohorts. The cumulative incidence of stroke was estimated by using the Kaplan-Meier method.

RESULTS

After performing a propensity score matching with a 1:1 ratio, there were 65,487 patients in the acupuncture and non-acupuncture cohorts with similar distributions in the baseline characteristics. The cumulative incidence of stroke was significantly lower in the acupuncture cohort (log-rank test, p < 0.001). In the follow-up period, 4,216 patients in the acupuncture cohort (11.01 per 1000 person-years) and 6,849 patients in the non-acupuncture cohort (19.82 per 1000 person-years) suffered from stroke (adjusted HR 0.53, 95% CI 0.51-0.55). Acupuncture favorably affected the incidence of stroke regardless of the patient's age, sex, comorbidities, and conventional drug use.

CONCLUSIONS

Our study found that acupuncture might have a beneficial effect on reducing the risk of stroke in patients with fibromyalgia in Taiwan. Additional clinical and basic science studies are warranted.

摘要

背景

本研究旨在探讨针刺疗法降低纤维肌痛患者中风风险的效果。

方法

我们从台湾全民健康保险研究数据库中纳入了 2000 年 1 月 1 日至 2010 年 12 月 31 日期间新诊断为纤维肌痛的患者。从索引日期到 2013 年 12 月 31 日,评估了针刺组和非针刺组的索赔数据。使用 Cox 回归模型,调整年龄、性别、合并症和药物使用情况,比较两组的风险比。采用 Kaplan-Meier 法估计中风的累积发生率。

结果

进行倾向评分 1:1 匹配后,针刺组和非针刺组各有 65487 例患者,基线特征分布相似。针刺组中风的累积发生率明显较低(对数秩检验,p<0.001)。在随访期间,针刺组有 4216 例(11.01/1000人年)和非针刺组有 6849 例(19.82/1000 人年)患者发生中风(校正 HR 0.53,95%CI 0.51-0.55)。针刺对无论患者年龄、性别、合并症和常规药物使用情况,中风的发生率都有有利影响。

结论

我们的研究发现,针刺可能对降低台湾纤维肌痛患者中风风险有有益作用。需要开展更多的临床和基础科学研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e36/7529290/99086e99c35c/pone.0239703.g001.jpg

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