中医药预防心房颤动等心律失常造成的脑卒中有前途(转载)

    发布时间:2016-01-04   来源:中华康网   

  心律失常患者脑卒中预防:中医力量不容小觑
原创 2016-01-12 徐巍巍 心在线
心律失常患者发生脑卒中风险增加,而长期以来,针对传统中医(TCM)治疗对心律失常患者脑卒中的预防效果,我们知之甚少。近期,台湾一项研究发现,TCM治疗可减小心律失常患者的脑卒中发生风险。

研究从一项样本量为100万例的队列研究中,选取了2000年-2004年间,年龄≥20岁,新近诊断为心律失常,并且接受至少一次TCM治疗的患者2029例,同时利用倾向性匹配,确定了2029例对照组受试者。

研究中的TCM治疗包括中药、针灸、艾灸、推拿及拔罐等,其中以中药和针灸最常用。

随访至2010年12月31日,与不接受TCM治疗者相比,接受TCM治疗者的新发脑卒中率较低,11.4/1000人年 vs. 17.7/1000人年(HR:0.62,95%CI:0.50-0.78)。

这一结果在男性、女性中均显著。在不同年龄段中,45~54岁患者发生脑卒中的风险最小(HR:0.48,95%CI:0.27-0.87)。
并且,与未接受TCM治疗者相比,接受治疗次数越多的患者,发生脑卒中的风险越小。

综上,该研究表明,心律失常患者接受TCM治疗,可减小脑卒中发生风险较小。这一结果在所有性别组、年龄组中均成立。

研究的局限性在于缺少生活方式、生化检查、中药剂量等方面的信息。同时,TCM治疗可预防心律失常患者发生脑卒中的潜在机制,未来也还需进一步的探索。
心在线编译自:Complementary Therapies in Medicine
英文原文

Reduced risk of stroke in patients with cardiac arrhythmia receiving traditional Chinese medicine: A nationwide matched retrospective cohort study

Objective

Patients with cardiac arrhythmia were more likely to develop stroke than general population. The therapeutic effect of traditional Chinese medicine (TCM) on the risk of stroke in patients with cardiac arrhythmia was unknown. The aim of this study is to investigate the risk of stroke in patients with cardiac arrhythmia receiving TCM.

Methods

From the one million cohort of the Taiwan's National Health Insurance Research Database, we identified cohort of cardiac arrhythmia included 2029 patients who receiving TCM treatment in 2000-2004. The matching methods with propensity score was used to select 2029 appropriate control cohort for comparison. Incident events of stroke were identified during the follow-up period at the end of 2010. Cox proportional hazard model was used to calculate adjusted hazard ratios and 95% confidence intervals of stroke associated with TCM treatment.

Results

During the follow-up period, patients with cardiac arrhythmia who underwent TCM treatment (11.4 per 1000 person-years) had a lower incidence of new-onset stroke than those without TCM treatment (17.7 per 1000 person-years), with an HR of 0.62 (95% CI = 0.50-0.78). The association between TCM treatment and decreased new-onset stroke was both significant in women and men. The young patients aged 45-54 years who receiving TCM had the lowest risk of stroke (HR = 0.48, 95% CI = 0.27-0.87).

Conclusions

Receiving TCM treatment was associated with a lower risk of stroke in patients with cardiac arrhythmia. However, this study was limited by lack of information regarding lifestyles, biochemical profiles, the dose of herbal medicine, and acupuncture points used in treatments.

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