Traditional Chinese Medicine Users Research Articles

Traditional Chinese Medicine Herbs for Breast Cancer Prevention and Survival: A Narrative Review of Epidemiological Studies from Taiwan.

This review aims to describe the association of integrating traditional Chinese medicine (TCM) herbs into conventional medicine (CM) in preventing breast cancer and improving survival rates among breast cancer patients of Taiwan. Of 7 relevant studies, spanning 2014-2023, 4 investigated breast cancer risk in women with menopausal symptoms and other comorbidities. All 4 reported that TCM herbal use was associated with lower risks of developing breast cancer. Three studies investigated survival in newly-diagnosed breast cancer patients receiving CM. All reported that adjunctive TCM users had lower mortality rates than CM-only patients. However, the heterogeneity of study designs, populations, and interventions may limit the generalizability and robustness of the findings. TCM herbs may promote breast cancer prevention and survival when used alongside CM. More rigorous observational research and clinical trials in specific patient populations are needed to guide clinical decision-making.

Effectiveness of adjuvant traditional Chinese medicine on macrovascular invasion in patients with hepatocellular carcinoma: a real-world propensity score-matched study.

The study aimed to investigate the potential of traditional Chinese medicine (TCM) in reducing the risk of macrovascular invasion (MVI) in Chinese patients with hepatocellular carcinoma (HCC). This retrospective analysis involved 2,267 HCC patients treated at our hospital. Propensity score (PS) matching was used to compare TCM users (n = 485) with non-users (n = 485) in terms of age, Barcelona Clinic Liver Cancer (BCLC) staging, type of treatment, and AFP. The impact of TCM on the hazard ratio (HR) of MVI was evaluated using a Cox multivariate regression model. The efficacy of TCM therapy on MVI was further examined using the log-rank test. The analysis revealed that TCM medication was a significant protective factor for MVI in HCC patients, as evidenced by the Cox analysis (adjusted HR = 0.496, 95% CI: 0.387-0.635, p < 0.001). After PS matching, the Kaplan-Meier curve demonstrated a lower occurrence rate of MVI in TCM users compared to non-users. The study findings suggest that TCM treatment has the potential to decrease the incidence of MVI in HCC patients, irrespective of etiology, BCLC staging, liver function, or treatment type. Notably, as the use of TCM increased, the percentage of MVI in patients showed a gradual decrease, indicating the potential of TCM therapy as a successful strategy for preventing MVI.

Association between traditional Chinese Medicine and osteoarthritis outcome: A 5-year matched cohort study

ObjectiveThe aim of this study was to investigate the relationship between Traditional Chinese medicine (TCM) and pain reduction, hospital readmission, and joint replacement in patients with osteoarthritis (OA). Chinese herbal medicine (CHM) prescription patterns were further analyzed to confirm the association with prognosis and quality of life in OA patients. MethodsWe retrospectively followed 3,850 hospitalized patients with osteoarthritis between January 2018 and December 2022 using the hospital's HIS system. Propensity score matching (PSM) was used for data matching. Cox's proportional risk model was used to assess the impact of various factors on the outcomes of patients with OA, including pain worsening, readmission, and joint replacement. The Kaplan-Meier survival curve was applied to determine the impact of TCM intervention time on patient outcomes. Data mining methods including association rules, cluster analysis, and random walks have been used to assess the efficacy of TCM. ResultsThe utilization rate of TCM in OA patients was 67.01% (2,511/3,747). After PSM matching, 1,228 TCM non-user patients and 1,228 TCM user patients were eventually included. The outcomes of pain worsening, re-admission rate, and joint replacement rate of the TCM non-user group were observably higher than those of the TCM user group with OA (p < 0.05). Based on the Cox proportional risk model, TCM is an independent protective factor. Compared with non-TCM users, TCM users had 58.4% lower rates of pain, 51.1% lower rates of re-admission, and 42% lower rates of joint replacement. In addition, patients in the high-exposure subgroup (TCM＞24 months) had a markedly lower risk of outcome events than those in the low-exposure subgroup (TCM ≤24 months). Data mining methods have shown that TCM therapy can significantly improve immune-inflammatory indices, VAS scores, and SF-36 scale scores in OA patients. Conclusions TCM acts as a protective factor to improve the prognosis of patients with OA, and the benefits of long-term use of herbal medicines are even greater.

Traditional Chinese formulas reduce hospitalization for infection among patients with systemic lupus erythematosus in Taiwan

IntroductionSystemic lupus erythematosus (SLE) is a chronic autoimmune disease with many associated comorbidities. Disease activity and the long-term use of steroids or immunosuppressants are related to infection in SLE. Thus, identifying a safe complementary medicine, which can reduce inflammation and symptoms and can be used in conjunction with conventional SLE drugs, is necessary. MethodsThis study was designed to determine whether traditional Chinese medicine (TCM) formulas are associated with the infectious hospitalization rate of patients with SLE. A population-based retrospective cohort study covering 23,084 patients that were diagnosed with SLE from 1999 to 2009 was conducted. ResultsA total of 2638 incident cases of hospitalization among patients with SLE were due to infectious diseases. TCM users were significantly associated with a decreased risk of hospitalization for infectious diseases (hazard ratios = 0.85, 95% CI = 0.78–0.92). Other risk factors that were associated with increased risks of infectious hospitalization were old age, gender (male), hospitalization due to infectious diseases 1 year prior to diagnosis, low amount of insurance, comorbidities, and use of steroids and immunosuppressive agents. ConclusionThis study showed that TCM formulas were significantly associated with a decreased risk of infectious hospitalization among patients with SLE. TCM formulas may be used as a part of SLE treatments to decrease infectious hospitalization in SLE in the future. Health promotion programs can be planned in accordance with the risk factors associated with the increased risk of infectious hospitalization of SLE in response to disease burden and cost.

Differences in medical costs between TCM users and TCM nonusers in inpatients with thalassemia

BackgroundThalassemia has brought serious health threats and economic burdens to patients worldwide. There is no sovereign remedy for thalassemia, both conventional and Traditional Medicine (TM) methods have certain effects on this disease. As typical of TM, Traditional Chinese Medicine (TCM) has been widely used in the treatment of thalassemia. Previous studies mainly focused on conventional treatments for thalassemia and patients’ medical burden, but no research has examined the effects of TCM use on the economic burdens for thalassemia inpatients in mainland China. The main objective of this study is to compare the medical cost differences between TCM users and TCM nonusers, furtherly, we will discuss the role of TCM use in the treatment of thalassemia.MethodsWe employed the 2010–2016 Medicare claims database provided by the China Health Insurance Research Association (CHIRA). Chi-square and Mann-Whitney tests were used to analyze the differences between TCM users and TCM nonusers. Multiple regression analysis was performed using the ordinary least squares method to compare the TCM users’ inpatient medical cost with TCM nonusers’, and to further examine the correlation between TCM cost, conventional medication cost and nonpharmacy cost for TCM users.ResultsA total of 588 urban thalassemia inpatients were identified, including 222 TCM users and 366 TCM nonusers. The inpatient medical cost of TCM users was RMB10,048 (USD1,513), which was significantly higher than TCM nonusers (RMB1,816 (USD273)). Total inpatient cost for TCM users was 67.4% higher than those of TCM nonusers (P < 0.001). With confounding factors fixed, we found that the conventional medication cost and nonpharmacy cost were positively correlated with TCM cost.ConclusionTotal hospitalization expenses for TCM users were higher than TCM nonusers. Both the conventional medication cost and nonpharmacy cost of TCM users were all higher than TCM nonusers. We infer TCM plays a complementary role, rather than an alternative, in the treatment of thalassemia due to the lack of cooperative treatment guidelines. It is recommended that a cooperative diagnosis and treatment guidelines should be generated to balance the use of TCM and conventional medicine for treating thalassemia, so as to reduce the economic burdens on patients.

Traditional Chinese medicine may be associated with a reduced risk of recurrent exacerbation in patients with rheumatoid arthritis: A matched cohort study based on 1383 individuals

Ethnopharmacological relevanceThis study determines whether traditional Chinese medicine (TCM) treatment is associated with the risk of recurrent exacerbation in patients with rheumatoid arthritis (RA). Materials and methodsIn this retrospective study, we selected 1383 patients who were diagnosed with RA between 2013 and 2021 from the medical record information management system of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine. Then, patients were classified into TCM users and non-TCM users. Gender, age, recurrent exacerbation, TCM, death, surgery, organ lesions, Chinese patent medicine, external medicine, and non-steroidal anti-inflammatory drugs were adjusted one TCM user-to-one non-TCM user with propensity score matching to reduce selection bias and confusion using propensity score matching (PSM). A Cox regression model was used to compare the hazard ratio of the risk of recurrent exacerbation and the Kaplan Meier curve of recurrent exacerbation proportion between the two groups. ResultsMost of the tested clinical indicators in this study improved in patients, which was correlated with the use of TCM, with a statistical significance. TCM was preferred in female and younger (<58 years old) patients with RA. Of note, recurrent exacerbation was observed in more than 850 (61.461%) RA patients. The results of the Cox proportional hazard model showed TCM as a protective factor for the recurrent exacerbation of RA patients (HR = 50%, 95% CI = 0.65–0.92, P < 0.01). Kaplan Meier curves demonstrated that the survival rate of TCM users was higher than that of non-TCM users (log-rank P < 0.01). ConclusionConclusively, the use of TCM may be related to a lower risk of recurrent exacerbation in RA patients. These findings provide evidence for the recommendation of TCM treatment for RA patients.

Correlation between traditional Chinese medicine and reduced risk of readmission in rheumatoid arthritis patients with hypoproteinemia:a retrospective cohort study

This study aimed to explore the correlation between traditional Chinese medicine(TCM) and reduced risk of readmission in patients having rheumatoid arthritis with hypoproteinemia(RA-H). A retrospective cohort study was conducted on 2 437 rheumatoid arthritis patients in the information system database of the First Affiliated Hospital of Anhui University of Chinese Medicine from 2014 to 2021, and 476 of them were found to have hypoproteinemia. The patients were divided into TCM users and non-TCM users by propensity score matching. Exposure was defined as the use of oral Chinese patent medicine or herbal decoction for ≥1 month. Cox regression analysis was performed to explore the risk factors of clinical indicators of rheumatoid arthritis. Additionally, the use of TCM during hospitalization was analyzed, and analysis of association rules was conducted to investigate the correlation between TCM, improvement of indicators and readmission of patients. Kaplan-Meier survival curve was plotted to compare the readmission rate of TCM users and non-TCM users. It was found the readmission rate of RA-H patients was significantly higher than that of RA patients. By propensity score matching, 232 RA-H patients were divided into TCM group(116 cases) and non-TCM group(116 cases). Compared with the conditions in the non-TCM group, the readmission rate of the TCM group was lowered(P&lt;0.01), and the readmission rate of middle-aged and elderly patients was higher than that of young patients(P&lt;0.01). Old age was a risk factor for readmission of RA-H patients, while TCM, albumin(ALB) and total protein(TP) were the protective factors. During hospitalization, the TCMs used for RA-H patients were mainly divided into types of activating blood and resolving stasis, relaxing sinew and dredging collaterals, clearing heat and detoxifying, and invigorating spleen and resolving dampness. The improvement of rheumatoid factor(RF), immunoglobulin G(IgG), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and ALB was closely related to TCM. On the basis of western medicine treatment, the application of TCM could reduce the readmission rate of RA-H patients, and longer use of TCM indicated lower readmission rate.

TCM as adjunctive therapy improves risks of respiratory hospitalizations in persons with type 2 diabetes: A retrospective cohort study.

Patients with type 2 diabetes are at a higher risk of chronic obstructive pulmonary disease (COPD) and asthma than the general population. In addition, emerging evidence suggests that traditional Chinese medicine (TCM) might be beneficial for patients with type 2 diabetes. We investigated whether TCM use was associated with a reduced risk of respiratory hospitalizations in patients with type 2 diabetes. Conducting a retrospective cohort study, we used data retrieved from the NDCMP database. Among 56,035 patients, 5226 were classified as TCM users; 50,809 were classified as TCM nonusers. Both groups were analyzed until the end of 2011 to examine the incidence of respiratory hospitalizations by using a Cox proportional hazards model to evaluate effects of TCM use on respiratory hospitalizations. During the 6-year study follow-up period, the incidence density rates of COPD- and asthma-related hospitalization were estimated to be 13.03 and 4.47 per 10,000 patient-years for TCM nonusers and 10.08 and 3.28 per 10,000 patient-years for TCM users, respectively. The HR of COPD-related hospitalization in TCM users was 0.88 (95% CI = 0.79-0.99); and the HR of asthma-related hospitalization in TCM users was 0.81 (95% CI = 0.66-1.00). Stratified analyses revealed that effects of TCM use were stronger among individuals who had diabetes for <3 years. As a part of Integrative Medicine, our study results demonstrate that TCM use was associated with a significant reduced risk of respiratory hospitalizations, especially in patients with diabetes for <3 years.

Impact of Traditional Chinese Medicine on Prognosis of Patients with Hepatocellular Carcinoma: A Retrospective Cohort Study.

In a previous study, we found that traditional Chinese medicine (TCM) alleviated the clinical symptoms and improved the quality of life (QoL) in patients with hepatocellular carcinoma (HCC). A cohort was continuously followed up to determine the impact of the TCM adjuvant therapies on the prognosis of HCC after conventional treatments. We did a retrospective monocentric cohort study including 175 eligible patients. The participants who received TCM adjuvant therapies were termed as TCM group. For the purpose of stratification analysis, the patients who received TCM adjuvant therapies over 3 months per year were further classified into the high frequency group, while the rest of the TCM users were classified into the low frequency group. Non-users were recorded as the control group. The primary outcome was overall survival (OS) and the secondary outcome was the mean progression-free survival (mPFS) primarily introduced in this study, referring to the time from initial diagnosis to the latest progression over the number of disease progressions. Analyses used Cox proportional hazards and Kaplan-Meier (K-M) methods, adjusted for stratification factors. Until June 30, 2021, 56 patients survived, 21 patients were lost to follow-up, and 98 patients died from the disease. Each disease progression of every individual was recorded, and most of the PFS was within 1 year. The baseline data of the allocated groups were balanced, the result revealed that TCM adjuvant therapies might have little influence on OS (P = .129). However, the 1, 3, and 5-year progression-free survival rates of the patients in TCM and control group were 68.75%, 37.50%; 25.00%, 8.33% and 8.33%, 2.08%, respectively, indicating TCM use significantly extended the mPFS, and decreased the risk of disease progression by a factor of 0.676 (P = .006). In the patients with BCLC stage B HCC, compared with controls, a 37-month median OS advantage in the high frequency group was noted (P = .045); and the high frequency of TCM use significantly suppressed disease progression (P = .001). The present study revealed that TCM adjuvant therapies could postpone disease progression in HCC. Furthermore, using TCM over 3 months per year might extend OS in patients with intermediate HCC.

Traditional Chinese medicine use in patients with oral cancer: A retrospective longitudinal cohort study in Taiwan.

Oral cancer is frequently associated with smoking, alcohol consumption, and betel quid chewing, which are common harmful behaviors observed in certain cohorts of the Taiwanese population. Some reports have explored the potential therapeutic effect of certain herbal remedies on cancer treatments and the outcomes thereof. However, supportive evidence regarding the specific use of traditional Chinese medicine (TCM) in oral cancer treatment is lacking and deserves further investigation. This study measured the use of TCM therapies for oral cancer in a Taiwanese population-based retrospective longitudinal cohort study. The Taiwan National Health Insurance Research Database was utilized to conduct this study. The study population was limited to oral cancer patients diagnosed between 2000 and 2009, which were followed up for at least 5 years. Therapeutic strategies investigated included acupuncture and the Chinese herbs and formula used. Additionally, the frequency of TCM treatment visits, total medical costs, and all-cause mortality were also analyzed. Between 2000 and 2009, a total of 951 patients were diagnosed with various oral cancers. 13.7% of the diagnosed patients utilized TCM treatment measures. The majority of the patients were males. The top 3 common single herbs used were Xuán shēn (Radix Scrophulariae), Shí hú (Herba Dendrobii), and Mài mén dōng (Ophiopogon Japonicus). Then, Gān lù yǐn, Zhī bǎi dì huáng wán, and Sàn zhǒng kuì jiān tāng were the most frequently used herbal formulas. The survival probability was higher in TCM users when compared to non-TCM users in 5- and 12-year all-cause mortality (P < .05). This study explored the use of TCM therapies in oral cancer patients and identified essential information regarding the specifics of conventional herbal medicine used, affiliated medical costs, survival probability, and common symptoms observed in Taiwanese oral cancer patients.

Perceived Quality of Traditional Chinese Medicine Care in Community Health Services: A Cross-Sectional Survey in Hangzhou of China.

Background Traditional Chinese medicine (TCM) is an integral part of the mainstream health care system in China. Public community health services are required by the government to deliver TCM services. This study aimed to assess patient perceived quality of TCM care in community health services. Methods A cross-sectional questionnaire survey was conducted on 471 TCM users in four community health centers in Hangzhou. Respondents were asked to rate their experiences on a Likert scale about tangibility, reliability, responsiveness, assurance and empathy of the TCM services they received. Linear regression models were established to determine the sociodemographic and services factors associated with the ratings. Results Average ratings on the five aspects of the TCM care ranged from 78 to 88 out of a possible 100, with assurance attracting the highest and empathy attracting the lowest score. Overall, higher perceived quality of TCM care (except for assurance) was associated with a choice of TCM in preference to western medicine. Those who reported higher cost (≥100 yuan) of TCM care rated higher on responsiveness and empathy of the care. But higher frequency of visits to community TCM services was associated with lower ratings on reliability, assurance and empathy. Those who received two or more TCM modalities also perceived lower tangible care. In addition, higher ratings on reliability and responsiveness were found in women. The respondents with a university qualification gave higher ratings on reliability and responsiveness; by contrast, those with a highest education of senior high school rated lower on assurance and empathy. Lower perceived tangibility and assurance was also associated with rural residency. Compared with those working in the public sector, the respondents from the retail and services sector gave a higher rating on assurance but a lower rating on empathy. Conclusion Overall, the TCM users perceived high quality of TCM care in community health services in Hangzhou. However, there is a need to further improve TCM care from all quality perspectives in order to attract and maintain consumer trust in TCM.

Predictors of the intention to use traditional Chinese medicine (TCM) using extended theory of planned behavior: a cross-sectional study among TCM users in Hong Kong

BackgroundTraditional Chinese medicine (TCM) and Western medicine are available and have a long history in Hong Kong. Little is known on the intention to use TCM in Hong Kong. In this study, the intention to use TCM was examined by the extended theory of planned behavior.MethodsAn online cross-sectional survey was conducted from 15 and 29 November 2021. Respondents’ attitude towards using TCM, intention to use TCM, knowledge, perceived behavioral control, perceived service quality, satisfaction, subjective norms and demographic characteristics were collected from the survey. To examine the conceptual framework in this study, partial least square structural equation model (PLS-SEM) was adopted.ResultsIn total, 446 responses (completion rate = 74.3%) were analysed. Attitude towards TCM was the strongest predictor to the intention to use TCM followed by satisfaction and subjective norms. Attitude had a partial mediating effect on the relationship between subjective norms, perceived behavioral control and intention to use TCM. Attitude had a full mediating effect on the relationship between knowledge and intention to use TCM. Satisfaction had a full mediating effect on the relationship between perceived service quality and intention to use TCM.ConclusionsThis is the first study to investigate the predictors of the intention to use TCM in Hong Kong by using TPB. Individuals’ attitude towards TCM has showed stronger effect to the intention to use TCM than other predictors, such as satisfaction, perceived behavioral control and subjective norms. To enhance the intention to use TCM in Hong Kong, key stakeholders, including TCM professional organisations, health professionals and policymakers, should develop a positive attitude towards TCM among Hong Kong population.

Acceptability of Traditional Chinese Medicine in Chinese People Based on 10-Year's Real World Study With Mutiple Big Data Mining.

In the past decades, numerous clinical researches have been conducted to illuminate the effects of traditional Chinese medicine for better inheritance and promotion of it, which are mostly clinical trials designed from the doctor's point of view. This large-scale data mining study was conducted from real-world point of view in up to 10 years' big data sets of Traditional Chinese Medicine (TCM) in China, including both medical visits to hospital and cyberspace and contemporaneous social survey data. Finally, some important and interesting findings appear: (1) More Criticisms vs. More Visits. The intensity of criticism increased by 2.33 times over the past 10 years, while the actual number of visits increased by 2.41 times. (2) The people of younger age, highly educated and from economically developed areas have become the primary population for utilizing TCM, which is contrary to common opinions on the characteristics of TCM users. The discovery of this phenomenon indicates that TCM deserves further study on how it treats illness and maintains health.

Adjuvant therapy with traditional Chinese medicine and long-term mortality in patients with stroke: A nationwide population-based cohort study in Taiwan

ObjectivesWe investigated whether the use of adjuvant traditional Chinese medicine (TCM) therapy, a form of complementary and alternative medicine, is associated with long-term mortality after stroke. Study designWe conducted a retrospective cohort study and used claims data from Taiwan's National Health Insurance program linked to the National Registry of Death. The cohort included patients aged ≥18 years who were hospitalized for their first stroke event between January 1, 2006, and December 31, 2013. Adjuvant TCM therapy was defined as additional treatments with TCM, which included acupuncture, Chinese herbal medicine, and Tuina, during hospitalization for up to six months. Main outcome measureThe mortality rate was measured through to December 31, 2014. ResultsOf 321,157 patients with stroke, 14,579 received adjuvant TCM therapy. Propensity score matching resulted in 13,918 matched pairs of patients who did and did not receive adjuvant TCM care. Both multivariable-adjusted Cox proportional hazards models (hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.64–0.69) and propensity score-matching analysis (HR, 0.65; 95% CI, 0.60–0.66) revealed a reduced mortality risk associated with the use of adjuvant TCM therapy, as compared with routine inpatient care only. Acupuncture was the most commonly used TCM therapy. Patients treated with acupuncture only, which accounted for 41.3% of TCM users, had a reduced risk of mortality compared with those treated with routine inpatient care. ConclusionsThe use of TCM therapy adjuvant to Western inpatient care in the acute and subacute stages of stroke recovery is associated with a reduced risk of long-term mortality.

Use of Traditional Chinese Medicine and Its Impact on Medical Cost among Urban Ischemic Stroke Inpatients in China: A National Cross-Sectional Study.

Background Traditional Chinese medicine (TCM) has long been widely adopted by the Chinese people and has been covered by China's basic medical insurance schemes to treat ischemic stroke. Previous research has mainly highlighted the therapy effect of TCM on ischemic stroke patients. Some studies have demonstrated that employing TCM can reduce the medical burden on other diseases. But no research has explored whether using TCM could reduce inpatient medical cost for ischemic stroke in mainland China. The purpose of this study is to investigate the impact of the use of TCM on the total inpatient cost of ischemic stroke and to explore whether TCM has played the role of being complementary to, or an alternative for, conventional medicine to treat ischemic stroke. Methods We conducted a national cross-sectional analysis based on a 5% random sample from claims data of China Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI) schemes in 2015. Mann–Whitney test was used to compare unadjusted total inpatient cost, conventional medication cost, and nonpharmacy cost estimates. Ordinary least square regression analysis was performed to compare demographics-adjusted total inpatient cost and to examine the association between TCM cost and conventional medication cost. Results A total of 47321 urban inpatients diagnosed with ischemic stroke were identified in our study, with 92.6% (43843) of the patients using TCM in their inpatient treatment. Total inpatient cost for TCM users was significantly higher than TCM nonusers (USD 1217 versus USD 1036, P < 0.001). Conventional medication cost was significantly lower for TCM users (USD 335 versus USD 436, P < 0.001). The average cost of TCM per patient among TCM users was USD 289. Among TCM users, conventional medication costs were found to be positively associated with TCM cost after adjusting for confounding factors (Coef. = 0.144, P < 0.001). Conclusion Although the use of TCM reduced the cost of conventional medicine compared with TCM nonusers, TCM imposed an extra financial component on the total inpatient cost on TCM users. Our study suggests that TCM mainly played a complementary role to conventional medicine in ischemic stroke treatment in mainland China.

Liu Wei Di Huang Wan and the Delay of Insulin Use in Patients with Type 2 Diabetes in Taiwan: A Nationwide Study.

Introduction Patients with type 2 diabetes are widely prescribed metformin for controlling blood glucose levels to avoid related comorbidities. In Taiwan, traditional Chinese medicine (TCM) is also commonly used, especially Liu Wei Di Huang Wan (LWDHW), which has been reported to delay the occurrence of kidney failure. However, the effect of combinational therapy of TCM and oral antidiabetic drugs is still unclear. This study aims to estimate their efficacy in delaying insulin use. Materials and Methods This case-control study was conducted using one million randomized samples from the National Health Insurance Research Database in Taiwan. The effects of TCM and LWDHW were estimated using the Cox proportional hazards model. Results In this study, 70,036 diabetic patients were enrolled; of them, 17,451 (24.9%) used insulin, while the rest (52,585, 75.1%) did not. TCM users had a lower risk for insulin use (HR: 0.58, 95% CI: 0.56–0.60). LWDHW users had a lower risk compared with patients who used other TCM (HR: 0.86, 95% CI: 0.82–0.90) and presented a dose-dependent effect. Conclusion The use of LWDHW and oral antidiabetic drugs is highly associated with the delay in the use of insulin. Clinical practitioners may take them into consideration when treating patients with type 2 diabetes.

Evaluation of the efficacy of traditional Chinese medicine for the reproductive and pregnancy outcomes in women with endometriosis: A nationwide population-based study

ObjectivePatients with endometriosis may seek traditional Chinese medicine (TCM) to help them conceive. The present study aims to evaluate the effects of TCM on reproductive and pregnancy outcomes in patients with endometriosis. Materials and methodsThe patients with endometriosis taken from the National Health Insurance (NHI) research database between 2000 and 2012 were divided into two cohorts based on the use of TCM treatment. The two cohorts were matched by age and comorbidities and followed up until a new diagnosis of infertility, ectopic pregnancy, or miscarriage. Multivariable Cox proportional hazards models were used to evaluate the hazard ratio (HR) of reproductive and pregnancy outcomes. ResultsA total of 5244 patients with endometriosis were analyzed, including 1748 TCM users and 3496 matched control subjects. The proportion of infertility was higher in TCM users than in non-TCM users (adjusted hazard ratio [HR]: 1.34, 95% confidence interval [CI]: 1.13–1.60). However, there was no significant difference in the proportion of ectopic pregnancies between TCM users and non-TCM users (adjusted HR: 0.82, 95% CI: 0.60–1.13). There was no significant difference in the proportion of miscarriages between TCM users and non-TCM users (adjusted HR: 1.23, 95% CI: 0.95–1.61). ConclusionTCM treatment showed insignificant efficacy in decreasing the risk of ectopic pregnancy and miscarriage in patients with endometriosis.

Traditional Chinese Medicine Enhances Survival in Patients with Gastric Cancer after Surgery and Adjuvant Chemotherapy in Taiwan: A Nationwide Matched Cohort Study

Background Gastric cancer remains a major cancer globally. More than half of patients with gastric cancer undergo surgery in Taiwan; however, few large nationwide studies have investigated the effects of traditional Chinese medicine (TCM) on gastric cancer management after surgery. This study aimed to evaluate the effect of TCM on patients with gastric cancer following surgery and adjuvant chemotherapy in Taiwan and its prescription trends. Methods and Materials The cohort sampling data set was obtained from the Registry of Catastrophic Illness Patient Database, a research database of patients with severe illnesses from the National Health Insurance Research Database, Taiwan. Patients who had received a new diagnosis of gastric cancer and had undergone surgery were enrolled. We matched TCM users and nonusers at a ratio of 1 : 3 based on the propensity score, and TCM users were also grouped into short-term and long-term users. Results The number of TCM users and nonusers was 1701 and 5103 after applying the propensity score at a ratio of 1 : 3. Short-term users and long-term TCM users were independently associated with a decreased risk of death with HRs of 0.59 (95% confidence interval (CI), 0.55–0.65) and 0.41 (95% CI, 0.36–0.47), respectively, compared with TCM nonusers. We also obtained similar results when we adjusted for covariates in the main model, as well as each of the additional listed covariates. We also observed similar HR trends in short-term users and long-term TCM users among men and women aged <65 years and ≥65 years. The most commonly prescribed single herb and herbal formula in our cohort were Hwang-Chyi (Radix Hedysari; 11.8%) and Xiang-Sha-Liu-Jun-Zi-Tang (15.5%), respectively. Conclusion TCM use was associated with higher survival in patients with gastric cancer after surgery and adjuvant chemotherapy. TCM could be used as a complementary and alternative therapy in patients with gastric cancer after surgery and adjuvant chemotherapy.

Chinese Herbal Products for Non-Motor Symptoms of Parkinson's Disease in Taiwan: A Population-Based Study.

Objective: Combinations of Chinese herbal products (CHPs) are widely used for Parkinson’s disease (PD) in Taiwan. Thereby, we investigated the use of CHPs in patients with PD. Methods: This study was a population-based cohort study that analyzed the data of patients with PD from the National Health Insurance Research Database. A total of 9,117 patients were selected from a random sample of one million individuals included in this database. We used multiple logistic regression models to estimate the adjusted odds ratios of the demographic factors and analyzed the formula and single CHPs commonly used for PD. Results: Traditional Chinese medicine users were more commonly female, younger, of white-collar status, and residents of Central Taiwan. Chaihu-Jia-Longgu-Muli-Tang was the most commonly used formula, followed by Ma-Zi-Ren-Wan and then Shao-Yao-Gan-Cao-Tang. The most commonly used single herb was Uncaria tomentosa (Willd. ex Schult.) DC., followed by Gastrodia elata Blume and then Radix et Rhizoma Rhei (Rheum palmatum L., Rheum tanguticum Maxim. ex Balf., and Rheum officinale Baill.). Chaihu-Jia-Longgu-Muli-Tang and U. tomentosa (Willd. ex Schult.) DC. have shown neuroprotective effects in previous studies, and they have been used for managing non-motor symptoms of PD. Conclusion: Chaihu-Jia-Longgu-Muli-Tang and U. tomentosa (Willd. ex Schult.) DC. are the most commonly used CHPs for PD in Taiwan. Our results revealed the preferences in medication prescriptions for PD. Further studies are warranted to determine the effectiveness of these CHPs for ameliorating the various symptoms of PD, their adverse effects, and the mechanisms underlying their associated neuroprotective effects.

Effect of Fuzheng Qingdu Therapy for Metastatic Gastric Cancer is Associated With Improved Survival: A Multicenter Propensity-Matched Study.

ObjectiveTo evaluate the therapeutic effect of Traditional Chinese Medicine (TCM), specifically Fuzheng Qingdu (FZQD) therapy, on the survival time of metastatic GC patients.Patients and MethodsDatabases of medical records of 6 hospitals showed that 432 patients with stage IV GC were enrolled from March 1, 2012 to October 31, 2020. Propensity score matching (PSM) was used to reduce the bias caused by confounding factors in the comparison between the TCM and the non-TCM users. We used a Cox multivariate regression model to compare the hazard ratio (HR) value for mortality risk, and Kaplan-Meier survival curve for the survival time of GC patientsResultsThe same number of subjects from the non-TCM group were matched with 122 TCM-treated patients after PSM to evaluate their overall survival (OS) and progression-free survival (PFS). Median time of OS of TCM and non-TCM users were 16.53 and 9.10 months, respectively. TCM and non-TCM groups demonstrated a 1-year survival rate of 68.5% and 34.5%, 2-year survival rate of 28.6% and 3.5%, and 3-year survival rate of 17.8% and 0.0%, respectively. A statistical difference exists in OS between the 2 groups (χ2 = 33.39 and P < .0001). The PFS of TCM users was also longer than that of non-TCM users (χ2 = 4.95 and P = 0.026). Notably, Chinese herbal decoction, Shenmai and compound Kushen injections were commonly used for FZQD therapy.ConclusionThis propensity-matched study showed that FZQD therapy could improve the survival of metastatic GC patients.