Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Complement Ther Med. 2024 Mar;80:103007. doi: 10.1016/j.ctim.2023.103007. Epub 2023 Nov 30.
Acupuncture, a widely employed traditional therapeutic modality known for its efficacy in pain alleviation and diverse condition management, may inadvertently result in mechanical nerve injury due to its invasive nature. This research aimed to ascertain the incidence of nerve injuries post-acupuncture, identify associated risk factors, and map the distribution of nerve injury sites.
A case-control study nested in the National Health Insurance Research Database (NHIRD) 2000-2018 two million cohort was conducted. Patients previously diagnosed with nerve injury, surgery, or degeneration before acupuncture were excluded. Cases were defined as patients receiving acupuncture and seeking medical attention for nerve injury (ICD9-CM code 950-957) within 14 days post-procedure, while control groups comprised patients undergoing acupuncture without subsequent adverse events. Invasive treatments prior to adverse events and adverse events occurring more than 14 days post-acupuncture were excluded. To ensure case-control comparability, factors such as age, gender, socioeconomic status, and medical facility environment were controlled using propensity score matching.
The study encompassed 14,507,847 acupuncture treatments administered to 886,753 patients, with 8361 instances of post-acupuncture nerve injury identified, representing an incidence rate of approximately 5.76 per 10,000 procedures. Age emerged as a significant risk factor, with the adjusted odds ratios escalating with age. Several comorbidities including diabetes, hypothyroidism, liver cirrhosis, chronic kidney disease, herpes zoster, hepatitis virus, rheumatoid arthritis, systemic lupus erythematosus, dementia, and cerebrovascular accidents were associated with an elevated risk of nerve injury post-acupuncture.
This study underscores the importance of meticulous patient profiling and cautious therapeutic approach in acupuncture, considering the evident influence of various demographic, systemic, and treatment-related factors on the incidence of nerve injuries.
针灸是一种广泛应用的传统治疗方法，以缓解疼痛和治疗多种疾病而闻名，但其有创性可能导致机械性神经损伤。本研究旨在确定针灸后神经损伤的发生率，确定相关危险因素，并绘制神经损伤部位的分布图。
采用 2000-2018 年全国健康保险研究数据库（NHIRD）中的病例对照嵌套研究。排除有神经损伤、手术或退变病史及针灸前接受过神经损伤治疗的患者。病例定义为接受针灸治疗后 14 天内因神经损伤（ICD9-CM 代码 950-957）就诊的患者，对照组为接受针灸治疗后无不良反应的患者。排除针灸前有侵入性治疗和针灸后 14 天以上发生的不良反应。为确保病例对照的可比性，采用倾向评分匹配控制年龄、性别、社会经济地位和医疗设施环境等因素。
研究共纳入 14507847 例针灸治疗，涉及 886753 例患者，其中 8361 例发生针灸后神经损伤，发生率约为 5.76/10000 例。年龄是一个显著的危险因素，调整后的比值比随年龄增长而增加。一些合并症，包括糖尿病、甲状腺功能减退症、肝硬化、慢性肾脏病、带状疱疹、肝炎病毒、类风湿关节炎、系统性红斑狼疮、痴呆和脑血管意外，与针灸后神经损伤的风险增加相关。
本研究强调了在针灸治疗中仔细评估患者状况和谨慎治疗方法的重要性，因为各种人口统计学、系统性和治疗相关因素对神经损伤的发生率有明显影响。
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