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Acupuncture Decreased the Risk of Coronary Heart Disease in Patients with Osteoarthritis in Taiwan: A Nationwide Matched Cohort Study.

针灸降低台湾骨关节炎患者冠心病风险: 一项全国性匹配队列研究。

  • 影响因子:1.75
  • DOI:10.1089/acm.2020.0153
  • 作者列表:"Ton G","Yang YC","Lee LW","Ho WC","Chen YH","Yen HR","Lee YC
  • 发表时间:2021-03-01
Abstract

: Objectives: Patients with osteoarthritis (OA) are more likely to develop coronary heart disease (CHD) than the general population. Acupuncture is commonly used in OA patients; however, the therapeutic effect of acupuncture on the risk of CHD in patients with OA and the association between OA patients and their risk to develop CHD in Taiwan are unknown. We investigated the risk of CHD according to acupuncture use in OA patients and compared it with the general population. Design: Records obtained from Taiwan's National Health Insurance Research Database identified 84,773 patients with OA, which were compared with 727,359 patients without OA diagnosis. Five thousand forty-six of those who met study inclusion criteria had 1:1 frequency matching and were categorized as OA-acupuncture cohort (n = 1682), OA nonacupuncture cohort (n = 1682), and non-OA cohort (n = 1682). Cox proportional hazards regression analysis determined the risk of CHD, which was defined as the study main outcome. Therapeutic effects of acupuncture and medical expenditure were also analyzed. Results: OA nonacupuncture cohort had 3.04 higher risk to develop CHD compared with OA-acupuncture cohort (95% confidence interval [CI], 2.54-3.63, p < 0.001) and non-OA cohort had 1.88 higher risk to develop CHD compared with OA-acupuncture cohort (95% CI, 1.52-2.32, p < 0.001). In subgroup analyses, OA patients treated with both acupuncture and oral steroids were at significantly lower risk of CHD compared with those who used neither (adjusted hazard ratio 0.34; 95% CI, 0.22-0.53), and OA patients treated with acupuncture had the lowest medical expenditure in a follow-up time of 6 months, and 3 and 5 years. Conclusion: This is the first large-scale investigation in Taiwan that shows the association between OA and CHD and the beneficial effects of acupuncture in OA patients, and their associated risk to develop CHD. Our results may provide valuable information for health policy decision making. Further randomized controlled trials are needed to confirm these observational findings.

摘要

: 目标: 骨关节炎 (OA) 患者比普通人群更容易发生冠心病 (CHD)。针灸常用于OA患者; 然而,针灸对OA患者CHD风险的治疗效果以及OA患者与他们在台湾发展为CHD的风险之间的关联尚不清楚。我们调查了OA患者针刺治疗的冠心病风险,并与普通人群进行了比较。 设计: 从台湾国家健康保险研究数据库获得的记录确定了84,773例OA患者,并与727,359例没有OA诊断的患者进行了比较。1682名符合研究纳入标准的患者具有1:1的频率匹配,并被归类为OA-针灸队列 (n   =   1682) 、OA非针灸队列 (n   =   1682) 和非OA队列 (n   =  )。Cox比例风险回归分析确定了CHD的风险,这被定义为研究的主要结果。并对针灸的疗效和医疗费用进行了分析。 结果: OA非针灸队列与OA针灸队列相比,发生CHD的风险高3.04 (95% 置信区间 [CI],2.54-3.63,p <0.001),而非OA队列与OA针灸队列相比,发生CHD的风险高1.88 (95% CI,1.52-2.32,P <0.001)。在亚组分析中,同时接受针灸和口服类固醇治疗的OA患者与未接受针灸和口服类固醇治疗的患者相比,CHD风险显著降低 (校正风险比0.34; 95% CI,0.22-0.53),在6个月的随访时间中,接受针灸治疗的OA患者的医疗费用最低,3年和5年。 结论: 这是台湾首次大规模调查,显示OA和CHD之间的关联,以及针灸对OA患者的有益作用,以及它们发展为CHD的相关风险。我们的结果可能为卫生政策决策提供有价值的信息。需要进一步的随机对照试验来证实这些观察性研究结果。

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