The utilization of traditional Chinese medicine in patients with dysfunctional uterine bleeding in Taiwan: a nationwide population-based study

Yi-Rong Lin,Su-Tso Yang,Jen-Huai Chiang,Mei-Yao Wu,Hung-Rong Yen

doi:10.1186/s12906-017-1939-1

Abstract

BackgroundMany patients with gynecological disorders seek traditional medicine consultations in Asian countries. This study intended to investigate the utilization of traditional Chinese medicine (TCM) in patients with dysfunctional uterine bleeding (DUB) in Taiwan.MethodsWe analyzed a cohort of one million individuals randomly selected from the National Health Insurance Research Database in Taiwan. We included 46,337 subjects with newly diagnosed DUB (ICD-9-CM codes 626.8) from January 1, 1997 to December 31, 2010. The patients were categorized into TCM seekers and non-TCM seekers according to their use of TCM.ResultsAmong the subjects, 41,558 (89.69%) were TCM seekers and 4,779 (10.31%) were non-TCM seekers. Patients who were younger tended to be TCM seekers. Most of the patients had also taken Western medicine, especially tranexamic acid and non-steroidal anti-inflammatory drugs (NSAIDs). More than half of TCM seekers (55.41%) received combined treatment with both Chinese herbal remedies and acupuncture. The most commonly used TCM formula and single herb were Jia-Wei-Xiao-Yao-San (Bupleurum and Peony Formula) and Yi-Mu-Cao (Herba Leonuri), respectively. The core pattern of Chinese herbal medicine for DUB patients consisted of Jia-Wei-Xiao-Yao-San, Xiang-Fu (Rhizoma Cyperi), and Yi-Mu-Cao (Herba Leonuri).ConclusionsTCM use is popular among patients with DUB in Taiwan. Further pharmacological investigations and clinical trials are required to validate the efficacy and safety of these items.

Highlights

Many patients with gynecological disorders seek traditional medicine consultations in Asian countries
The NHI administration constructed a National Health Insurance Research Database (NHIRD), which was managed by the National Health Research Institutes in Taiwan
Patients who lived in highly urbanized areas preferred to use traditional Chinese medicine (TCM)

Summary

Introduction

Many patients with gynecological disorders seek traditional medicine consultations in Asian countries. This study intended to investigate the utilization of traditional Chinese medicine (TCM) in patients with dysfunctional uterine bleeding (DUB) in Taiwan. Dysfunctional uterine bleeding (DUB) is defined as excessive, prolonged, frequent, and unpattern bleeding from the uterine in the absence of any structural etiology [1]. In order to standardize the terminology, diagnosis and investigations of abnormal uterine bleeding, the FIGO classification system (PALM-COEIN) was published in 2011 [2]. DUB is considered as non-structural abnormal uterine bleeding. DUB significantly and negatively impacts the patient’s physical and social quality of life. It may put patients at risk for developing anemia, fatigue, and depression. Patients with heavy menstrual bleeding had higher hospitalization rates, emergency room visits, and outpatient visits [3]. Heavy bleeding had significant economic implications for women because it was associated with work loss [4]

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