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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.
J Ethnopharmacol. 2014 Oct 28; 156:358-64.JE

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.

Authors+Show Affiliations

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.Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 11221, Taiwan.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. Electronic address: kareny@ms10.hinet.net.Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, No.155, Sec. 2, Li-Nong Road, Taipei 11221, Taiwan.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.Department of Traditional Medicine, Wan Fang Hospital, Taipei Medical University, Taipei , Taiwan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25178949

Citation

Hsu, Pei-Chien, et al. "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, vol. 156, 2014, pp. 358-64.
Hsu PC, Tsai YT, Lai JN, et al. 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. J Ethnopharmacol. 2014;156:358-64.
Hsu, P. C., Tsai, Y. T., Lai, J. N., Wu, C. T., Lin, S. K., & Huang, C. Y. (2014). 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, 156, 358-64. https://doi.org/10.1016/j.jep.2014.08.029
Hsu PC, et al. 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. J Ethnopharmacol. 2014 Oct 28;156:358-64. PubMed PMID: 25178949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Hsu,Pei-Chien, AU - Tsai,Yueh-Ting, AU - Lai,Jung-Nien, AU - Wu,Chien-Tung, AU - Lin,Shun-Ku, AU - Huang,Chung-Yu, Y1 - 2014/08/29/ PY - 2014/06/07/received PY - 2014/08/11/revised PY - 2014/08/23/accepted PY - 2014/9/3/entrez PY - 2014/9/3/pubmed PY - 2015/7/29/medline KW - Chinese herbal product KW - Diabetes KW - Kidney failure KW - Liu-Wei-Di-Huang-Wan KW - National Health Insurance Research Database KW - Traditional Chinese medicine SP - 358 EP - 64 JF - Journal of ethnopharmacology JO - J Ethnopharmacol VL - 156 N2 - 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. SN - 1872-7573 UR - https://www.unboundmedicine.com/medline/citation/25178949/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-8741(14)00623-0 DB - PRIME DP - Unbound Medicine ER -