Wu Li-Kung, Hung Chung-Shan, Kung Yen-Lun, Chen Zhong-Kui, Lin Shinn-Zong, Lin Jaung-Geng, Ho Tsung-Jung
Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Department of Aging and Community Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Evid Based Complement Alternat Med. 2022 Feb 1;2022:3919866. doi: 10.1155/2022/3919866. eCollection 2022.
Acupuncture has been applied as a complementary therapy in stroke survivors worldwide and approved to be beneficial to stroke recovery. However, there is little medical evidence regarding the association between acupuncture and the risk of poststroke comorbidities. We reviewed big data studies from the Taiwan National Health Insurance Research Database to investigate the risk of poststroke comorbidities after acupuncture treatment in a real-world situation. Ten English (PubMed, Embase, Medline, Cochrane, Alt HealthWatch, CINAHL, Health Source, PsycINFO, PsycARTICLES, and Psychology and Behavioral Sciences Collection) and two Chinese (AiritiLibray and Visualizing Health Data) electronic databases were searched from inception until December 2020 for nationalized cohort studies comparing the effects of acupuncture treatment with a nonacupuncture control group among stroke patients. Eight nationalized cohort studies were included. Six of eight studies showed a moderate overall risk of bias, while two studies showed a serious overall risk of bias. Included studies have investigated the effect of acupuncture in reducing the risk of seven medical conditions after stroke, including stroke recurrence, new-onset acute myocardial infarction (AMI), pneumonia, dementia, epilepsy, urinary tract infection (UTI), and depression. The meta-analysis showed clinically significant reductions in the risk of poststroke comorbidities in the acupuncture group compared to the nonacupuncture group (HR, 0.776; 95% CI, 0.719-0.838; < 0.0001). In this systematic review and meta-analysis of nationalized cohort studies, acupuncture showed clinically relevant benefits in reducing the incidence of poststroke comorbidities, such as stroke recurrence, new-onset acute myocardial infarction (AMI), pneumonia, dementia, epilepsy, and UTI.
在全球范围内，针灸已被用作中风幸存者的辅助治疗方法，并被证实对中风恢复有益。然而，关于针灸与中风后合并症风险之间的关联，几乎没有医学证据。我们回顾了台湾国民健康保险研究数据库中的大数据研究，以调查在实际临床环境中接受针灸治疗后中风后合并症的风险。检索了10个英文电子数据库（PubMed、Embase、Medline、Cochrane、Alt HealthWatch、CINAHL、Health Source、PsycINFO、PsycARTICLES以及Psychology and Behavioral Sciences Collection）和2个中文电子数据库（华艺数位图书馆和可视化健康数据），从建库至2020年12月，查找比较中风患者中针灸治疗组与非针灸对照组效果的全国性队列研究。共纳入8项全国性队列研究。8项研究中有6项显示总体偏倚风险为中度，而2项研究显示总体偏倚风险严重。纳入的研究调查了针灸对降低中风后7种疾病风险的效果，包括中风复发、新发急性心肌梗死（AMI）、肺炎、痴呆、癫痫、尿路感染（UTI）和抑郁症。荟萃分析显示，与非针灸组相比，针灸组中风后合并症的风险有显著临床降低（HR，0.776；95%CI，0.719 - 0.838；<0.0001）。在这项对全国性队列研究的系统评价和荟萃分析中，针灸在降低中风后合并症（如中风复发、新发急性心肌梗死（AMI）、肺炎、痴呆、癫痫和UTI）的发生率方面显示出与临床相关的益处。
