Hsieh Chuan-Fa, Chang Huan-Cheng, Huang Song-Lih, Chen Chien-Lung, Chen Wei-Ta, Yang Chen-Chang
Department of Medical Education and Research, Taiwan Landseed Hospital, No. 77, Guangtai Rd., Pingzhen Dist., Taoyuan 32449, Taiwan.
Center for General Education, Hsin Sheng College of Medical Care and Management, No. 418, Zhongxing Rd., Longtan Dist., Taoyuan 32555, Taiwan.
Evid Based Complement Alternat Med. 2017;2017:5632195. doi: 10.1155/2017/5632195. Epub 2017 Jul 17.
Chinese herbal medicines (CHMs) containing aristolochic acid (AA) are associated with chronic kidney disease (CKD), but some prescribed CHMs have been shown to possess renoprotective effects. We conducted a nationwide retrospective cohort study to delineate the role of prescribed CHMs on the CKD progression. Renoprotective CHM (RPCHM) was defined if a CHM contained dong chong xia cao ( (Berk.) Sacc.), da huang ( L), huang qi , dan shen ( Bge.), and dong quai ( (Oliv.) Diels) or belonged to specific mixture herbal formulations (Yishen capsule, Saireito, or Wen Pi Tang). Subjects who had ever used AA-containing CHMs, had cancer or HIV prior to CKD diagnosis, or died within the first month of CKD diagnosis were excluded. A total of 11,625 patients were eligible subjects. The adjusted hazard ratio (aHR) for all-cause mortality was 0.6 ( < 0.001) and 0.6 ( = 0.013) among subjects receiving RPCHMs containing and those receiving other RPCHMs, respectively. For CKD-related mortality, the aHR among subjects receiving RPCHMs containing was 0.6 ( = 0.025). The use of specific RPCHMs, especially those that contained , was associated with a lower risk of mortality among CKD patients.
含马兜铃酸(AA)的中草药与慢性肾脏病(CKD)相关,但一些常用的中草药已被证明具有肾脏保护作用。我们进行了一项全国性的回顾性队列研究,以阐明常用中草药在CKD进展中的作用。如果一种中草药含有冬虫夏草(中华虫草菌)、大黄、黄芪、丹参和当归,或者属于特定的混合草药配方(益肾胶囊、柴苓汤或温脾汤),则定义为具有肾脏保护作用的中草药(RPCHM)。曾使用含AA中草药、在CKD诊断前患有癌症或艾滋病毒,或在CKD诊断后第一个月内死亡的受试者被排除。共有11625名患者为符合条件的受试者。在接受含冬虫夏草的RPCHM的受试者和接受其他RPCHM的受试者中,全因死亡率的调整后风险比(aHR)分别为0.6(P<0.001)和0.6(P=0.013)。对于CKD相关死亡率,接受含冬虫夏草的RPCHM的受试者的aHR为0.6(P=0.025)。使用特定的RPCHM,尤其是那些含有冬虫夏草的RPCHM,与CKD患者较低的死亡风险相关。