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Lin PC, Lin CC, Li CI, Wang TC, Peng YH, Chang TT, Lin CY, Li TC, Hsieh CL. TCM as adjunctive therapy improves risks of respiratory hospitalizations in persons with type 2 diabetes: A retrospective cohort study. Medicine (Baltimore) 2023; 102:e33318. [PMID: 36961191 PMCID: PMC10036058 DOI: 10.1097/md.0000000000033318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/27/2023] [Indexed: 03/25/2023] Open
Abstract
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.
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Affiliation(s)
- Pei-Chun Lin
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan, Republic of China
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, Republic of China
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, Republic of China
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Tang-Chuan Wang
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan, Republic of China
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, Republic of China
- Department of Otolaryngology-Head and Neck Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, Republic of China
| | - Yi-Hao Peng
- Department of Respiratory Therapy, Asia University Hospital, Asia University, Taichung, Taiwan, Republic of China
| | - Tung-Ti Chang
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan, Republic of China
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Chin-Yi Lin
- PhD Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan, Republic of China
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan, Republic of China
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan, Republic of China
| | - Ching-Liang Hsieh
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan, Republic of China
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan, Republic of China
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan, Republic of China
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Tsai LJ, Chung CH, Lin CJ, Su SC, Kuo FC, Liu JS, Chen KC, Ho LJ, Kuo CC, Chang CY, Lin MH, Chu NF, Lee CH, Hsieh CH, Hung YJ, Hsieh PS, Lin FH, Lu CH, Chien WC. Traditional Chinese medicine attenuates hospitalization and mortality risks in diabetic patients with carcinoma in situ in Taiwan. Integr Med Res 2022; 11:100831. [PMID: 35059290 PMCID: PMC8760454 DOI: 10.1016/j.imr.2021.100831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 11/26/2021] [Accepted: 12/26/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Li-Jen Tsai
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan (Province of China)
| | - Chien-Jung Lin
- Department of Chinese Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Sheng-Chiang Su
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Feng-Chih Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Jhih-Syuan Liu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Kuan-Chan Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Li-Ju Ho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chih-Chun Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chun-Yung Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Ming-Hsun Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Nain-Feng Chu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chien-Hsing Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Yi-Jen Hung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Po-Shiuan Hsieh
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Department of Physiology and Biophysics, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Corresponding author at: Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City 11490, Taiwan, Republic of China.
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
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Ginseng-plus-Bai-Hu-Tang Combined with Western Medicine for the Treatment of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9572384. [PMID: 35469158 PMCID: PMC9034934 DOI: 10.1155/2022/9572384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/05/2022] [Accepted: 02/16/2022] [Indexed: 12/24/2022]
Abstract
Objective Type 2 diabetes mellitus (T2DM) is a chronic disease characterized by chronic hyperglycemia, which is also accompanied by changes in blood lipids and protein. According to research reports, Ginseng-plus-Bai-Hu-Tang (GBHT) has significant antihyperglycemic activity. Nevertheless, the evidence of effectiveness is not enough. In order to verify the effectiveness and safety of GBHT combined with conventional Western medicine (CWM) in the treatment of T2DM, we carried out this meta-analysis. Method We collected 7 electronic databases from the inception to September 1, 2021; then, 12 studies were selected. The data analysis and methodological evaluation were conducted by the software RevMan 5.3.3 and Stata 12.0. Results The meta-analysis revealed that when GBHT was adopted in combination with CWM, the effective rate (OR = 2.98, 95% CI = [2.01, 4.43], P < 0.00001), the FBG (MD = −0.86, 95% CI = [−1.06, −0.65], P < 0.00001), 2hBG (MD = −0.80, 95% CI = [−1.05, −0.55], P < 0.00001), and HbA1c (MD = −0.64, 95% CI = [−0.98, −0.30], P = 0.0002) of T2DM patients improved significantly compared with the control group. After GBHT combined with CWM treatment, HOME-RI (MD = −0.75, 95% CI = [−1.38, −0.12] P = 0.02) of T2DM patients was superior to CWM alone. In comparison, the benefit from FINS (MD = −1.42, 95% CI = [−4.46, −1.62], P = 0.36) was not apparent. In addition, none of the adverse events mentioned occurred, indicating that it is safe enough. Conclusion GBHT combined with CWM is an effective and safe as adjunctive treatment for patients with T2DM. Nevertheless, due to the limitation of the quality of the included studies, additional high-quality researches are required to further confirm these results.
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Xiong Y, Li Q, Chen X, Zhu T, Lu Q, Jiang G. Identification of the Active Compound of Liu Wei Di Huang Wan for Treatment of Gestational Diabetes Mellitus via Network Pharmacology and Molecular Docking. J Diabetes Res 2022; 2022:4808303. [PMID: 35669396 PMCID: PMC9167086 DOI: 10.1155/2022/4808303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/05/2022] [Indexed: 11/17/2022] Open
Abstract
Liu Wei Di Huang Wan (LWDHW) is a well-known Chinese herbal compound, which has been prescribed for the treatment of gestational diabetes mellitus (GDM). We sought to clarify the potential therapeutic effects of LWDHW against GDM. Differentially expressed genes (DEGs) in GDM were firstly identified from the Gene Expression Omnibus (GEO) database. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to reveal the biological functions of the DEGs. Subsequently, the LWDHW-compound-target network was constructed based on public databases to identify the relationship between the active components in LWDHW and the corresponding targets. Furthermore, gene functional analysis and protein-protein interaction (PPI) network construction were applied to investigate the function of potential targets and to evaluate hub genes. Finally, molecular docking was used to verify the binding activities between active ingredients and hub targets. Thirteen active components and 39 corresponding therapeutic target genes were obtained via network pharmacology analysis. The enrichment analysis demonstrated that the anti-GDM effect of LWDHW included oxidoreductase activity, involvement in renal system process, and regulation of blood pressure, which may be achieved through regulation of serotonergic synapses, vascular smooth muscle contraction, and neuroactive ligand-receptor interaction pathways. Additionally, molecular docking revealed that the main active component, Mu Dan Pi, exhibited the best affinity for proteins encoded by hub genes. This study applied network pharmacology analysis and molecular docking to display the multicomponent and multitarget characteristics of LWDHW in the treatment of GDM. Our findings provide novel insights into the pathogenesis of GDM and the therapeutic mechanisms of LWDHW against GDM.
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Affiliation(s)
- Yunqi Xiong
- Department of Obstetrics and Gynaecology, Shuguang Hospital Affiliated to Shanghai Traditional Chinese Medical University, Shanghai 200120, China
| | - Qiutong Li
- Department of Obstetrics and Gynaecology, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, China
| | - Xiuhui Chen
- Department of Obstetrics and Gynaecology, Shuguang Hospital Affiliated to Shanghai Traditional Chinese Medical University, Shanghai 200120, China
| | - Ting Zhu
- Department of Obstetrics and Gynaecology, Shuguang Hospital Affiliated to Shanghai Traditional Chinese Medical University, Shanghai 200120, China
| | - Qitian Lu
- Department of Obstetrics and Gynaecology, Shuguang Hospital Affiliated to Shanghai Traditional Chinese Medical University, Shanghai 200120, China
| | - Guojing Jiang
- Department of Obstetrics and Gynaecology, Shuguang Hospital Affiliated to Shanghai Traditional Chinese Medical University, Shanghai 200120, China
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Liu Wei Di Huang Wan and the Delay of Insulin Use in Patients with Type 2 Diabetes in Taiwan: A Nationwide Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:1298487. [PMID: 34457016 PMCID: PMC8390129 DOI: 10.1155/2021/1298487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/12/2021] [Accepted: 08/07/2021] [Indexed: 11/18/2022]
Abstract
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.
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Alismatis Rhizoma Triterpenes Alleviate High-Fat Diet-Induced Insulin Resistance in Skeletal Muscle of Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8857687. [PMID: 33623531 PMCID: PMC7875633 DOI: 10.1155/2021/8857687] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/02/2021] [Accepted: 01/11/2021] [Indexed: 01/17/2023]
Abstract
Alismatis rhizoma (AR), which is the dried rhizome of Alisma orientale (Sam.) Juz. (Alismataceae), is an important component of many famous Chinese formulas for hypoglycemic. This study aimed to evaluate the insulin resistance (IR) alleviating effects of AR triterpenes (ART) and ART component compatibility (ARTC, the mixture of 16-oxo-alisol A, 16-oxo-alisol A 23-acetate, 16-oxo-alisol A 24-acetate, alisol C, alisol C 23-acetate, alisol L, alisol A, alisol A 23-acetate, alisol A 24-acetate, alisol L 23-acetate, alisol B, alisol B 23-acetate, 11-deoxy-alisol B and 11-deoxy-alisol B 23-acetate) in high-fat diet-induced IR mice and plamitate-treated IR C2C12 cells, respectively. A dose of 200 mg/kg of ART was orally administered to IR mice, and different doses (25, 50, and 100 μg/ml) of ARTC groups were treated to IR C2C12 cells. IPGTT, IPITT, body weight, Hb1AC, FFA, TNF-α, MCP-1, and IR-associated gene expression (p-AMPK, p-IRS-1, PI3K, p-AKT, p-JNK, and GLUT4) were measured in IR mice. Glucose uptake, TNF-α, MCP-1, and IR-associated gene expression were also measured in IR C2C12 cells. Results showed that ART alleviated high-fat diet-induced IR in the skeletal muscle of mice, and this finding was further validated by ARTC. This study demonstrated that ART presented a notable IR alleviating effect by regulating IR-associated gene expression, and triterpenes were the material basis for the IR alleviating activity of AR.
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Huang YH, Liu GH, Hsu TY, Yang LY, Lee MC, Huang CT, Wu YH. Effective Dose of Rhizoma Coptidis Extract Granules for Type 2 Diabetes Treatment: A Hospital-Based Retrospective Cohort Study. Front Pharmacol 2021; 11:597703. [PMID: 33568997 PMCID: PMC7868566 DOI: 10.3389/fphar.2020.597703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/23/2020] [Indexed: 01/11/2023] Open
Abstract
Rhizoma Coptidis is a popular phytomedicine for the treatment of type 2 diabetes in Asia, but its effective dose for diabetes treatment remains confused because of diverse origins. This study aimed to investigate the dose-response effects of Rhizoma Coptidis extract granules (RCEG), produced with standardized quality control, on hypoglycemic effects in patients with type 2 diabetes. We conducted a retrospective analysis of Chang Gung Research Database from January 01, 2008 to November 30, 2017. Outpatients visiting traditional Chinese medicine clinics and receiving RCEG for type 2 diabetes treatment were included. Plasma glucose, lipid, and other parameters were analyzed from 93 patients with a total of 737 visits within 60 weeks. Scatter plots with the LOESS analysis were used to explore the association between RCEG dose and hypoglycemic effect. The minimal effective dose was chosen to divide the study population into the high-dose and low-dose RCEG groups. Non-parametric tests were used for between-group and within-group comparisons. The multivariate nonlinear mixed-effects model was applied to access the effect of treatment length and groups simultaneously on the change of HbA1c and fasting plasma glucose. The “arule” package in R was used to present the network diagram of RCEG and other co-prescriptions. We first discovered a significant relationship between RCEG dose and HbA1c reduction when the dose reached 0.08 g/kg/day or higher. We thus defined 0.08 g/kg/day of RCEG as the minimum effective dose, and a threshold to separate patients into the high-dose (≥0.08 g/kg/d) and low-dose (<0.08 g/kg/d) RCEG groups. In the high-dose RCEG group, a significant decrease in total cholesterol and a trend toward triglyceride reduction were also noted. Patients more effectively responded to RCEG treatment if they had a higher initial HbA1c level, higher heart rates, better liver function tests, and better tolerance to the higher dose and treatment duration of RCEG. In addition, digestive/tonic/dampness draining formulas and blood regulation recipes were two of the most frequent co-prescriptions with RCEG. This study concluded that RCEG at a dose exceeding 0.08 g/kg/d had beneficial effects on glycemic and lipid control, without showing nephro- or hepatotoxicity, in patients with type 2 diabetes.
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Affiliation(s)
- Yueh-Hsiang Huang
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Geng-Hao Liu
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Tzu-Yang Hsu
- Biostatistics and Informatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Lan-Yan Yang
- Biostatistics and Informatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | | | - Chun-Teng Huang
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, United States
| | - Yi-Hong Wu
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Efficiency and Safety of Chinese Herbal Medicine in the Treatment of Prediabetes: A Systemic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:3628036. [PMID: 33123206 PMCID: PMC7584953 DOI: 10.1155/2020/3628036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/21/2020] [Accepted: 09/11/2020] [Indexed: 11/17/2022]
Abstract
Objective The aim of this study was to review existing evidence on the efficiency and safety of Chinese herbal medicine for the treatment of prediabetes. Methods Randomized controlled trials (RCTs) of Chinese herbal medicine (CHM) to treat prediabetes were searched in the following databases from their inception date onwards until 2 May 2020: MEDLINE, Cochrane, EMBASE, Web of Science, EBSCO, CINAHL, CNKI, VIP database, CBM, and Wanfang database. Quality assessment of included trials was accessed according to the guidance in Cochrane. Researchers independently assessed the validity of included trials and extracted outcome data for synthesis. RevMan 5.3 was used for the meta-analysis. Results Twenty-two RCTs including 3923 participants were included in the study. Our findings upon the 22 RCTs showed CHM is effective in the treatment of prediabetes, which can statistically reduce the incidence of diabetes (RR = 0.48; 95% CI = (0.41, 0.57); P < 0.001), increase the incidence of normalization of prediabetes (RR = 1.76; 95% CI = (1.57, 1.96); P < 0.001), and lower FPG (MD = −0.38; 95% CI = (−0.60, −0.16); P < 0.001), 2hPG (MD = −1.13; 95% CI = (−1.60, −0.67); P < 0.001), TG (MD = −0.23; 95% CI = (−0.33, −0.13); P < 0.001), TC (MD = −0.34; 95% CI = (−0.52, −0.16); P < 0.001), and BMI (MD = −0.48; 95% CI = (−0.78, −0.18); P < 0.001) after treatment, and there was no difference of HbA1c (P > 0.05). Conclusion CHM is effective for the treatment of prediabetes. CHM can statistically reduce the incidence of diabetes, increase the incidence of normalization of prediabetes, and lower the FPG, 2hPG, TG, TC, and BMI levels, but with no significant difference in HbA1c. In addition, CHM was relatively safe in clinical practice. More high-quality RCTs should be conducted to strengthen the finding.
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Tsai YY, Chen KJ, Yang YH, Lin YH. Use of Traditional Chinese Medicine May Delay the Need for Insulin Treatment in Patients with Type 2 Diabetes: A Population-Based Cohort Study. J Altern Complement Med 2020; 26:628-635. [PMID: 32543210 DOI: 10.1089/acm.2019.0375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Objectives: Traditional Chinese medicine (TCM) has been shown to reduce insulin resistance and improve beta cell function in previous studies. The aim of this study was to assess whether the use of TCM can delay the need for insulin therapy in patients with type 2 diabetes. Design: Data on patients with type 2 diabetes who received medical treatment for the first time between 2000 and 2003 were obtained from National Health Insurance Research Database (NHIRD) in Taiwan. Among these patients, those with a cumulative use of TCM of more than 28 days were defined as TCM users, and the others as non-users. Kaplan-Meier analysis was used to evaluate the cumulative risk of initiating insulin therapy. Cox proportional hazards models with and without competing risk events were used to evaluate the association between the use of TCM and insulin therapy. Settings/Location: Data were obtained from National Health Insurance Research Database (NHIRD) in Taiwan. Subjects: Patients with type 2 diabetes who received medical treatment for the first time between 2000 and 2003. Interventions: Among these patients, those with a cumulative use of TCM of more than 28 days were defined as TCM users, and the others as non-users. Outcome measures: After 1:1 propensity score matching, both groups were tracked until the initiation of insulin therapy, death, or the end of 2013. Results: We identified 6524 TCM users and 6524 non-users. The TCM users had a significantly lower risk of insulin initiation in a dose-dependent manner (log-rank test p < 0.001). This effect was consistent across subgroups with different severities of diabetes, and remained significant in competing risk analysis (for TCM users with 28 to 83 days cumulative use, HR 0.78 [0.70-0.87], p < 0.0001; for TCM users with ≥ 84 days cumulative use, HR 0.47 [0.42-0.53], p < 0.0001). Conclusions: The use of TCM in addition to standard diabetes treatment may delay the need for insulin treatment in patients who received medical treatment for type 2 diabetes for the first time. This benefit was strongly dose-dependent and applicable in patients with different severities of diabetes.
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Affiliation(s)
- Ying-Ying Tsai
- Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital Chiayi Branch, Chiayi County, Taiwan
| | - Ko-Jung Chen
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital Chiayi Branch, Chiayi County, Taiwan
| | - Yao-Hsu Yang
- Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital Chiayi Branch, Chiayi County, Taiwan.,Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital Chiayi Branch, Chiayi County, Taiwan
| | - Yung-Hsiang Lin
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital Chiayi Branch, Chiayi County, Taiwan
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10
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Study on the Antibreast Cancer Mechanism and Bioactive Components of Si-Wu-Tang by Cell Type-Specific Molecular Network. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2345970. [PMID: 32256636 PMCID: PMC7091537 DOI: 10.1155/2020/2345970] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/13/2020] [Indexed: 01/14/2023]
Abstract
Si-Wu-Tang (SWT), a traditional Chinese herbal formula, has shown an effect on antibreast cancer. However, the mechanisms and bioactive components of SWT are still unclear. Fortunately, cell type-specific molecular network has provided an effective method. This study integrated the data of formula components, all types of biomolecules in the human body, and nonexpressed protein in breast cancer cells and constructed the breast cancer cell network and the biological network that SWT acted on the breast cancer-related targets by Entity Grammar System (EGS). Biological network showed 59 bioactive components acting on 15 breast cancer-related targets. The antibreast cancer mechanisms were summarized by enrichment analysis: regulation of cell death, response to hormone stimulation, response to organic substance, regulation of phosphorylation of amino acids, regulation of cell proliferation, regulation of signal transmission, and affection of gland development. In addition, we discovered that verbascoside played the role of antibreast cancer by inhibiting cell proliferation, but there was not a report on this effect. The results of CCK8 and western blot were consistent with the antibreast cancer effect of verbascoside based on biological network. Biological network modeling by EGS and network analysis provide an effective way for uncovering the mechanism and identifying the bioactive components of SWT.
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11
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Huang YH, Chen ST, Liu FH, Hsieh SH, Lin CH, Liou MJ, Wang CC, Huang CH, Liu GH, Lin JR, Yang LY, Hsu TY, Lee MC, Huang CT, Wu YH. The efficacy and safety of concentrated herbal extract granules, YH1, as an add-on medication in poorly controlled type 2 diabetes: A randomized, double-blind, placebo-controlled pilot trial. PLoS One 2019; 14:e0221199. [PMID: 31415655 PMCID: PMC6695147 DOI: 10.1371/journal.pone.0221199] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/19/2019] [Indexed: 12/14/2022] Open
Abstract
Background In Asian countries, many patients with type 2 diabetes fail to achieve controlled glycated hemoglobin (HbA1c) levels while taking several classes of oral hypoglycemic agents (OHAs). Traditional Chinese medicine could be an alternative therapeutic option for poorly controlled type 2 diabetes. YH1 is a concentrated Chinese herbal extract formula that combines Rhizoma Coptidis and Shen-Ling-Bai-Zhu-San. This randomized, double-blind, placebo-controlled pilot study evaluated YH1 as an add-on medication for poorly controlled type 2 diabetes. Methods Forty-six patients with poorly controlled type 2 diabetes were randomly assigned 1:1 to the YH1 or placebo group. Before the trial, all subjects had received three or more classes of OHAs with HbA1c > 7.0% (53 mmol/mol) and a body mass index ≥ 23 kg/m2. During the 12-week trial, participants continued to take OHAs without any dose or medication changes. The primary endpoint was the percentage change in HbA1c level. Per-protocol analysis was applied to the final evaluation. Results At week 12, there was an 11.1% reduction in HbA1c from baseline and a 68.9% increase in homeostatic model assessment (HOMA) of β cell function in the YH1 group, which also exhibited significant reductions in two-hour postprandial glucose (-26.2%), triglycerides (-29.5%), total cholesterol (-21.6%), low-density lipoprotein cholesterol (-17.4%), body weight (-0.5%), and waist circumference (-1.1%). The changes in fasting plasma glucose, HOMA insulin resistance and symptom scores were not significantly different between the YH1 and placebo groups. No serious adverse events occurred during this clinical trial. Conclusions This pilot study indicates that YH1 together with OHAs can improve hypoglycemic action and β-cell function in overweight/obese patients with poorly controlled type 2 diabetes. YH1 is a safe add-on medication for OHAs and has beneficial effects on weight control and lipid metabolism. A larger study population with longer treatment and follow-up periods is required for further verification.
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Affiliation(s)
- Yueh-Hsiang Huang
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Szu-Tah Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Feng-Hsuan Liu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Sheng-Hwu Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chia-Hung Lin
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Miaw-Jene Liou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Ching Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chung-Huei Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Geng-Hao Liu
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jr-Rung Lin
- Clinical Informatics and Medical Statistics Research Center and Graduate Institute of Clinical Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Lan-Yan Yang
- Biostatistics and Informatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Tzu-Yang Hsu
- Biostatistics and Informatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | | | - Chun-Teng Huang
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California, United States of America
| | - Yi-Hong Wu
- Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
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12
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Chen HY, Pan HC, Chen YC, Chen YC, Lin YH, Yang SH, Chen JL, Wu HT. Traditional Chinese medicine use is associated with lower end-stage renal disease and mortality rates among patients with diabetic nephropathy: a population-based cohort study. Altern Ther Health Med 2019; 19:81. [PMID: 30943956 PMCID: PMC6448220 DOI: 10.1186/s12906-019-2491-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 03/24/2019] [Indexed: 11/13/2022]
Abstract
Background Diabetic nephropathy (DN) is a common complication of diabetes mellitus (DM) that imposes an enormous burden on the healthcare system. Although some studies show that traditional Chinese medicine (TCM) treatments confer a protective effect on DN, the long-term impact remains unclear. This study aims to examine end-stage renal disease (ESRD) and mortality rates among TCM users with DN. Methods A total of 125,490 patients with incident DN patients from 2004 to 2006 were identified from the National Health Insurance Research Database in Taiwan and followed until 2012. The landmark method was applied to avoid immortal time bias, and propensity score matching was used to select 1:1 baseline characteristics-matched cohort. The Kaplan–Meier method and competing-risk analysis were used to assess mortality and ESRD rates separately. Results Among all eligible subjects, about 60% of patients were classified as TCM users (65,812 TCM users and 41,482 nonusers). After 1:1 matching, the outcomes of 68,882 patients were analyzed. For the ESRD rate, the 8-year cumulative incidence was 14.5% for TCM users [95% confidence interval (CI): 13.9–15.0] and 16.6% for nonusers (95% CI: 16.0–17.2). For the mortality rate, the 8-year cumulative incidence was 33.8% for TCM users (95% CI: 33.1–34.6) and 49.2% for nonusers (95% CI: 48.5–49.9). After adjusting for confounding covariates, the cause-specific hazard ratio of ESRD was 0.81 (95% CI: 0.78–0.84), and the hazard ratio of mortality for TCM users was 0.48 (95% CI: 0.47–0.50). The cumulative incidence of mortality increased rapidly among TCM users with ESRD (56.8, 95% CI: 54.6–59.1) when compared with TCM users without ESRD (30.1, 95% CI: 29.4–30.9). In addition, TCM users who used TCM longer or initiated TCM treatments after being diagnosed with DN were associated with a lower risk of mortality. These results were consistent across sensitivity tests with different definitions of TCM users and inverse probability weighting of subjects. Conclusions The lower ESRD and mortality rates among patients with incident DN correlates with the use of TCM treatments. Further studies about specific TCM modalities or medications for DN are still needed. Electronic supplementary material The online version of this article (10.1186/s12906-019-2491-y) contains supplementary material, which is available to authorized users.
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13
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Characteristics of the traditional Liu-Wei-Di-Huang prescription reassessed in modern pharmacology. Chin J Nat Med 2019; 17:103-121. [DOI: 10.1016/s1875-5364(19)30013-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Indexed: 12/25/2022]
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14
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Lu HF, Lai YH, Huang HC, Lee IJ, Lin LC, Liu HK, Tien HH, Huang C. Ginseng-plus-Bai-Hu-Tang ameliorates diet-induced obesity, hepatic steatosis, and insulin resistance in mice. J Ginseng Res 2018; 44:238-246. [PMID: 32148405 PMCID: PMC7031743 DOI: 10.1016/j.jgr.2018.10.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/17/2018] [Accepted: 10/22/2018] [Indexed: 12/28/2022] Open
Abstract
Background Dietary fat has been suggested to be the cause of various health issues. Obesity, hypertension, cardiovascular disease, diabetes, dyslipidemia, and kidney disease are known to be associated with a high-fat diet (HFD). Obesity and associated conditions, such as type 2 diabetes mellitus and nonalcoholic fatty liver disease (NAFLD), are currently a worldwide health problem. Few prospective pharmaceutical therapies that directly target NAFLD are available at present. A Traditional Chinese Medicine, ginseng-plus-Bai-Hu-Tang (GBHT), is widely used by diabetic patients to control glucose level or thirst. However, whether it has therapeutic effects on fat-induced hepatic steatosis and metabolic syndrome remains unclear. Methods This study was conducted to examine the therapeutic effect of GBHT on fat-induced obesity, hepatic steatosis, and insulin resistance in mice. Results GBHT protected mice against HFD-induced body weight gain, hyperlipidemia, and hyperglycemia compared with mice that were not treated. GBHT inhibited the expansion of adipose tissue and adipocyte hypertrophy. No ectopic fat deposition was found in the livers of HFD mice treated with GBHT. In addition, glucose intolerance and insulin sensitivity in HFD mice was also improved by GBHT. Conclusion GBHT prevents changes in lipid and carbohydrate metabolism in a HFD mouse model. Our findings provide evidence for the traditional use of GBHT as therapy for the management of metabolic syndrome.
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Affiliation(s)
- Hsu-Feng Lu
- Departments of Clinical Pathology, Cheng Hsin General Hospital, Taipei, Taiwan.,Department of Restaurant, Hotel and Institutional Management, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Yu-Heng Lai
- Department of Chemistry, Chinese Culture University, Taipei, Taiwan
| | - Hsiu-Chen Huang
- Department of Applied Science, National Tsing Hua University South Campus, Hsinchu, Taiwan
| | - I-Jung Lee
- Department of Kampo Medicine, Yokohama University of Pharmacy, Kanagawa, Japan
| | - Lie-Chwen Lin
- National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taipei, Taiwan
| | - Hui-Kang Liu
- National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taipei, Taiwan.,Ph.D. Program in Clinical Drug Development of Chinese Herbal Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Hsuan Tien
- Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng Huang
- Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Earth and Life Sciences, University of Taipei, Taipei, Taiwan
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15
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Wu CT, Tsai YT, Lin JG, Fu SL, Lai JN. Chinese herbal products and the reduction of risk of breast cancer among females with type 2 diabetes in Taiwan: A case-control study. Medicine (Baltimore) 2018; 97:e11600. [PMID: 30075530 PMCID: PMC6081140 DOI: 10.1097/md.0000000000011600] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Women with type 2 diabetes have a higher risk of developing breast cancer. In Taiwan, traditional Chinese medicine is widely used to treat diabetes; however, its precise influence has not been empirically tested.The objective of the case-control study is to estimate the effect on the risk of breast cancer of using traditional Chinese medicine for women with type 2 diabetes.More than 80% of women with type 2 diabetes have used traditional Chinese medicine. The most commonly prescribed drug was metformin and the herbal formulas were the Di Huang Wan series, including Liu Wei Di Huang Wan, Qi Ju Di Huang Wan, and Zhi Bai Di Huang Wan, followed by Bai Hu Jia Ren Shen Tang and Yu Quan Wan. For the effect of metformin, women who used traditional Chinese medicine including Di Huang series have a lower risk of breast cancer HR: 0.35 (95%CI: 0.23-0.51) in women younger than 55 and HR: 0.54 (95%CI: 0.37-0.79) in women older than 55.The protective effect of the Di Huang Wan series may be due to the synergetic effect of reducing blood glucose or increasing insulin sensitivity and delaying the insulin resistance of cells. The relationship between the Di Huang Wan series and breast cancer of women with type 2 diabetes requires further investigation.
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Affiliation(s)
- Chien-Tung Wu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University Department of Chinese Medicine, Taipei City Hospital, Taipei School of Chinese Medicine Graduate Institute of Integrated Medicine Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
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16
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Traditional Chinese Medical Care and Incidence of Stroke in Elderly Patients Treated with Antidiabetic Medications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061267. [PMID: 29914063 PMCID: PMC6024911 DOI: 10.3390/ijerph15061267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/04/2018] [Accepted: 06/13/2018] [Indexed: 02/07/2023]
Abstract
Objectives: Experimental research has shown that herbal and traditional Chinese medicines (TCM) may serve as complements to Western medicine treatments in the control of blood glucose and cardiovascular complications, but population-based studies are limited. We investigated the association between TCM use and subsequent risk of stroke in older patients with diabetes. Study design: The database used in this cohort study contained longitudinal medical claims for one million subjects randomly selected among beneficiaries of a universal health care program in Taiwan. We identified a cohort of patients with diabetes aged 65 years and older who initiated anti-diabetic medications from 2000 to 2012. Patients who had at least two TCM outpatient visits after their initiation of anti-diabetic medications were considered TCM users. Main outcome measures: The incidence of stroke was measured until 2013. Cox regression models with TCM use as a time-dependent variable were used to calculate the adjusted hazard ratios (HRs) comparing TCM use with no use. Results: Over the 13-year period, 17,015 patients were identified; 4912 (28.9%) of them were TCM users. The incidence of stroke during the follow-up (per 1000 person-years) was 22.8 in TCM users and 25.7 in non-users. TCM users had an adjusted HR of 0.93 for the incidence of ischemic stroke (95% confidence interval [CI] 0.83, 1.04) and of 0.89 for developing hemorrhagic stroke (95% CI 0.66, 1.19), compared with non-users. Conclusions: In this study, in older patients receiving Western medicine treatments for diabetes, TCM use was not associated with an increased risk of developing ischemic stroke and hemorrhagic stroke.
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17
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Tsai FJ, Ho TJ, Cheng CF, Shiao YT, Chien WK, Chen JH, Liu X, Tsang H, Lin TH, Liao CC, Huang SM, Li JP, Lin CW, Lin JG, Lan YC, Liu YH, Hung CH, Lin JC, Lin CC, Lai CH, Liang WM, Lin YJ. Characteristics of Chinese herbal medicine usage in ischemic heart disease patients among type 2 diabetes and their protection against hydrogen peroxide-mediated apoptosis in H9C2 cardiomyoblasts. Oncotarget 2017; 8:15470-15489. [PMID: 28099940 PMCID: PMC5362500 DOI: 10.18632/oncotarget.14657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 12/27/2016] [Indexed: 02/07/2023] Open
Abstract
Evidence for long-term use of Chinese herbal medicine (CHM) as an adjuvant treatment in patients with type 2 diabetes (T2D) remains limited. This study aimed to assess the frequency of use, utilization patterns, and therapeutic effects of adjuvant CHM for ischemic heart disease (IHD) in patients with T2D in Taiwan. We identified 4620 IHD patients with T2D. After matching for age, gender, and insulin use, 988 subjects each were allocated to a CHM group and a non-CHM group. There were no differences in baseline characteristics except for comorbidities. The CHM group contained more cases with chronic obstructive pulmonary disease, hepatitis, ulcer disease, and hyperlipidemia. The cumulative survival probability was higher in CHM users than in matched non-CHM users aged 60 years or older (P < .0001, log rank test) regardless of gender (P = .0046 for men, P = .0010 for women, log rank test). Among the top 12 CHM combinations, Shu-Jing-Huo-Xue-Tang and Shao-Yao-Gan-Cao-Tang (13.6%) were the most common. This dual combination improved antiapoptotic activity in H2O2-exposed H9C2 cells by enhancing phosphorylation of glycogen synthase kinase-3β and p38 mitogen-activated protein kinase and could increase the survival of myocardial cells. Our study suggests that adjuvant CHM therapy may increase the survival probability and provides a comprehensive list for future investigations of the safety and efficacy of CHM for IHD patients with T2D.
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Affiliation(s)
- Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
| | - Tsung-Jung Ho
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Division of Chinese Medicine, China Medical University Beigang Hospital, Yunlin County, Taiwan.,Division of Chinese Medicine, Tainan Municipal An-Nan Hospital-China Medical University, Tainan, Taiwan
| | - Chi-Fung Cheng
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
| | - Yi-Tzone Shiao
- Heart Center, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Kuei Chien
- Biostatistics Center, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Jin-Hua Chen
- Biostatistics Center, College of Management, Taipei Medical University, Taipei, Taiwan.,School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Xiang Liu
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Hsinyi Tsang
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ting-Hsu Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Chu Liao
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shao-Mei Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ju-Pi Li
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Rheumatism Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Wen Lin
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Jaung-Geng Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Ching Lan
- Department of Health Risk Management, China Medical University, Taichung, Taiwan
| | - Yu-Huei Liu
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Chien-Hui Hung
- Graduate Institute of Clinical Medical Science, Chang-Gung University, Taipei, Taiwan
| | - Jung-Chun Lin
- School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chien Lin
- Department of Cosmetic Science, Providence University, Taichung, Taiwan
| | - Chih-Ho Lai
- Department of Microbiology and Immunology, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Miin Liang
- Department of Microbiology and Immunology, Chang Gung University, Taoyuan, Taiwan
| | - Ying-Ju Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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Tsai MY, Hu WL, Chiang JH, Huang YC, Chen SY, Hung YC, Chen YH. Improved medical expenditure and survival with integration of traditional Chinese medicine treatment in patients with heart failure: A nationwide population-based cohort study. Oncotarget 2017; 8:90465-90476. [PMID: 29163845 PMCID: PMC5685766 DOI: 10.18632/oncotarget.20063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/29/2017] [Indexed: 12/27/2022] Open
Abstract
Background No previous studies have evaluated the effects of traditional Chinese medicine (TCM) treatment on patients with heart failure (HF). Hence, in this study, we determined whether TCM treatment affects the healthcare burden and survival of HF patients. Methods Samples were retrieved from the registry of catastrophic illness patients of the Taiwan National Health Insurance Research Database (NHIRD). Based on a frequency (1:1) matched case-control design, patients with HF between 2000 and 2010 were designated as cases (TCM users) and controls (non-TCM users). TCM treatment for patients with HF was analyzed. Results Among these patients, 312 used TCM for HF treatment and exhibited significantly increased 5-year survival (p < .0001), with multivariate adjustment, compared with those without TCM use. Mean outpatient clinic visits at 1 year and 5 years after HF diagnosis were higher in TCM users, and accumulated medical costs were lower than in non-TCM users at 1 year. The hospitalization cost at 1-year follow-up was lower for TCM users than for non-TCM users. We found that, compared with non-TCM users, TCM users had an 86% reduction in risk of mortality in the compensated group, and a 68% reduction in the decompensated group receiving TCM treatment (aHR 0.32, 95% CI 0.20–0.52). The hazard ratio (HR) of Chinese herbal medicine (CHM) users with HF was significantly lower than that of non-users (aHR 0.24, 95% CI 0.16–0.35). We also analyzed the most commonly used herbal products as well as the HRs associated with their use, thus providing future research avenues. Conclusions This nationwide retrospective cohort study finds that combined therapy with TCM may improve survival in HF patients. This study also suggests that TCM may be used as an integral element of HF interventions on health care costs.
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Affiliation(s)
- Ming-Yen Tsai
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Long Hu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jen-Huai Chiang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chuen Huang
- Department of Medical Research, China Medical University Hospital and School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Yu Chen
- School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Chiang Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan.,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Effects of Chinese herbal medicines on the occurrence of diabetic retinopathy in type 2 diabetes patients and protection of ARPE-19 retina cells by inhibiting oxidative stress. Oncotarget 2017; 8:63528-63550. [PMID: 28969009 PMCID: PMC5609941 DOI: 10.18632/oncotarget.18846] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/05/2017] [Indexed: 01/20/2023] Open
Abstract
Diabetic retinopathy is a microvascular complication of type 2 diabetes and the leading cause of acquired blindness. In Taiwan, Chinese herbal medicine (CHM) is a popular adjunctive therapy. In this study, we investigated the CHM prescription patterns and their effects. We identified 23,701 subjects with type 2 diabetes in a database, and after matching for age and gender, 6,948 patients each were assigned to CHM and non-CHM groups. In the female subgroups, the cumulative retinopathy probability was lower for the CHM users than that for the CHM non-users (P < 0.001, log-rank test). Among the top 10 CHMs, Jia-Wei-Xiao-Yao-San (JWXYS; 52.9%), Shu-Jing-Huo-Xue-Tang (SJHXT; 45.1%), and Ge-Gen-Tang (GGT; 43.7%) were the most common herbal formulas. Yan-Hu-Suo (48.1%), Ge-Gen (42.1%), and Huang-Qin (HQin; 40.1%) were the most common single herbs. CHM network analysis showed that JWXYS was the core CHM of cluster 1. JWXYS, DS, XF, and SZRT exhibited both of the reductions of H2O2-induced phosphorylation of p38 MAPK and p44/42 MAPK (Erk1/2) in human ARPE-19 retina cells. In cluster 2, SJHXT was the core CHM. SJHXT and NX showed both of the phosphorylation reductions. In cluster 3, GGT was the core CHM, and it reduced the phosphorylation of both MAPKs. In cluster 4, HQin was the core CHM, and it also reduced the phosphorylation of both MAPKs. Our study suggests that adjunctive CHM therapy may reduce diabetic retinopathy via antioxidant activity of the herbs and provides information on core CHM treatments for further scientific investigations or therapeutic interventions.
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Abstract
BACKGROUND Self-medication is commonly practised by patients, underpinned by health beliefs that affect their adherence to medication regimens, and impacting on treatment outcomes. OBJECTIVES This review explores the scope of self-medication practices among people with hypertension, in terms of the scale of use, types of medication and influencing factors. METHOD A comprehensive search of English language, peer-reviewed literature published between 2000 and 2014 was performed. Twenty-seven studies met the inclusion criteria; 22 of these focused on complementary and alternative medicines (CAMs). RESULTS Anti-hypertensive medications are listed among the 11% of products that patients reportedly obtain over-the-counter (OTC) for self-medication. On average, 25% of patients use CAMs, mostly herbs, to lower blood pressure. Recommendations by family, friends and neighbours are the most influential factors for self-medication with CAMs. Faith in treatment with CAMs, dissatisfaction with conventional medicine and the desire to reduce medication costs are also cited. Most (70%) patients with hypertension take OTC medicines to treat minor illnesses. The concurrent use of anti-hypertensive medications with analgesics and herbal medicines is commonly practised. The sociodemographic profile of patients engaging in self-medication differs markedly in the articles reviewed; self-medication practices cannot be attributed to a particular profile. Low disclosure of self-medication is consistently reported. CONCLUSION This review highlights a high proportion of people with hypertension practise self-medication. Further studies are needed to assess the impact of self-medication with OTC and anti-hypertensive medications on hypertension treatment. Health professionals involved in hypertension management should be mindful of any types of self-medication practices.
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Affiliation(s)
- Riana Rahmawati
- Graduate School of Health, Discipline of Pharmacy, The University of Technology Sydney, Sydney, New South Wales, Australia.,Pharmacology Department, Faculty of Medicine, Islamic University of Indonesia, Yogyakarta, Indonesia
| | - Beata V Bajorek
- Graduate School of Health, Discipline of Pharmacy, The University of Technology Sydney, Sydney, New South Wales, Australia.,Department of Pharmacy, Royal North Shore Hospital, Sydney, New South Wales, Australia
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Hsu PC, Liao PY, Chang HH, Chiang JY, Huang YC, Lo LC. Nailfold capillary abnormalities are associated with type 2 diabetes progression and correlated with peripheral neuropathy. Medicine (Baltimore) 2016; 95:e5714. [PMID: 28033273 PMCID: PMC5207569 DOI: 10.1097/md.0000000000005714] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Diabetes mellitus (DM) is associated with a state of chronic hyperglycemia with a highly increased risk of vascular complications. The current study aimed to investigate microcirculation abnormalities in patients with type 2 DM and those with pre-DM using nailfold videocapillaroscopy (NVC) and evaluate the possible correlation with microvascular complications.A total of 115 patients with type 2 DM, 41 patients with pre-DM, and 37 healthy subjects without diabetes were enrolled. All subjects underwent NVC to evaluate capillary density, length, morphology, distribution, presence of enlarged loops or hemorrhages, and blood flow. NVC score was used to quantitate the aforementioned characteristics.Patients with type 2 DM showed significantly increased alterations including reduced capillary length (29.6%), irregular distribution (35.7%), and abnormal morphology (59.1%), while the corresponding NVC scores were comparable to those of control subjects. In addition, subjects with pre-DM had a significantly higher NVC score and greater alterations in distribution (26.8%) and morphology (48.8%) than control subjects. NVC score was positively correlated with diabetic peripheral neuropathy (DPN) and the number of microvascular complications.NVC identified a high frequency of microcirculation abnormalities in subjects with pre-DM or type 2 DM compared to those in the control group. NVC score was also capable of detecting microvascular complications in patients with type 2 DM and was correlated with DPN and the number of microvascular complications.
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Affiliation(s)
- Po-Chi Hsu
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung
- Department of Chinese Medicine, Changhua Christian Hospital
| | - Pei-Yung Liao
- Department of Endocrinology, Changhua Christian Hospital
| | - Hen-Hong Chang
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, and Research Center for Chinese Medicine and Acupuncture, China Medical University
- Department of Chinese Medicine, China Medical University Hospital, Taichung
| | - John Y. Chiang
- Department of Computer Science and Engineering, National Sun Yat-sen University
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung
| | - Yu-Chuen Huang
- School of Chinese Medicine, College of Chinese Medicine, China Medical University
- Department of Medical Research, China Medical University Hospital, Taichung
| | - Lun-Chien Lo
- Department of Chinese Medicine, Changhua Christian Hospital
- Graduate Institute of Statistical and informational Science, National Changhua University of Education, Changhua, Taiwan
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Evaluation of the In Vivo Therapeutic Effects of Radix Paeoniae Rubra Ethanol Extract with the Hypoglycemic Activities Measured from Multiple Cell-Based Assays. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3262790. [PMID: 28018473 PMCID: PMC5153506 DOI: 10.1155/2016/3262790] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/24/2016] [Accepted: 11/03/2016] [Indexed: 01/28/2023]
Abstract
Background. Radix Paeoniae Rubra (Chi Shao) contains several phytochemicals with hypoglycemic actions. Current research aims to explore potential insulinotropic effects and long-term therapeutic efficacy of such herb against type 2 diabetes. Methods. Composition analysis for the ethanol extract (PRExt) was executed by high performance liquid chromatography. Polyphenol-enriched fraction was characterized by high pressure size exclusion chromatography. Multiple cell platforms were employed to evaluate hypoglycemic bioactivities. In animal experiments, blood glucose, the homeostasis model assessment (HOMA)-index assessment, glucose tolerance test, and in vivo glucose uptake were all measured. Additional effects of PRExt on obesity and hepatic steatosis were evaluated by serum and histological analysis. Results. PRExt provides multiple hypoglycemic effects including the enhancement of glucose-mediated insulin secretion. Pentagalloylglucose and polyphenol-enriched fraction are two insulinotropic constituents. Moreover, PRExt intraperitoneal injection causes acute hypoglycemic effects on fasted db/db mice. Oral administration of PRExt (200 mg/kg b.w.) gradually reduces blood glucose in db/db mice to the level similar to that in C57J/B6 mice after 30 days. The improvement of glucose intolerance, HOMA-index, and in vivo glucose uptake is evident in addition to the weight loss effect and attenuation of hepatic steatosis. Conclusion. PRExt is an effective antidiabetic herbal extract with multiple hypoglycemic bioactivities.
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Liu CY, Chu JY, Chiang JH, Yen HR, Hsu CH. Utilization and prescription patterns of traditional Chinese medicine for patients with hepatitis C in Taiwan: a population-based study. Altern Ther Health Med 2016; 16:397. [PMID: 27769222 PMCID: PMC5073439 DOI: 10.1186/s12906-016-1379-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 10/08/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND To characterize the utilization of Traditional Chinese Medicine (TCM) among patients with hepatitis C (HC). METHODS This study examined datasets from the National Health Insurance Research Database in Taiwan. One cohort, including one million patients randomly sampled from the beneficiaries of the National Health Insurance Programme from January 1 to December 31 in 2010, was chosen for this analysis. People who had at least three outpatient or inpatient records and had been diagnosed with hepatitis C virus infection from 2000 to 2010 were defined as patients with HC. Patients with HC who had at least one TCM outpatient clinical record from 2000 to 2010 were defined as TCM users (N = 5,691), whereas patients with no TCM outpatient records were defined as non-TCM users (N = 2,876). The demographic data, treatment modalities and disease distributions of TCM users were analysed. RESULTS Overall, 66.4 % of the patients with HC had used TCM from 2000 to 2010. Of the TCM users, 54.1 % were female. The utilization rate of TCM increased with age and peaked in the age group of those 40 - 64 years old. Herbal remedies (52.4 %) were the most commonly used agents, followed by combination therapy (46.4 %) and acupuncture alone (1.2 %). Patients who had more extrahepatic diseases and were taking more antiviral agents tended to visit TCM clinics. Jia-Wei-Xiao-Yao-San and Dan-Shen (Salvia miltiorrhiza) were the most commonly used formula and single herb, with 88,124 person-days and 59,252 person-days, respectively. CONCLUSIONS Our nationwide population-based study revealed a high prevalence and specific usage patterns of TCM in patients with HC in Taiwan.
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Lien ASY, Jiang YD, Mou CH, Sun MF, Gau BS, Yen HR. Integrative traditional Chinese medicine therapy reduces the risk of diabetic ketoacidosis in patients with type 1 diabetes mellitus. JOURNAL OF ETHNOPHARMACOLOGY 2016; 191:324-330. [PMID: 27340102 DOI: 10.1016/j.jep.2016.06.051] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 06/12/2016] [Accepted: 06/18/2016] [Indexed: 06/06/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Life-long insulin is the standard treatment for type 1 diabetes mellitus (T1DM). The role of traditional Chinese medicine (TCM) in T1DM is still not clear. The aim of this study is to explore the prescription pattern of TCM and its impact on the risk of diabetic ketoacidosis (DKA) in patients with T1DM. MATERIALS AND METHODS We retrieved samples from the registry for catastrophic illness patients from the National Health Insurance Research Database (NHIRD). Based on a frequency (1:4) matched case-control design, patients with T1DM in 2000-2011 were designated as cases (TCM users) and controls (non-TCM users). TCM treatment for patients with T1DM was analyzed. The incidence of DKA and the annual costs of emergency visits and hospitalizations were evaluated for all causes. RESULTS Overall, 416 subjects were TCM users, whereas a total of 1608 matched subjects were classified as non-TCM users. The most common Chinese herbal formula and single herb is Liu-wei-di-huang-wan (Six-ingredient pill of Rehmannia) and Huang-qi (Radix Astragali; Astragalus membranaceus (Fisch.) Bunge, Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao), respectively. Compared with non-TCM users, we found a 33% reduction in DKA incidence for all TCM users (aHR 0.67, 95% CI 0.56-0.81, p <0.000) and a 40% reduction for users receiving TCM treatment for more than 180 days (aHR 0.58, 95% CI 0.41-0.82, p <0.01). There were no significant differences between TCM users and non-users in the frequency and medical costs of emergency visits and hospitalizations. CONCLUSIONS Integrative TCM use may reduce the risk of DKA in patients with T1DM. Our results suggest that TCM may have a substantial positive impact on the management of TIDM.
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MESH Headings
- Adolescent
- Adult
- Blood Glucose/drug effects
- Blood Glucose/metabolism
- Case-Control Studies
- Delivery of Health Care, Integrated/economics
- Delivery of Health Care, Integrated/trends
- Diabetes Mellitus, Type 1/blood
- Diabetes Mellitus, Type 1/drug therapy
- Diabetes Mellitus, Type 1/economics
- Diabetes Mellitus, Type 1/epidemiology
- Diabetic Ketoacidosis/blood
- Diabetic Ketoacidosis/economics
- Diabetic Ketoacidosis/epidemiology
- Diabetic Ketoacidosis/prevention & control
- Drug Costs
- Drug Prescriptions
- Drugs, Chinese Herbal/adverse effects
- Drugs, Chinese Herbal/economics
- Drugs, Chinese Herbal/therapeutic use
- Emergency Service, Hospital/economics
- Female
- Hospital Costs
- Hospitalization/economics
- Humans
- Hypoglycemic Agents/adverse effects
- Hypoglycemic Agents/economics
- Hypoglycemic Agents/therapeutic use
- Incidence
- Male
- Medicine, Chinese Traditional/economics
- Medicine, Chinese Traditional/trends
- Practice Patterns, Physicians'/economics
- Practice Patterns, Physicians'/trends
- Registries
- Taiwan/epidemiology
- Time Factors
- Treatment Outcome
- Young Adult
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Affiliation(s)
- Angela Shin-Yu Lien
- Department of Nursing, College of Medicine, National Taiwan University, Taipei 100, Taiwan; School of Nursing, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Yi-Der Jiang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chih-Hsin Mou
- Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
| | - Mao-Feng Sun
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Bih-Shya Gau
- Department of Nursing, College of Medicine, National Taiwan University, Taipei 100, Taiwan.
| | - Hung-Rong Yen
- Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
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From "Kidneys Govern Bones" to Chronic Kidney Disease, Diabetes Mellitus, and Metabolic Bone Disorder: A Crosstalk between Traditional Chinese Medicine and Modern Science. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:4370263. [PMID: 27668003 PMCID: PMC5030442 DOI: 10.1155/2016/4370263] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/13/2016] [Accepted: 08/17/2016] [Indexed: 11/18/2022]
Abstract
Although traditional Chinese medicine (TCM) and Western medicine have evolved on distinct philosophical foundations and reasoning methods, an increasing body of scientific data has begun to reveal commonalities. Emerging scientific evidence has confirmed the validity and identified the molecular mechanisms of many ancient TCM theories. One example is the concept of "Kidneys Govern Bones." Here we discuss the molecular mechanisms supporting this theory and its potential significance in treating complications of chronic kidney disease (CKD) and diabetes mellitus. Two signaling pathways essential for calcium-phosphate metabolism can mediate the effect of kidneys in bone homeostasis, one requiring renal production of bioactive vitamin D and the other involving an endocrine axis based on kidney-expressed Klotho and bone-secreted fibroblast growth factor 23. Disruption of either pathway can lead to calcium-phosphate imbalance and vascular calcification, accelerating metabolic bone disorder. Chinese herbal medicine is an adjunct therapy widely used for treating CKD and diabetes. Our results demonstrate the therapeutic effects and underlying mechanisms of a Chinese herbal formulation, Shen-An extracts, in diabetic nephropathy and renal osteodystrophy. We believe that the smart combination of Eastern and Western concepts holds great promise for inspiring new ideas and therapies for preventing and treating complications of CKD and diabetes.
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Wu CT, Tsai YT, Lai JN. Demographic and medication characteristics of traditional Chinese medicine users among colorectal cancer survivors: A nationwide database study in Taiwan. J Tradit Complement Med 2016; 7:188-194. [PMID: 28417089 PMCID: PMC5388081 DOI: 10.1016/j.jtcme.2016.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 07/11/2016] [Indexed: 11/28/2022] Open
Abstract
Chinese herbal product (CHP) is the major type of traditional Chinese medicine (TCM) and widely used to relief the symptom of colorectal cancer. The aim of the study was to analyze the utilization of CHP for treating patients with colorectal cancer in Taiwan. The usage of CHP, frequency of services, and prescription pattern for colorectal cancer were analyzed from a randomly sampled cohort of 1 million beneficiaries from the National Health Insurance Research Database. The odds ratios for utilization of CHP were estimated with logistic regression model. 2846 patients were newly diagnosed as colorectal cancer during 1998–2008 in the million cohort in Taiwan. 42.7% (n = 1214) of them used CHP. Colorectal cancer was the most common diagnosis coded by TCM doctor, followed by symptoms, signs, and ill-defined conditions. Costusroot and Amomum Six Gentlemen Decoction (香砂六君子湯 xiāng shā liù jūn zǐ tāng) was the most frequently prescribed formula for treating colorectal cancer. Among the top 10 most frequently prescribed CHP for treating colorectal cancer, six containing Ginseng Radix (人參, Panax ginseng) and two containing Astragali Radix (黃耆, Astragalus membranaceus), which are reported to have potential beneficial synergistic effects on colorectal cancer cells. CHP containing Ginseng Radix or Astragali Radix are the most frequently prescribed for colorectal cancer and their effects should be taken into account by healthcare providers.
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Affiliation(s)
- Chien-Tung Wu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Chinese Medicine, Taipei City Hospital, Linsen Chinese Medicine Branch, Taipei, Taiwan.,Taiwan Association for Traditional Chinese Medicine of Family, Taipei, Taiwan
| | - Yueh-Ting Tsai
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.,Taiwan Association for Traditional Chinese Medicine of Family, Taipei, Taiwan
| | - Jung-Nien Lai
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.,China Medical University Hospital, Taichung, Taiwan.,Taiwan Association for Traditional Chinese Medicine of Family, Taipei, Taiwan
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Kim JH, Weeratunga P, Kim MS, Nikapitiya C, Lee BH, Uddin MB, Kim TH, Yoon JE, Park C, Ma JY, Kim H, Lee JS. Inhibitory effects of an aqueous extract from Cortex Phellodendri on the growth and replication of broad-spectrum of viruses in vitro and in vivo. Altern Ther Health Med 2016; 16:265. [PMID: 27484768 PMCID: PMC4970287 DOI: 10.1186/s12906-016-1206-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 06/14/2016] [Indexed: 11/19/2022]
Abstract
Background Cortex Phellodendri (C. Phellodendri), the dried trunk bark of Phellodendron amurense Ruprecht, has been known as a traditional herbal medicine, showing several bioactivities. However, antiviral activity of C. Phellodendri aqueous extract (CP) not reported in detail, particularly aiming the prophylactic effectiveness. Methods In vitro CP antiviral activity evaluated against Influenza A virus (PR8), Vesicular Stomatitis Virus (VSV), Newcastle Disease Virus (NDV), Herpes Simplex Virus (HSV), Coxsackie Virus (H3-GFP) and Enterovirus-71 (EV-71) infection on immune (RAW264.7) and epithelial (HEK293T/HeLa) cells. Such antiviral effects were explained by the induction of antiviral state which was determined by phosphorylation of signal molecules, secretion of IFNs and cytokines, and cellular antiviral mRNA expression. Furthermore, Compounds present in the aqueous fractions confirmed by HPLC analysis and evaluated their anti-viral activities. Additionally, in vivo protective effect of CP against divergent influenza A subtypes was determined in a BALB/c mouse infection model. Results An effective dose of CP significantly reduced the virus replication both in immune and epithelial cells. Mechanically, CP induced mRNA expression of anti-viral genes and cytokine secretion in both RAW264.7 and HEK293T cells. Furthermore, the main compound identified was berberine, and shows promising antiviral properties similar to CP. Finally, BALB/c mice treated with CP displayed higher protection levels against lethal doses of highly pathogenic influenza A subtypes (H1N1, H5N2, H7N3 and H9N2). Conclusion CP including berberine play an immunomodulatory role with broad spectrum antiviral activity, due to induction of antiviral state via type I IFN stimulation mechanism. Consequently, C. Phellodendri could be a potential source for promising natural antivirals or to design other antiviral agents for animal and humans. Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-1206-x) contains supplementary material, which is available to authorized users.
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Chang CC, Lee YC, Lin CC, Chang CH, Chiu CD, Chou LW, Sun MF, Yen HR. Characteristics of traditional Chinese medicine usage in patients with stroke in Taiwan: A nationwide population-based study. JOURNAL OF ETHNOPHARMACOLOGY 2016; 186:311-321. [PMID: 27090345 DOI: 10.1016/j.jep.2016.04.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Stroke has been the leading causes of death worldwide. Traditional Chinese medicine (TCM) has been used for stoke patients for thousands of years. This study aimed to investigate TCM usage and prescription patterns in stroke patients in Taiwan. MATERIALS AND METHODS We analyzed a random sample of one million individuals representing the 23 million enrollees selected from the National Health Insurance Research Database in Taiwan. Demographic characteristics, TCM usage, prescription patterns and mortality rate among stroke patients were analyzed. RESULTS We identified 23,816 patients who were newly diagnosed with stroke between 2001 and 2009 by their diagnostic codes (ICD-9-CM 430-438). Among them, 4302 patients had hemorrhagic stroke while 19,514 patients had ischemic stroke. Overall, 12% of the stroke patients (n=2862) were TCM users. The median interval between stroke onset to the first TCM consultation is 12.2 months. Among the TCM users, more than half (52.7%) of the patients received both Chinese herbal remedies and acupuncture/traumatology treatment. Bu-yang-huan-wu-tang and Dan-shen (Radix Salviae Miltiorrhizae; Salvia miltiorrhiza Bunge) was the most commonly prescribed Chinese herbal formula and single herb, respectively. TCM users had a higher incidence rate ratio in myalgia, myositis, fasciitis and insomnia than non-TCM users. Mental disorders such as anxiety and depression are common in both TCM and non-TCM users. Comparing with the non-TCM users, the TCM users had a lower mortality rate (adjusted hazard ratios were 0.44 in overall stroke, 0.50 in ischemic stroke and 0.25 in hemorrhagic stroke). CONCLUSION Adjunctive TCM use may reduce the risk of mortality rate among stroke patients. Bu-yang-huan-wu-tang and Dan-shen are the most common prescribed Chinese herbal formula and single herb for stroke patients, respectively. Future study investigating the anti-inflammatory and neuroprotective efficacy of Bu-yang-huan-wu-tang and Dan-shen in stroke is warranted.
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Affiliation(s)
- Chia-Chi Chang
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan.
| | - Yu-Chen Lee
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; Graduate Institute of Acupuncture Science, China Medical University, Taichung 404, Taiwan.
| | - Che-Chen Lin
- Health Data Management Office, China Medical University Hospital, Taichung 404, Taiwan.
| | - Chin-Hsien Chang
- Department of Traditional Chinese Medicine, En Chu Kong Hospital, New Taipei City 237, Taiwan; Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan.
| | - Cheng-Di Chiu
- Department of Neurosurgery, China Medical University Hospital, Taichung 404, Taiwan; School of Medicine, China Medical University, Taichung 404, Taiwan.
| | - Li-Wei Chou
- Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; Graduate Institute of Acupuncture Science, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 404, Taiwan.
| | - Mao-Feng Sun
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
| | - Hung-Rong Yen
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
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Wang J, Cheng X, Zhang X, Cheng J, Xu Y, Zeng J, Zhou W, Zhang Y. The anti-aging effects of LW-AFC via correcting immune dysfunctions in senescence accelerated mouse resistant 1 (SAMR1) strain. Oncotarget 2016; 7:26949-65. [PMID: 27105505 PMCID: PMC5053624 DOI: 10.18632/oncotarget.8877] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 04/03/2016] [Indexed: 12/18/2022] Open
Abstract
Although there were considerable advances in the anti-aging medical field, it is short of therapeutic drug for anti-aging. Mounting evidence indicates that the immunosenescence is the key physiopathological mechanism of aging. This study showed the treatment of LW-AFC, an herbal medicine, decreased the grading score of senescence, increased weight, prolonged average life span and ameliorated spatial memory impairment in 12- and 24-month-old senescence accelerated mouse resistant 1 (SAMR1) strain. And these anti-aging effects of LW-AFC were more excellent than melatonin. The administration of LW-AFC enhanced ConA- and LPS-induced splenocyte proliferation in aged SAMR1 mice. The treatment of LW-AFC not only reversed the decreased the proportions of helper T cells, suppressor T cells and B cells, the increased regulatory T cells in the peripheral blood of old SAMR1 mice, but also could modulate the abnormal secretion of IL-1β, IL-2, IL-6, IL-17, IL-23, GM-CSF, IFN-γ, TNF-α, TNF-β, RANTES, eotaxin, MCP-1, IL-4, IL-5, IL-10 and G-CSF. These data indicated that LW-AFC reversed the immunosenescence status by restoring immunodeficiency and decreasing chronic inflammation and suggested LW-AFC may be an effective anti-aging agent.
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Affiliation(s)
- Jianhui Wang
- Department of Neuroimmunopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
| | - Xiaorui Cheng
- Department of Neuroimmunopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
| | - Xiaorui Zhang
- Department of Neuroimmunopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
| | - Junping Cheng
- Department of Neuroimmunopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
| | - Yiran Xu
- Department of Neuroimmunopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
| | - Ju Zeng
- Department of Neuroimmunopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
| | - Wenxia Zhou
- Department of Neuroimmunopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
| | - Yongxiang Zhang
- Department of Neuroimmunopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing, China
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing, China
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Lin SK, Yan SH, Lai JN, Tsai TH. Patterns of Chinese medicine use in prescriptions for treating Alzheimer's disease in Taiwan. Chin Med 2016; 11:12. [PMID: 27028311 PMCID: PMC4810525 DOI: 10.1186/s13020-016-0086-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 03/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Certain Chinese medicine (CM) herbs and acupuncture may protect against Alzheimer's disease (AD). However, there is a lack of research regarding the use of CM in patients with AD. The aim of this study was to investigate CM usage patterns in patients with AD, and identify the Chinese herbal formulae most commonly used for AD. METHODS This retrospective, nationwide, population-based cohort study was conducted using a randomly sampled cohort of one million patients, selected from the National Health Insurance Research Database between 1997 and 2008 in Taiwan. CM use and the top ten most frequently prescribed formulae for treating AD were assessed, including average formulae dose and frequency of prescriptions. Demographic characteristics, including sex, age and insurance level were examined, together with geographic location. Existing medical conditions with the behavioral and psychological symptoms of dementia, and medications associated with CM were also examined. Factors associated with CM use were analyzed by multiple logistic regressions. RESULTS The cohort included 1137 newly diagnosed AD patients, who were given conventional treatment for AD between 1997 and 2008. Among them, 78.2 % also used CM treatments, including Chinese herbal remedies, acupuncture and massage manipulation. Female patients (aOR 1.57 with 95 % CI 1.16-2.13) and those living in urban areas (aOR 3.00 with 95 % CI 1.83-4.90 in the middle of Taiwan) were more likely to use CM. After adjusting for demographic factors, AD patients suffering from the behavioral and psychological symptoms of dementia were more likely to seek CM treatment than those with no symptoms (aOR 2.26 with 95 % CI 1.48-3.43 in patients suffering more than three symptoms). Bu-Zhong-Yi-Qi-Tang and Ji-Sheng-Shen-Qi-Wan were the two formulae most frequently prescribed by CM practitioners for treating AD. CONCLUSION Most people with AD who consumed herbal products used supplement qi, nourish the blood, and quiet the heart spirit therapy as complementary medicines to relieve AD-related symptoms, in addition to using standard anti-AD treatments.
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Affiliation(s)
- Shun-Ku Lin
- />Department of Chinese Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
| | - Sui-Hing Yan
- />Department of Neurology, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
| | - Jung-Nien Lai
- />The Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- />School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Tung-Hu Tsai
- />Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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31
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Isidoro C, Huang CC, Sheen LY. Report from the Second International Conference of Traditional and Complementary Medicine on Health 2015. J Tradit Complement Med 2016; 6:5-9. [PMID: 26870692 PMCID: PMC4738037 DOI: 10.1016/j.jtcme.2016.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The Second International Conference of Traditional and Complementary Medicine on Health was held from October 24th through 27th at the GIS National Taiwan University Convention Center in Taipei. Twenty-seven invited speakers, representative of fourteen Countries, delivered their lecture in front of an audience of more than two hundreds of attendees. In addition, a poster exhibition with seventy-two presenters completed the scientific sessions. The leitmotif of the Conference was to promote a common platform in which all medical knowledge is integrated to improve the health care system. Traditional medicine and complementary medicine are characterized by a holistic approach to prevent and cure diseases, making use of natural products and/or physical manipulations. In this context, the Conference emphasized the importance of the Quality Control and of standardized methods for the authentication, preparation and characterization of the herbal products and nutrient supplements, as well as the need for controlled clinical trials and for experimental studies to demonstrate the efficacy and to understand the underlying mechanisms of the preventive and curative treatments. In this report, we highlight the novel findings and the perspectives in Traditional and Complementary Medicine (TCM; 傳統暨互補醫學 chuán tǒng jì hù bǔ yī xué) that emerged during the conference.
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Affiliation(s)
- Ciro Isidoro
- Department of Health Sciences, Università del Piemonte Orientale, Via P. Solaroli 17, 28100 Novara, Italy
| | - Chia-Chi Huang
- Institute of Food Science and Technology, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan; Center for Food and Biomolecules, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan
| | - Lee-Yan Sheen
- Institute of Food Science and Technology, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan; Center for Food and Biomolecules, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan
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Lee AL, Chen BC, Mou CH, Sun MF, Yen HR. Association of Traditional Chinese Medicine Therapy and the Risk of Vascular Complications in Patients With Type II Diabetes Mellitus: A Nationwide, Retrospective, Taiwanese-Registry, Cohort Study. Medicine (Baltimore) 2016; 95:e2536. [PMID: 26817897 PMCID: PMC4998271 DOI: 10.1097/md.0000000000002536] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
With an increasing use of traditional Chinese medicine (TCM) in type 2 diabetes mellitus (T2DM), evidence of long-term benefit with adjunctive TCM treatment is limited. This study investigated whether the concurrent TCM treatment reduces the risk of vascular complications in T2DM patients by using a large population from National Health Insurance Research Database (NHIRD).We identified 33,457 adult patients with newly diagnosed T2DM using anti-diabetic agents from a random sample of one million beneficiaries in the NHIRD between January 1, 2000 and December 31, 2011. We recruited 1049 TCM users (received TCM over 30 days with a diagnosis of T2DM) and randomly selected 4092 controls as the non-TCM cohort at a ratio of 1:4 frequency-matched by age, sex, hypertension, hyperlipidemia, and index year. We investigated the prescription pattern of TCM and conducted a Cox proportional hazards regression to calculate the hazard ratios (HRs) of stroke, chronic kidney diseases (CKD), and diabetic foot between the 2 cohorts.In the TCM cohort, the prescription pattern of TCM was different between insulin and noninsulin patients. The most common herbs were Dan-Shen (Radix Salviae Miltiorrhizae) in noninsulin group and Da-Huang (Radix et Rhizoma Rhei) in insulin group. The most common formulae were Liu-Wei-Di-Huang-Wan in noninsulin group and Yu-Quan-Wan in insulin group. Although no significant reduction in the hazard ratio of CKD and diabetic foot, the incidence rate of stroke was 7.19 per 1000 person-years in the TCM cohort and 10.66 per 1000 person-years in the control cohort, respectively. After adjustment of age, sex, hypertension, hyperlipidemia, and antidiabetes agent use (including sulfonylureas, α-glucosidase, metformin, meglitinide, thiazolidinediones, and insulin), TCM cohorts were found to have a 33% decreased risk of stroke (95% CI = 0.46-0.97; P < 0.05).This population-based retrospective study showed that the complementary TCM therapy might associate with the decreased risk of stroke in T2DM, suggesting TCM as an adjunctive therapy for T2DM to prevent subsequent stroke.
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Affiliation(s)
- Ai-Lin Lee
- From the Department of Chinese Medicine, China Medical University Hospital, Taichung (A-LL, M-FS, H-RY); Department of Chinese Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi (B-CC); Management Office for Health Data (C-HM); Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung (H-RY); Research Center for Chinese Medicine and Acupuncture (M-FS, H-RY); and School of Chinese Medicine, China Medical University, Taichung, Taiwan (M-FS, H-RY)
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Lin YJ, Ho TJ, Yeh YC, Cheng CF, Shiao YT, Wang CB, Chien WK, Chen JH, Liu X, Tsang H, Lin TH, Liao CC, Huang SM, Li JP, Lin CW, Pang HY, Lin JG, Lan YC, Liu YH, Chen SY, Tsai FJ, Liang WM. Chinese Herbal Medicine Treatment Improves the Overall Survival Rate of Individuals with Hypertension among Type 2 Diabetes Patients and Modulates In Vitro Smooth Muscle Cell Contractility. PLoS One 2015; 10:e0145109. [PMID: 26699542 PMCID: PMC4689379 DOI: 10.1371/journal.pone.0145109] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 11/27/2015] [Indexed: 12/23/2022] Open
Abstract
Type 2 diabetes (T2D) is a chronic, multifactorial, and metabolic disorder accounting for 90% diabetes cases worldwide. Among them, almost half of T2D have hypertension, which is responsible for cardiovascular disease, morbidity, and mortality in these patients. The Chinese herbal medicine (CHM) prescription patterns of hypertension individuals among T2D patients have yet to be characterized. This study, therefore, aimed to determine their prescription patterns and evaluate the CHM effect. A cohort of one million randomly sampled cases from the National Health Insurance Research Database (NHIRD) was used to investigate the overall survival rate of CHM users, and prescription patterns. After matching CHM and non-CHM users for age, gender and date of diagnosis of hypertension, 980 subjects for each group were selected. The CHM users were characterized with slightly longer duration time from diabetes to hypertension, and more cases for hyperlipidaemia. The cumulative survival probabilities were higher in CHM users than in non-CHM users. Among these top 12 herbs, Liu-Wei-Di-Huang-Wan, Jia-Wei-Xiao-Yao-San, Dan-Shen, and Ge-Gen were the most common herbs and inhibited in vitro smooth muscle cell contractility. Our study also provides a CHM comprehensive list that may be useful in future investigation of the safety and efficacy for individuals with hypertension among type 2 diabetes patients.
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Affiliation(s)
- Ying-Ju Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Tsung-Jung Ho
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Division of Chinese Medicine, China Medical University Beigang Hospital, Yunlin, Taiwan
- Division of Chinese Medicine, Tainan Municipal An-Nan Hospital-China Medical University, Tainan, Taiwan
| | - Yi-Chun Yeh
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
| | - Chi-Fung Cheng
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
| | - Yi-Tzone Shiao
- Heart Center, China Medical University Hospital, Taichung, Taiwan
| | - Chang-Bi Wang
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
| | - Wen-Kuei Chien
- Biostatistics Center, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Jin-Hua Chen
- Biostatistics Center, College of Management, Taipei Medical University, Taipei, Taiwan
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Xiang Liu
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Hsinyi Tsang
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Ting-Hsu Lin
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Chu Liao
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shao-Mei Huang
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Ju-Pi Li
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Rheumatism Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Wen Lin
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Hao-Yu Pang
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Jaung-Geng Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Ching Lan
- Department of Health Risk Management, China Medical University, Taichung, Taiwan
| | - Yu-Huei Liu
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Yin Chen
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Asia University, Taichung, Taiwan
- * E-mail: (FJT); (WML)
| | - Wen-Miin Liang
- Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan
- * E-mail: (FJT); (WML)
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Bai-Hu-Jia-Ren-Shen-Tang Decoction Reduces Fatty Liver by Activating AMP-Activated Protein Kinase In Vitro and In Vivo. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:651734. [PMID: 26508982 PMCID: PMC4609840 DOI: 10.1155/2015/651734] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/14/2015] [Accepted: 08/11/2015] [Indexed: 02/07/2023]
Abstract
Obesity and associated conditions, such as type 2 diabetes mellitus (T2DM) and
nonalcoholic fatty liver disease (NAFLD), are currently a worldwide health problem.
In Asian traditional medicine, Bai-Hu-Jia-Ren-Shen-Tang (BHJRST) is widely used in
diabetes patients to reduce thirst. However, whether it has a therapeutic effect on
T2DM or NAFLD is not known. The aim of this study was to examine whether BHJRST
had a lipid-lowering effect using a HuS-E/2 cell model of fatty liver induced by palmitate
and in a db/db mouse model of dyslipidemia. Incubation of HuS-E/2 cells with palmitate
markedly increased lipid accumulation and expression of adipose triglyceride lipase (ATGL),
which is involved in lipolysis. BHJRST significantly decreased lipid accumulation and increased
ATGL levels and phosphorylation of AMP-activated protein kinase (AMPK)
and its primary downstream target, acetyl-CoA carboxylase (ACC), which are
involved in fatty acid oxidation. Furthermore, after twice daily oral administration
for six weeks, BHJRST significantly reduced hepatic fat accumulation in db/db mice,
as demonstrated by increased hepatic AMPK and ACC phosphorylation, reduced serum
triglyceride levels, and reduced hepatic total lipid content. The results show that BHJRST
has a lipid-lowering effect in the liver that is mediated by activation of the AMPK signaling pathway.
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Effects of the Chinese Herbal Formulation (Liu Wei Di Huang Wan) on the Pharmacokinetics of Isoflavones in Postmenopausal Women. BIOMED RESEARCH INTERNATIONAL 2015; 2015:902702. [PMID: 26146635 PMCID: PMC4471402 DOI: 10.1155/2015/902702] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 04/30/2015] [Indexed: 11/18/2022]
Abstract
A combination of soy isoflavones and Liu Wei Di Huang Wan (LWDHW) is potentially effective for postmenopausal women with intolerable vasomotor episodes who are not suitable candidates for hormonal therapy. The objective of this open-label, three-phase, crossover study was to determine the influence of both single and multiple oral doses of LWDHW on isoflavone pharmacokinetics in healthy postmenopausal women. Eleven subjects were assigned to receive the following regimens in a fixed sequence with washout periods of at least one week: Phase A, a single oral dose of soy milk; Phase B, a single oral dose of soy milk coadministered with LWDHW; and Phase C, multiple oral doses of LWDHW for 14 days followed by a single oral dose of soy milk. Blood samples were collected and mixed with β-glucuronidase/sulfatase to hydrolyze isoflavone conjugates to their respective aglycones (i.e., daidzein and genistein) and were determined using high performance liquid chromatography. The pharmacokinetic parameters analyzed were maximal plasma concentration (Cmax), time to reach peak concentration (Tmax), area under the plasma concentration-time curve (AUC), and half-life (t1/2). The results found no statistically significant differences in pharmacokinetic parameters of daidzein and genistein among the three regimens.
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Chang CM, Chu HT, Wei YH, Chen FP, Wang S, Wu PC, Yen HR, Chen TJ, Chang HH. The Core Pattern Analysis on Chinese Herbal Medicine for Sjögren's syndrome: A Nationwide Population-Based Study. Sci Rep 2015; 5:9541. [PMID: 25923413 PMCID: PMC5386216 DOI: 10.1038/srep09541] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 03/10/2015] [Indexed: 12/11/2022] Open
Abstract
This large-scale survey aimed to evaluate frequencies and patterns of Chinese herbal medicine (CHM) used for Sjögren's syndrome (SS) in Taiwan by analyzing the National Health Insurance Research Database (NHIRD) for cases in which CHM was used as an alternative therapy to Western medicine for improving patients' discomforts. We analyzed cases of SS principal diagnosis (ICD-9:710.2) with a catastrophic illness certificate (CIC) in traditional Chinese medicine (TCM) outpatient clinics from three cohorts of the Longitudinal Health Insurance Database (LHID) in the NHIRD between 2002 and 2011. CHM prescription patterns for SS were evaluated from claimed visitation files and corresponding prescription files. There were 15,914 SS patients with CIC (SS/CIC), and we found only 130 SS/CIC cases visiting TCM clinics in LHID2000, 133 in LHID2005, and 126 in LHID2010. After removing duplicate data, 366 SS/CIC and 4,867 visits were analyzed. The 50–59 year age group showed the highest ratio (29.51%) in both women and men. “Qi-Ju-Di-Huang-Wan” and “Xuan-Shen” (Scrophularia ningpoensis Hemsl.) was the most commonly used formula and single herb, respectively. “Qi-Ju-Di-Huang-Wan, Gan-Lu-Yin, Xuan-Shen, Mai-Men-Dong (Ophiopogon japonicus (L. f.) Ker-Gawl.), and Sheng-Di-Huang (raw Rehmannia glutinosa Libosch)” were the core pattern prescriptions in treating SS/CIC.
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Affiliation(s)
- Ching-Mao Chang
- 1] Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan [2] Graduate Institute of Clinical Medicine, and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsueh-Ting Chu
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yau-Huei Wei
- 1] Department of Biochemistry and Molecular Biology, School of Life Sciences, National Yang-Ming University, Taipei, Taiwan [2] Department of Medicine, Mackay Medical College, New Taipei, Taiwan
| | - Fang-Pey Chen
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shengwen Wang
- Cloud Computing and System Integration Division, National Center for High-Performance Computing, Taichung, Taiwan
| | - Po-Chang Wu
- Division of Rheumatology and Immunology and Department of Education, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Rong Yen
- Research Center for Chinese Medicine and Acupuncture, and School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Tzeng-Ji Chen
- 1] Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan [2] Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hen-Hong Chang
- Research Center for Chinese Medicine and Acupuncture, and School of Chinese Medicine, China Medical University, Taichung, Taiwan
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Lin SS, Tsai CL, Tu CY, Hsieh CL. Reducing drug-herb interaction risk with a computerized reminder system. Ther Clin Risk Manag 2015; 11:247-53. [PMID: 25733840 PMCID: PMC4337713 DOI: 10.2147/tcrm.s78124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background Traditional Chinese medicine (TCM) and Western medicine are both popular in Taiwan. Approximately 14.1% of Taiwanese residents use Western drugs and Chinese herbs concurrently; therefore, drug–herb interaction is critical to patient safety. This paper presents a new procedure for reducing the risk of drug interactions. Methods Hospital computer systems are modified to ensure that drug–herb interactions are automatically detected when a TCM practitioner is writing a prescription. A pop-up reminder appears, warning of interactions, and the practitioner may adjust doses, delete herbs, or leave the prescription unchanged. A pharmacist will receive interaction information through the system and provide health education to the patient. Results During the 2011–2013 study period, 256 patients received 891 herbal prescriptions with potential drug–herb interactions. Three of the 50 patients who concurrently used ginseng and antidiabetic drugs manifested hypoglycemia (fasting blood sugar level ≤70 mg/dL). Conclusion Drug–herb interactions can cause adverse reactions. A computerized reminder system can enable TCM practitioners to reduce the risk of drug–herb interactions. In addition, health education for patients is crucial in avoiding adverse reaction by the interactions.
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Affiliation(s)
- Sheng-Shing Lin
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan ; Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Lin Tsai
- Division of Chinese Medicine, Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Yeh Tu
- Division of Chinese Medicine, Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Liang Hsieh
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan ; Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan ; Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung, Taiwan
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Hsu PC, Tsai YT, Lai JN, Wu CT, Lin SK, Huang CY. Integrating traditional Chinese medicine healthcare into diabetes care by reducing the risk of developing kidney failure among type 2 diabetic patients: a population-based case control study. JOURNAL OF ETHNOPHARMACOLOGY 2014; 156:358-364. [PMID: 25178949 DOI: 10.1016/j.jep.2014.08.029] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 08/11/2014] [Accepted: 08/23/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Our previous study indicated that the traditional Chinese medicine (TCM) formula Liu-Wei-Di-Huang-Wan, which consists of six type of herbs, namely Rehmannia glutinosa (Gaertn.) DC., root, dried; Cornus officinalis Siebold & Zucc., fructus, dried; Dioscorea oppositifolia L., root, dried; Alisma plantago-aquatica subsp. orientale (Sam.) Sam., tuber, dried; Paeonia × suffruticosa Andrews, bark, dried; Poria cocos (Fr.) Wolf., sclerotium, dried, is the most frequently prescribed herbal formula used to treat type 2 diabetes patients. The aim of the study was to evaluate the integration of TCM into diabetes care in terms of how it reduces the risk of developing kidney failure. MATERIALS AND METHODS The Taiwan׳s National Health Insurance Research Database (NHIRD) provided detailed information of health care services for each patient and covers 98% of all Taiwan residents as of 2007. Case and control subjects were selected from the NHIRD. Two multivariable logistic regression models were constructed in order to explore two types of exposure assessments including prescription of TCMs (model 1) and prescription of different estimated dosages of Liu-Wei-Di-Huang-Wan (model 2). RESULTS Using logistic regression model 1, having used TCMs was independently associated with a decreased risk of kidney failure by multivariable analysis (OR=0.69, 95% CI: 0.61-0.77). Using logistic regression model 2, there was no difference between non-Liu-Wei-Di-Huang-Wan TCM users and Liu-Wei-Di-Huang-Wan TCM users in terms of the risk of developing kidney failure. Furthermore, there was also no linear dose-response trend when we used exposure to prescribed Liu-Wei-Di-Huang-Wan as a continuous variable (for non-Liu-Wei-Di-Huang-Wan TCM users, OR=0.68, 95% CI: 0.60-0.77; for TCM users consuming 1-30 g of Liu-Wei-Di-Huang-Wan, OR=0.69, 95% CI: 0.54-0.87; for >30 g of Liu-Wei-Di-Huang-Wan, OR=0.84, 95% CI: 0.49-1.44). CONCLUSIONS Integrating TCM healthcare into diabetes care was found to be associated with a decreased risk of developing kidney failure. Having recognized the use of TCM, exploring any potential interactions and adverse effects, and integrating both technologies into a holistic treatment system may be beneficial to the relief of diabetic nephropathy on patients with type 2 diabetes.
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Affiliation(s)
- Pei-Chien Hsu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 11221, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan; Department of Chinese Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Yueh-Ting Tsai
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 11221, Taiwan
| | - Jung-Nien Lai
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 11221, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan.
| | - Chien-Tung Wu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 11221, Taiwan
| | - Shun-Ku Lin
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 11221, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan
| | - Chung-Yu Huang
- Department of Traditional Medicine, Wan Fang Hospital, Taipei Medical University, Taipei , Taiwan
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Yu MC, Lin SK, Lai JN, Wei JCC, Cheng CY. The traditional Chinese medicine prescription patterns of Sjögren׳s patients in Taiwan: a population-based study. JOURNAL OF ETHNOPHARMACOLOGY 2014; 155:435-442. [PMID: 24905866 DOI: 10.1016/j.jep.2014.05.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 05/09/2014] [Accepted: 05/23/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Traditional Chinese medicines (TCM), when given for symptom relief, have gained widespread popularity among Sjögren׳s patients. The aim of this study was to analyze the utilization of TCM among Sjögren׳s patients in Taiwan. MATERIALS AND METHODS The usage, frequency of service, and the Chinese herbal products prescribed among Sjögren׳s patients were evaluated in a cohort of 1,000,000 beneficiaries recruited from the National Health Insurance Research Database. The logistic regression method was employed to estimate the odds ratios (ORs) for utilization of a TCM. RESULTS More than 90% of Sjögren׳s patients received TCM out-patient services at least once during the study period. Patients with secondary Sjögren׳s syndrome were more likely to seek TCM treatment than those with primary Sjögren׳s syndrome. The aOR for those suffering from at least one rheumatologic disease was 1.56 (95% CI: 1.26-1.93), those with two rheumatologic diseases was 1.98 (95% CI: 1.29-3.04), while those with three or more rheumatologic diseases was 7.86 (95% CI: 1.09-56.58). Compared to Sjögren׳s patients who used no medical treatment, the aOR for those who took one type of conventional medication was 1.55 (95% CI: 1.25-1.92), those who took two types was 1.98 (95% CI: 1.60-2.47) while those who took three or more types was 2.91 (95% CI: 2.20-3.84). Qi-Ju-Di-Huang-Wan (Lycium Berry, Chrysanthemum, and Rehmannia Pill) was the most frequently prescribed formula among Sjögren׳s patients. CONCLUSION Qi-Ju-Di-Huang-Wan is the most commonly prescribed Chinese herbal formula for Sjögren׳s syndrome and its effects should be taken into account by healthcare providers.
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Affiliation(s)
- Min-Chien Yu
- School of Medicine, Chung Shan Medical University, Department of Integrated Chinese and Western Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan; Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei City 112, Taiwan
| | - Shun-Ku Lin
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei City 112, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Ren-Ai Chinese Medicine Branch, Taipei, Taipei City 106, Taiwan
| | - Jung-Nien Lai
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei City 112, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei City 111, Taiwan.
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Division of Allergy, Immunology and Rheumatology, Department of Medicine, Chung Shan Medical University Hospital, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Chieh-Yuan Cheng
- Department of Oral and Maxillofacial Surgery, Mackay Memorial Hospital, Taipei, Taiwan
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Wang HM, Lin SK, Yeh CH, Lai JN. Prescription pattern of Chinese herbal products for adult-onset asthma in Taiwan: a population-based study. Ann Allergy Asthma Immunol 2014; 112:465-70. [PMID: 24656660 DOI: 10.1016/j.anai.2014.02.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 02/17/2014] [Accepted: 02/20/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Throughout the world, asthma can be a life-threatening disease. Traditional Chinese medicine (TCM) is commonly used among Taiwanese adults to control many diseases. OBJECTIVE To analyze the use of Chinese herbal products (CHPs) among adults with asthma in Taiwan. METHODS The use, frequency of service, and the type of CHP prescribed for asthma among adults with asthma were evaluated. The study group consisted of a randomly sampled cohort of 1,000,000 beneficiaries from the National Health Insurance Research Database. Logistic regression was used to estimate the odds ratios (ORs) for use of CHP. RESULTS Overall, 20,627 asthma patients (85.7%) used TCM. Ding-chuan-tang (panting-stabilizing decoction) was the most frequently prescribed CHP, followed by xiao-qing-long-tang (minor green-blue dragon decoction) and ma-xing-gan-shi-tang (ephedra, apricot kernel, licorice, and gypsum decoction). CONCLUSION The use of CHPs among adults with asthma appears high. Ding-chuan-tang containing ma-huang is the most commonly prescribed and consumed among adults with asthma.
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Affiliation(s)
- Hung-Ming Wang
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
| | - Shun-Ku Lin
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan
| | - Chia-Hao Yeh
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
| | - Jung-Nien Lai
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Chinese Medicine, Taipei City Hospital, Yangming Branch, Taipei, Taiwan.
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