Chen Kuan-Yu, Huang Ming-Cheng, Lin Cheng-Li, Lee Yu-Chen, Wu Mei-Yao, Yen Hung-Rong
Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan.
Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
Neuropsychiatr Dis Treat. 2021 Nov 4;17:3255-3266. doi: 10.2147/NDT.S331026. eCollection 2021.
Depression is one of the most disabling disorders, which causes long-term complications such as neurodegenerative disorder and cerebrovascular disease. Some patients with depression seek acupuncture treatment. We aimed to investigate the association between acupuncture treatment and the risk of dementia in patients with depression from the perspective of real-world evidence.
Patients over 18 years old and newly diagnosed with depression between 1997 and 2010 were selected from the Taiwanese National Health Insurance Research Database and followed up until the end of 2013. Propensity score was used to match equal numbers of patients 1:1 (N = 16,609 per group) into acupuncture and non-acupuncture cohorts based on characteristics including sex, age, baseline comorbidity and drug use. The outcome measurement was the comparison of dementia incidence in the two cohorts.
Compared with the non-acupuncture cohort, patients who received acupuncture treatment had a decreased risk of dementia (adjusted hazard ratio (aHR) = 0.54; 95% confidence interval (CI) = 0.50-0.58, P < 0.001) after adjustment for age, sex, comorbidities and drug use. Compared with depression patients who did not receive acupuncture, the aHR of vascular dementia and Alzheimer's disease incidences for patients who had acupuncture therapy was 0.59 (95% CI 0.48-0.71) and 0.51 (95% CI 0.39-0.67), respectively. The cumulative incidence of dementia was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (Log rank test, p < 0.001).
The present study from real-world data revealed that acupuncture reduced the risk of dementia in depression patients, which supports healthcare decisions in clinical practice.
抑郁症是最具致残性的疾病之一，会引发神经退行性疾病和脑血管疾病等长期并发症。一些抑郁症患者会寻求针灸治疗。我们旨在从真实世界证据的角度研究针灸治疗与抑郁症患者患痴呆症风险之间的关联。
从台湾国民健康保险研究数据库中选取1997年至2010年间新诊断为抑郁症的18岁以上患者，并随访至2013年底。根据性别、年龄、基线合并症和药物使用等特征，使用倾向得分将等量患者（每组N = 16,609）1:1匹配到针灸组和非针灸组。结局指标是比较两组痴呆症发病率。
在对年龄、性别、合并症和药物使用进行调整后，与非针灸组相比，接受针灸治疗的患者患痴呆症的风险降低（调整后风险比[aHR]=0.54；95%置信区间[CI]=0.50 - 0.58，P < 0.001）。与未接受针灸的抑郁症患者相比，接受针灸治疗的患者血管性痴呆和阿尔茨海默病发病率的aHR分别为0.59（95%CI 0.48 - 0.71）和0.51（95%CI 0.39 - 0.67）。针灸组痴呆症的累积发病率显著低于非针灸组（对数秩检验，p < 0.001）。
本项基于真实世界数据的研究表明，针灸可降低抑郁症患者患痴呆症的风险，这为临床实践中的医疗决策提供了支持。
