Mortality and recurrence of vascular disease among stroke patients treated with combined TCM therapy.

OBJECTIVE: To confirm the long-term outcomes of stroke patients and determine predicting factors for death, recurrence of vascular events and poor outcome (either recurrence or death) after the use of combined TCM therapy. METHODS: This was a retrospective hospital-based cohort study and was performed in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine in Tianjin. All subjects with stroke consecutively admitted to an inpatient ward of the Acupuncture Department from January 1, 2008, to December 31, 2008 were retrospectively followed through one year. The main outcomes were either a recurrence of vascular events, mortality or both. Risk factors were recorded from medical records. Multivariate regression models were used to analyze predictors. The following independent variables were used: age, gender, hypertension, ischemic heart disease, atrial fibrillation, diabetes mellitus, carotid arterial lesions and history of stroke. RESULTS: Four-hundred and five patients were included. The 1-year mortality rate was 11.11%. 23.70% of the patients had a recurrent vascular event, and 30.86% suffered a poor outcome. Multiple logistic regression analysis found that previous stroke, and advanced age were predictors of death within one year, Recurrence of vascular events was associated with carotid arterial lesions, history of diabetes and previous stroke. Long-term poor outcome was predicted by advanced age, history of diabetes, and previous stroke. CONCLUSION: Age, previous stroke, carotid arterial lesions and diabetes history seem to have different impacts on the three outcomes within one year. Our findings provide important data for planning future hospital register studies of stroke patients in TCM hospitals.

[Discussion on clinical trial design of treatment of hypertension with acupuncture and moxibustion].

Differences in design and implementation of clinical research on hypertension treatment with acupuncture and moxibustion were analyzed in this article so as to provide experiences to the design of clinical research on its treatment. Through document retrieval, it can be acquired that results of high quality clinical researches on treatment of hypertension with acupuncture and moxibustion have already been published. However, limitations in terms of sample size calculation, stochastic method, implementation of the blind method, selection of the control group and report on implementation process still existed in domestic documents. Therefore, high quality design proposals which not only in compliance with the features of acupuncture-moxibustion, but also accepted by modern medicine should be established with the combination of the advantages of acupuncture-moxibustion and clinical features of the disease. Moreover, standardizations on measuring the blood pressure, sample size calculation, selection of the control measurements, stochastic method and implementation of the blind methods should be established as well.