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吴佩芸1,2 廖建彰3,4,5,6,7 施纯全1,8*
1 义守大学医学院学士後中医学系，高雄，台湾
2 台北市立联合医院仁爱院区中医科，台北，台湾
3 台北医学大学医学院医学系麻醉科，台北，台湾
4 台北医学大学附设医院麻醉科，台北，台湾
5 台北医学大学附设医院麻醉暨卫生政策研究中心，台北，台湾
6 台北医学大学万芳医院大数据暨统合分析研究中心，台北，台湾
7 中国医药大学中医学院中医系，台中，台湾
8 台北医学大学中草药临床药物研发博士学位学程，台北，台湾
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Pei-Yun Wu1,2Chien-Chang Liao1,3,4,5,6,7Chun-Chuan Shih1,8*
1School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University,
Kaohsiung, Taiwan
2Department of Chinese Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
3Department of Anesthesiology, School of Medicine, College of Medicine, Taipei, Taiwan
4Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
5Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital,
Taipei, Taiwan
6Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical
University, Taipei, Taiwan
7School of Chinese Medicine, College of Chinese Medicine, China Medical University,
Taichung, Taiwan
8Ph.D. Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy,
Taipei Medical University, Taipei, Taiwan
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Background: Traditional Chinese medicine was prevalent in Asian ries and it was as one of major therapies for stroke patients. Our purpose is to evaluate the risk of dementia for stroke patients with and without use of Chinese herbal medicine (CHM).
Method: We used claim data of Taiwan’s National Health Insurance and conducted a stroke cohort study including hospitalized stroke patients aged 50 years and old in 2000-2004. Use a matching procedure by propensity score, we selected 55074 stroke patients who received CHM and 55074 stroke patients without Chinese medicine for comparison. Both cohorts were followed until the end of 2009. Multivariate Cox proportional hazard regressions were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of incidence of dementia after stroke associated with CHM. We also analyzed the most common use of formula and herbs in stroke patients.
Results: During the follow-up period, use of CHM was associated with a decreased risk of dementia in stroke patients (HR, 0.70; 95% CI 0.67 to 0.73). The association between CHM and reduced risk of post-stroke dementia was significant in both sexes, all age group and all type of stroke. The most common used herb and formula for stroke patients were Dan Shen and Shu Jing Huo Xie Tang, respectively.
Conclusions: Our study raised the possibility that CHM is beneficial in reducing dementia risk in stroke patients. We suggested that the health authority and hospitals to encourage stroke patients receiving CHM and adjuvant therapy of traditional Chinese medicine during the stroke admission. The findings of this study is the important references for the health authority to making health policy
for stroke patients and traditional Chinese medicine.
【Keywords】Stroke; Dementia; Traditional Chinese Medicine; Chinese Herbal Medicine; National Health Insurance
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233.2 中药治疗中风後失智症的疗效评估：一项回溯性世代研究
