Choi Sung-Ryul, Kim Eun-San, Jang Bo-Hyoung, Jung Boyoung, Ha In-Hyuk
Jaseng Hospital of Korean Medicine, Seoul 06110, Korea.
Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Korea.
Healthcare (Basel). 2022 Apr 19;10(5):756. doi: 10.3390/healthcare10050756.
This study investigated the time-dependent characteristics of acupuncture and analyzed the association between acupuncture utilization and mortality rates, readmission rates, and complications among ischemic stroke patients. Data from the National Health Insurance Service-National Sample Cohort 2.0 from South Korea were used to track patients with subacute and chronic ischemic stroke, who had survived more than one month after onset, between 2010 and 2013. A total of 2299 patients were followed up until 2015. At baseline, the acupuncture group ( = 195) and the control group ( = 2104) had similar ages (acupuncture group: 69.0 ± 11.1 years; control group: 68.5 ± 11.8 years), but the acupuncture group had more comorbidities (Charlson comorbidity index; acupuncture group: 4.7 ± 2.1, control group: 4.3 ± 2.4). According to time-dependent Cox regression survival analysis, acupuncture treatment was associated with low hazard ratios (HR) for death (HR: 0.32; 95% confidence interval (CI): 0.18-0.60), fewer composite complications (HR: 0.34; 95% CI: 0.21-0.53), and reduced urinary tract infection (HR: 0.24; 95% CI: 0.11-0.54). Many acupuncture session sensitivity analyses were performed to assess the robustness using different criteria to define the acupuncture group, and the results were consistent with those of the main analysis. Therefore, acupuncture treatment might be associated with lower mortality rates and the prevention of complications after ischemic stroke.
本研究调查了针灸的时间依赖性特征，并分析了缺血性中风患者的针灸使用情况与死亡率、再入院率及并发症之间的关联。利用韩国国民健康保险服务-全国样本队列2.0的数据，追踪2010年至2013年间发病后存活超过1个月的亚急性和慢性缺血性中风患者。共有2299名患者随访至2015年。在基线时，针灸组（n = 195）和对照组（n = 2104）年龄相似（针灸组：69.0±11.1岁；对照组：68.5±11.8岁），但针灸组合并症更多（查尔森合并症指数；针灸组：4.7±2.1，对照组：4.3±2.4）。根据时间依赖性Cox回归生存分析，针灸治疗与较低的死亡风险比（HR）（HR：0.32；95%置信区间（CI）：0.18 - 0.60）、较少的复合并发症（HR：0.34；95%CI：0.21 - 0.53）以及降低的尿路感染发生率（HR：0.24；95%CI：0.11 - 0.54）相关。进行了多次针灸疗程敏感性分析，以使用不同标准定义针灸组来评估稳健性，结果与主要分析结果一致。因此，针灸治疗可能与缺血性中风后较低的死亡率及并发症预防相关。
