Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Aging Clin Exp Res. 2024 Oct 12;36(1):204. doi: 10.1007/s40520-024-02858-9.
This study aims to assess the impact of Traditional Chinese Medicine (TCM) on dementia patients, utilizing real-world data. Specifically, it seeks to evaluate how TCM influences clinical outcomes by examining changes in the Clinical Dementia Rating (CDR) and Mini-Mental State Examination (MMSE) scores, as well as its effect on medical expenses over a two-year period. Data from a multi-center research database spanning from 2004 to 2021 will be used to achieve these objectives, addressing the current gap in empirical data concerning intuitive outcomes and cognitive function assessments.
Propensity score matching was adopted to improve comparability among the intervention and control groups. Due to repeated dependent variable measurements, the generalized estimating equation was used to control for socio-demographic characteristics, regional characteristics, and Western medicine treatments for dementia.
After propensity score matching, a total of 441 research subjects were included: 90 in the TCM intervention group and 351 in the non-TCM intervention group. The results of multivariate regression analysis showed that compared with the non-TCM intervention group, the MMSE scores in the TCM intervention group increased by 0.608 points each year. The annual change in CDR scores in the TCM intervention group was 0.702 times that of the non-TCM utilization group. After TCM intervention, annual outpatient expenses increased by US$492.2, hospitalization expenses increased by US$324.3, and total medical expenses increased by US$815.9, compared with the non-intervention group.
TCM interventions significantly decelerate cognitive decline in dementia patients, evidenced by slower reductions in MMSE scores and mitigated increases in CDR scores. However, these benefits are accompanied by increased medical expenses, particularly for outpatient care. Future healthcare strategies should balance the cognitive benefits of TCM with its economic impact, advocating for its inclusion in dementia care protocols.
本研究旨在利用真实世界数据评估中医药(TCM)对痴呆患者的影响。具体而言,通过考察 TCM 对临床结局的影响,即观察临床痴呆评定量表(CDR)和简易精神状态检查量表(MMSE)评分的变化,以及 TCM 对两年内医疗费用的影响,评估其对痴呆患者的影响。本研究将使用 2004 年至 2021 年多中心研究数据库的数据来实现这些目标,旨在填补关于直观结果和认知功能评估的实证数据空白。
采用倾向评分匹配法提高干预组和对照组之间的可比性。由于重复的因变量测量,采用广义估计方程来控制社会人口学特征、地域特征和痴呆的西药治疗。
经过倾向评分匹配后,共纳入 441 名研究对象:TCM 干预组 90 名,非 TCM 干预组 351 名。多变量回归分析结果显示,与非 TCM 干预组相比,TCM 干预组的 MMSE 评分每年增加 0.608 分。TCM 干预组 CDR 评分的年变化率是非 TCM 利用组的 0.702 倍。与非干预组相比,TCM 干预后,年门诊费用增加 492.2 美元,住院费用增加 324.3 美元,总医疗费用增加 815.9 美元。
TCM 干预可显著减缓痴呆患者的认知能力下降,表现在 MMSE 评分降低速度较慢,CDR 评分增加幅度较小。然而,这些益处伴随着医疗费用的增加,尤其是门诊费用。未来的医疗保健策略应在 TCM 的认知益处与其经济影响之间取得平衡,倡导将其纳入痴呆护理方案。