Huang Chia-Yu, Huang Ming-Cheng, Sun Mao-Feng, Lin Cheng-Li, Wu Mei-Yao, Lin Wu-Chou, Yen Hung-Rong
Department of Family Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, 427, Taiwan.
School of Medicine, Tzu Chi University, Hualien, 970, Taiwan.
Neuropsychiatr Dis Treat. 2021 Jul 12;17:2315-2325. doi: 10.2147/NDT.S315572. eCollection 2021.
Major depressive disorder is a significant public health concern, which often leads to loss of productivity, functional decline, and various complications. The aim of this study was to investigate the effectiveness of acupuncture in the risk reduction of coronary heart disease (CHD) in patients with depression.
We enrolled patients diagnosed with depression between January 1, 1997, and December 31, 2010, through the Taiwanese National Health Insurance Research Database (NHIRD). Propensity score was used to match equal numbers (n=14,647) of acupuncture cohort and no-acupuncture cohort based on characteristics including sex, age, baseline comorbidity and medication. Patients were followed up until December 31, 2013, or withdrawn from the NHIRD. The Cox regression model was used to compare the hazard ratios (HRs) of CHD in the two cohorts.
The basic characteristics of the two groups were similar. A lower cumulative incidence of CHD was noted in the acupuncture cohort (Log rank test, p < 0.001). Over time, 1626 patients in the acupuncture cohort (21.05 per 1000 person-years) and 2412 patients in the no-acupuncture cohort (39.84 per 1000 person-years) developed CHD (adjusted HR=0.50, 95% CI 0.47-0.53). The decreased CHD incidence was independent of age, sex, comorbidities, and medications used. The cumulative incidence of CHD was significantly lower in the acupuncture cohort than in the no-acupuncture cohort (Log rank test, p<0.001).
The results provided a real-world evidence that acupuncture may have beneficial effect on CHD risk reduction in patients with depression.
重度抑郁症是一个重大的公共卫生问题,常导致生产力丧失、功能衰退及各种并发症。本研究旨在探讨针刺对抑郁症患者降低冠心病(CHD)风险的有效性。
我们通过台湾国民健康保险研究数据库(NHIRD)纳入了1997年1月1日至2010年12月31日期间被诊断为抑郁症的患者。采用倾向评分法,根据性别、年龄、基线合并症和用药等特征,将针刺组和非针刺组的患者数量匹配为相等(n = 14,647)。对患者进行随访至2013年12月31日,或退出NHIRD。采用Cox回归模型比较两组冠心病的风险比(HRs)。
两组的基本特征相似。针刺组冠心病的累积发病率较低(对数秩检验,p < 0.001)。随着时间的推移,针刺组有1626例患者(每1000人年21.05例)发生冠心病,非针刺组有2412例患者(每1000人年39.84例)发生冠心病(调整后HR = 0.50,95% CI 0.47 - 0.53)。冠心病发病率的降低与年龄、性别、合并症及所用药物无关。针刺组冠心病的累积发病率显著低于非针刺组(对数秩检验,p < 0.001)。
研究结果提供了真实世界的证据,表明针刺可能对降低抑郁症患者的冠心病风险有有益作用。