NIH Library of Medicine PubMed Central
Journal List Integr Med Res v.5(2); 2016 Jun PMC5381414
This study aimed to compare the risk of acute myocardial infarction (AMI) between stroke patients who received acupuncture treatment and those who did not. The nationwide retrospective cohort study included 182,619 new-onset stroke survivors aged 40–79 years. Among them, 23,475 patients received acupuncture treatment, and a nonexposure group of 46,950 patients was matched based on propensity scores. The follow-up duration was until December 31, 2009, or censored. The exposure group had a lower incidence of AMI (9.2 per 1000 person-years) compared to the nonexposure group (10.8 per 1000 person-years), with an adjusted hazard ratio of 0.86 (95% confidence interval, 0.80–0.93). A dose-response relationship was observed, with an HR of 0.61 (95% CI, 0.51–0.73) for patients receiving more than 15 acupuncture treatment courses. The authors concluded that stroke patients receiving acupuncture treatment appeared to have a lower risk of AMI, suggesting potential cardiovascular benefits associated with acupuncture.
Critique:
This preliminary nationwide cohort study suggests a potential reduction in the risk of AMI in stroke patients receiving acupuncture. The observed dose-response relationship and various explanations, such as enhanced physical movement capacity, heart rate reduction, lipid profile-lowering effect, antidepressant effect, and increased nitric oxide production, provide plausible mechanisms for the observed results. However, further research and exploration of these mechanisms are warranted to establish the efficacy and underlying pathways of acupuncture in reducing cardiovascular risks in stroke patients.
摘要：
本研究旨在比較接受針灸治療和未接受針灸治療的中風患者急性心肌梗塞（AMI）風險。這項全國性回顧性队列研究包括182,619名40-79歲的新發中風幸存者。其中，23,475名患者接受了針灸治療，非暴露組有46,950名患者根據傾向分數進行匹配。隨訪期限至2009年12月31日或被截至。暴露組AMI發生率（每1000人年9.2）較非暴露組（每1000人年10.8）低，調整風險比為0.86（95%置信區間，0.80-0.93）。觀察到劑量-反應關係，接受超過15次針灸治療的患者風險比為0.61（95% CI，0.51-0.73）。作者得出結論，接受針灸治療的中風患者似乎具有較低的AMI風險，暗示針灸可能與心血管益處相關。
評論：
這項初步的全國性队列研究暗示接受針灸治療的中風患者AMI風險可能降低。觀察到的劑量-反應關係和各種解釋，如增強體能運動能力，降低心率，降低脂質水平，抗抑鬱作用以及增加針灸對一氧化氮的產生，提供了觀察結果的合理機制。然而，進一步的研究和探索這些機制是必要的，以建立針灸在減少中風患者心血管風險方面的療效和基本途徑。
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