Effects of Combining Traditional East Asian and Conventional Western Medicine on Acute Stroke Outcomes

Abstract

Background: Traditional East Asian medicine (TM) is widely used in Korea and other East Asian countries. However, the effects of TM treatment on acute ischemic stroke (AIS) outcomes remain unclear, as previous studies lacked a sufficient sample size, a consecutive series design, or a prospective outcome capture approach. We aimed to investigate whether combining TM with conventional Western medicine (CM) treatments (C+TM) leads to better outcomes after AIS, relative to CM treatment alone.

Methods: We retrospectively analyzed 2157 consecutive patients with AIS from a prospectively collected registry (2011-2021) at our center and compared the CM and C+TM groups in terms of demographics and clinical efficacy, including a 3-month favorable functional outcome (modified Rankin scale score ≤1) by performing modified Poisson regression analysis, with inverse probability of treatment weighting to balance key clinical and demographic variables, as the main analysis.

Results: Mean age was 66.7±12.8 years, and 63.5% were men. Compared with patients in the CM group (n=1750), those in the C+TM group (n=407) were more likely to be women, have higher admission National Institutes of Health Stroke Scale scores, present more frequently with strokes due to large-arteryatherosclerosis or small-vessel occlusion, and have a lower prevalence of smoking history. C+TM treatment was associated with a ~40% significantly lower rate of 3-month favorable functional outcome (adjusted relative risk [RR], 0.60 [95% CI, 0.51-0.70]; RR, 0.62 [95% CI, 0.53-0.72] after inverse probability of treatment weighting; both P<0.001) compared with CM treatment.

Conclusions: TM, when integrated into CM care, may be linked to less favorable functional outcomes after AIS.

Keywords: ischemic stroke; outcome; traditional medicine.