1Department of Chinese Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
2School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University,
Kaohsiung, Taiwan
3School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
4Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University
5Department of Anesthesiology, School of Medicine, College of Medicine, Taipei, Taiwan
6Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
7Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
8Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical
University, Taipei, Taiwan
【Summary】
Background: It has been proved that traditional Chinese medicine (TCM) has beneficial effects on the clinical outcomes in patients with stroke. However, little was known about the effects of TCM on patients with Parkinson’s disease (PD). Our purpose is to evaluate the effect of TCM on the use of emergency care and hospitalization in patients with PD who had stroke history. Methods: Using research data of Taiwan’s National Health Insurance, we conducted a retrospective cohort study included 30,373 patients with post-stroke PD who aged over 40 years in 2000-2007. After propensity-score matching, we obtained 2,701 pairs of PD patients who had previous stroke with and without TCM treatment for comparison. Using multiple Cox proportional hazard models, we calculated the adjusted hazard ratio (HRs) and 95% confidence interval (CI) of 1-year use of emergency care and hospitalization associated with TCM treatment. Results: Among PD patients with previous stroke, those who received TCM treatment had significantly lower frequency of emergency care medical visits (β= 0.06, p=0.0063), frequency of hospitalization (β=-0.22, p<-0.0001), expenditure of hospitalization (β=-817.43, p=0.0001), and length of hospitalization (β=- 4.92, p=0.0006). The HRs of emergency care, hospitalization and intensive care associated with TCM treatment were 0.89 (95% CI 0.81-0.99), 0.78 (95% CI 0.79- 0.83) and 0.67 (95% CI 0.58-0.78). In addition, only acupuncture (HR=0.76, 95% CI=0.62-0.93), only Chinese herbal medicine (HR=0.67, 95% CI=0.60-0.74) and both acupuncture and Chinese medicine (HR=0.67, 95% CI=0.59-0.77) were associated with decreased risks of emergency care visit and hospitalization. Conclusion: Among patients with post-stroke PD, TCM treatment was associated with reduced risks of emergency care visit and hospitalization. Our findings implicated that the health authority and hospitals may encourage patients with post-stroke PD to receive TCM treatment.
【Keywords】Emergency care; Hospitalization; Parkinson’s disease; Stroke; Traditional Chinese Medicine
261.2 中风後帕金森氏症患者接受中医治疗可减少急诊与住院医疗耗用
