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Characteristics of traditional Chinese medicine usage in patients with stroke in Taiwan: A nationwide population-based study.
J Ethnopharmacol. 2016 Jun 20; 186:311-321.JE

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.

Authors+Show Affiliations

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. Electronic address: cheerpachang@gmail.com.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. Electronic address: d5167@mail.cmuh.org.tw.Health Data Management Office, China Medical University Hospital, Taichung 404, Taiwan. Electronic address: a21745@mail.cmuh.org.tw.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. Electronic address: 01399@km.eck.org.tw.Department of Neurosurgery, China Medical University Hospital, Taichung 404, Taiwan; School of Medicine, China Medical University, Taichung 404, Taiwan. Electronic address: cdchiu@yahoo.com.tw.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. Electronic address: chouliwe@gmail.com.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. Electronic address: maofeng@mail.cmuh.org.tw.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. Electronic address: hungrongyen@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27090345

Citation

Chang, Chia-Chi, et al. "Characteristics of Traditional Chinese Medicine Usage in Patients With Stroke in Taiwan: a Nationwide Population-based Study." Journal of Ethnopharmacology, vol. 186, 2016, pp. 311-321.
Chang CC, Lee YC, Lin CC, et al. Characteristics of traditional Chinese medicine usage in patients with stroke in Taiwan: A nationwide population-based study. J Ethnopharmacol. 2016;186:311-321.
Chang, C. C., Lee, Y. C., Lin, C. C., Chang, C. H., Chiu, C. D., Chou, L. W., Sun, M. F., & Yen, H. R. (2016). Characteristics of traditional Chinese medicine usage in patients with stroke in Taiwan: A nationwide population-based study. Journal of Ethnopharmacology, 186, 311-321. https://doi.org/10.1016/j.jep.2016.04.018
Chang CC, et al. Characteristics of Traditional Chinese Medicine Usage in Patients With Stroke in Taiwan: a Nationwide Population-based Study. J Ethnopharmacol. 2016 Jun 20;186:311-321. PubMed PMID: 27090345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of traditional Chinese medicine usage in patients with stroke in Taiwan: A nationwide population-based study. AU - Chang,Chia-Chi, AU - Lee,Yu-Chen, AU - Lin,Che-Chen, AU - Chang,Chin-Hsien, AU - Chiu,Cheng-Di, AU - Chou,Li-Wei, AU - Sun,Mao-Feng, AU - Yen,Hung-Rong, Y1 - 2016/04/14/ PY - 2015/10/28/received PY - 2016/04/11/revised PY - 2016/04/12/accepted PY - 2016/4/20/entrez PY - 2016/4/20/pubmed PY - 2017/3/4/medline KW - Bu-Yang-Huan-Wu-Tang KW - Cerebrovascular accident KW - National Health Insurance Research Database KW - Salvia miltiorrhiza Bunge KW - Stroke KW - Traditional Chinese medicine SP - 311 EP - 321 JF - Journal of ethnopharmacology JO - J Ethnopharmacol VL - 186 N2 - 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. SN - 1872-7573 UR - https://www.unboundmedicine.com/medline/citation/27090345/Characteristics_of_traditional_Chinese_medicine_usage_in_patients_with_stroke_in_Taiwan:_A_nationwide_population_based_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-8741(16)30209-4 DB - PRIME DP - Unbound Medicine ER -