School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
J Altern Complement Med. 2021 Jul;27(7):606-612. doi: 10.1089/acm.2020.0422. Epub 2021 May 12.
Patients who have Parkinson's disease (PD) comorbid with dementia is common. With the prolonged life expectancy, dementia is gradually becoming prevalent and affects most patients' life qualities. However, the efficacy of current treatments in dementia of PD is limited. Previous studies indicated the potential roles of Chinese herbal medicine (CHM) in treating dementia, yet the correlation between CHM usage and risk of dementia in PD patients is unclear. This case-control study was nested within a National Health Insurance database of patients over 50 years with newly diagnosed PD from year 2000 to 2010. Among these PD patients, dementia and nondementia groups were discussed, respectively, in terms of the duration of taking CHM (≥90 vs. <90 days), age (50-64 vs. ≥65 years) and gender. The risk of dementia in patients with PD is lower in CHM users compared with non-CHM users, especially in those taking CHM for more than 90 days (adjusted odds ratio [aOR] 0.58; 95% confidence interval [95% CI] 0.39-0.87). The use of CHM was significantly related to the lower risk of dementia in the subgroups of patients with age ≥65 years for CHM usage <90 days (aOR 0.68; 95% CI 0.53-0.88), patients with age ≥65 years for CHM usage ≥90 days (aOR 0.63; 95% CI 0.42-0.94), female patients using CHM for ≥90 days (aOR 0.43; 95% CI 0.22-0.84), and male patients using CHM for <90 days (aOR 0.62; 95% CI 0.43-0.88). The authors demonstrated the association of CHM usage with lower risk of dementia in patients with PD, especially in women with the usage of CHM for more than 90 days. Since no arbitrary causal conclusions could be drawn from retrospective cohort studies, the finding in this study could be used to generate a hypothesis for a subsequent design of prospective longitudinal study.
帕金森病（PD）合并痴呆的患者很常见。随着预期寿命的延长，痴呆症逐渐变得普遍，并影响大多数患者的生活质量。然而，目前治疗 PD 痴呆症的疗效有限。先前的研究表明，中草药（CHM）在治疗痴呆症方面具有潜在作用，但 CHM 使用与 PD 患者痴呆症风险之间的相关性尚不清楚。这项病例对照研究嵌套在一个国家卫生保险数据库中，该数据库包含 2000 年至 2010 年间新诊断为 PD 的 50 岁以上患者。在这些 PD 患者中，分别讨论了痴呆症组和非痴呆症组，讨论的内容包括服用 CHM 的时间（≥90 天与<90 天）、年龄（50-64 岁与≥65 岁）和性别。与非 CHM 使用者相比，PD 患者中 CHM 使用者发生痴呆症的风险较低，尤其是服用 CHM 时间超过 90 天的患者（调整后的优势比[aOR]0.58；95%置信区间[95%CI]0.39-0.87）。在年龄≥65 岁的 CHM 使用时间<90 天的患者亚组（aOR 0.68；95%CI 0.53-0.88）、年龄≥65 岁的 CHM 使用时间≥90 天的患者亚组（aOR 0.63；95%CI 0.42-0.94）、女性患者 CHM 使用时间≥90 天的患者亚组（aOR 0.43；95%CI 0.22-0.84）和男性患者 CHM 使用时间<90 天的患者亚组（aOR 0.62；95%CI 0.43-0.88）中，CHM 的使用与痴呆症风险降低相关。作者表明，CHM 的使用与 PD 患者痴呆症风险降低相关，尤其是女性患者 CHM 使用时间超过 90 天。由于不能从回顾性队列研究中得出任意因果结论，因此本研究的发现可用于产生后续前瞻性纵向研究的假设。
