Chinese herbal medicine reduced the risk of stroke in patients with Parkinson's disease: A population-based retrospective cohort study from Taiwan.

Ching-Yuan Lai,Hung-Rong Yen,Jaung-Geng Lin,Yi-Hung Chen,Cheng-Hao Tu,Jen-Huan Chiang,Chao Qiu

doi:10.1371/journal.pone.0203473

Ching-Yuan Lai, Hung-Rong Yen + Show 5 more

Open Access

https://doi.org/10.1371/journal.pone.0203473

Copy DOI

Abstract

Parkinson’s disease (PD) is associated with a significantly increased risk of stroke. Traditional Chinese medicine (TCM) has long been used in Asia to treat stroke, but there are no large-scale clinical data to confirm its efficacy in protecting PD patients against stroke. Herein, we analyzed a cohort of 1,000,000 records from Taiwan’s National Health Insurance Research Database for the period 1997–2011, and identified 1,882 patients with new-onset PD. We matched 290 patients who received Chinese herbal medicine (CHM) by age, sex, year of CHM prescription, and year of PD diagnosis with 290 patients who did not use CHM as control. Both cohorts were followed until the end of 2013 for the incidence of new-onset stroke. In a multivariable Cox proportional hazard model adjusted for potential comorbidities, the incidence of stroke was lower among PD patients using CHM compared with non-CHM users (11.10 per 100 person-years vs 23.15 per 100 person-years; Hazard ratio: 0.56; 95% confidence interval: 0.44 to 0.72). The probability curve generated from our follow-up data showed that PD patients receiving CHM treatment had a decreased risk of stroke compared with those not receiving CHM treatment (P <0.001). The analysis on the prescription pattern of CHM revealed that Danshen is the most common single herb and Ma Zi Ren Wan is the most common herbal formula. Although the analysis are limited by a lack of analytic information regarding lifestyle patterns, biochemical profiles, and levels of PD severity in database, this population-based study suggest that CHM may be an complementary therapy to reduce the risk of stroke in PD patients.

Highlights

Parkinson’s disease (PD) is a slowly progressive, irreversible neurodegenerative disease of the central nervous system that affects about 1% of people aged 65 years and over worldwide [1]
PD patients who had at least one Chinese herbal medicine (CHM) prescription were defined as CHM users, whereas PD patients who had no such details were defined as nonCHM users
We evaluated whether CHM treatment reduced the risk of stroke among PD patients using a Longitudinal Health Insurance Database in Taiwan

Summary

Introduction

Parkinson’s disease (PD) is a slowly progressive, irreversible neurodegenerative disease of the central nervous system that affects about 1% of people aged 65 years and over worldwide [1]. Specific non-motor features become obvious as the disease progresses (olfactory dysfunction, cognitive impairment, psychiatric symptoms, sleep disorders, autonomic dysfunction, pain, and fatigue), resulting in clinically significant disability [1]. Patients with latestage disease tend to experience axial motor symptoms such as postural instability with frequent falls and freezing of gait [1]. In late-stage disease, levodopa-resistant symptoms contribute to disability and markedly increase the risk of all-cause mortality [1]

Objectives

Methods

Results

Discussion

Conclusion