Hung Yu-Chiang, Tseng Ying-Jung, Hu Wen-Long, Chen Hsuan-Ju, Li Tsai-Chung, Tsai Pei-Yuan, Chen Hsin-Ping, Huang Meng-Hsuan, Su Fang-Yen
Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist., Kaohsiung 833, Taiwan; School of Chinese Medicine for Post Baccalaureate, I-Shou University, No.1, Sec. 1, Syuecheng Rd., Dashu District, Kaohsiung City 84001, Taiwan.
Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, No.123, Dapi Rd., Niaosong Dist., Kaohsiung 833, Taiwan.
PLoS One. 2015 Aug 31;10(8):e0137058. doi: 10.1371/journal.pone.0137058. eCollection 2015.
Combinations of Chinese herbal products (CHPs) are widely used for ischemic heart disease (IHD) in Taiwan. We analyzed the usage and frequency of CHPs prescribed for patients with IHD.
A nationwide population-based cross-sectional study was conducted, 53531 patients from a random sample of one million in the National Health Insurance Research Database (NHIRD) from 2000 to 2010 were enrolled. Descriptive statistics, the multiple logistic regression method and Poisson regression analysis were employed to estimate the adjusted odds ratios (aORs) and adjusted risk ratios (aRRs) for utilization of CHPs.
The mean age of traditional Chinese medicine (TCM) nonusers was significantly higher than that of TCM users. Zhi-Gan-Cao-Tang (24.85%) was the most commonly prescribed formula CHPs, followed by Xue-Fu-Zhu-Yu-Tang (16.53%) and Sheng-Mai-San (16.00%). The most commonly prescribed single CHPs were Dan Shen (29.30%), Yu Jin (7.44%), and Ge Gen (6.03%). After multivariate adjustment, patients with IHD younger than 29 years had 2.62 times higher odds to use TCM than those 60 years or older. Residents living in Central Taiwan, having hyperlipidemia or cardiac dysrhythmias also have higher odds to use TCM. On the contrary, those who were males, who had diabetes mellitus (DM), hypertension, stroke, myocardial infarction (MI) were less likely to use TCM.
Zhi-Gan-Cao-Tang and Dan Shen are the most commonly prescribed CHPs for IHD in Taiwan. Our results should be taken into account by physicians when devising individualized therapy for IHD. Further large-scale, randomized clinical trials are warranted in order to determine the effectiveness and safety of these herbal medicines.
中药复方制剂在台湾被广泛用于治疗缺血性心脏病（IHD）。我们分析了IHD患者使用中药复方制剂的情况及频率。
进行一项基于全国人口的横断面研究，纳入了2000年至2010年从“国民健康保险研究数据库”（NHIRD）中随机抽取的100万样本中的53531名患者。采用描述性统计、多因素逻辑回归方法和泊松回归分析来估计使用中药复方制剂的调整优势比（aORs）和调整风险比（aRRs）。
未使用中药的患者平均年龄显著高于使用中药的患者。炙甘草汤（24.85%）是最常处方的复方中药制剂，其次是血府逐瘀汤（16.53%）和生脉散（16.00%）。最常处方的单味中药是丹参（29.30%）、郁金（7.44%）和葛根（6.03%）。多因素调整后，年龄小于29岁的IHD患者使用中药的几率是60岁及以上患者的2.62倍。居住在台湾中部、患有高脂血症或心律失常的居民使用中药的几率也较高。相反，男性、患有糖尿病（DM）、高血压、中风、心肌梗死（MI）的患者使用中药的可能性较小。
炙甘草汤和丹参是台湾IHD患者最常处方的中药复方制剂。医生在为IHD患者制定个体化治疗方案时应考虑我们的研究结果。有必要进一步开展大规模、随机临床试验以确定这些草药的有效性和安全性。
