Chiu Mu-Lin, Hsu Yu-Lung, Chen Chao-Jung, Li Te-Mao, Chiou Jian-Shiun, Tsai Fuu-Jen, Lin Ting-Hsu, Liao Chiu-Chu, Huang Shao-Mei, Chou Chen-Hsing, Liang Wen-Miin, Lin Ying-Ju
School of Chinese Medicine, China Medical University, Taichung, Taiwan.
Proteomics Core Laboratory, Department of Medical Research, Genetic Center, China Medical University Hospital, Taichung, Taiwan.
Front Pharmacol. 2021 Oct 8;12:730776. doi: 10.3389/fphar.2021.730776. eCollection 2021.
Aplastic Anemia (AA) is a rare but fatal hematologic disease that may occur at any age and especially higher in Asia. We investigated whether Chinese herbal medicine (CHM) is beneficial to AA patients as a complementary therapy using a nationwide population-based database in Taiwan between 2000-2016. Patient survival was estimated by Kaplan‒Meier survival analyses and Cox proportional-hazard model. CHM-users presented lower risks of overall and anemia-related mortalities when compared to non-users. The risk of overall mortality for CHM-users in AA patients was 0.70-fold [adjusted hazard ratio (aHR): 0.70, 95% confidence interval (CI): 0.66-0.74, < 0.001). The risk of anemia-related mortality was lower in CHM-users when compared to non-users (aHR: 0.46, 95% CI: 0.32-0.67, < 0.001). The association rule analysis revealed that CHM pairs were Ban-Zhi-Lian (BZL; D. Don)→Bai-Hua-She-She-Cao (BHSSC; (Willd.) Roxb.), followed by Dang-Gui (DG; (Oliv.) Diels)→Huang-Qi (HQi; (Fisch.) Bunge), and Xian-He-Cao (XHC; (Kitag.) Chu)→Gui-Pi-Tang (GPT). Network analysis showed that BZL, BHSSC, DG, HQi, XHC, GPT, and Dan-Shen (DanS; (H.Lév.) C.Y.Wu) were commonly used CHMs for AA patients. Therefore, further studies for these commonly prescribed herbs are needed in functional investigations in hematopoiesis-stimulating effect and large-scale randomized controlled trials (RCT) in bone marrow failure related diseases.
再生障碍性贫血（AA）是一种罕见但致命的血液疾病，可发生于任何年龄，在亚洲发病率尤其较高。我们利用台湾2000年至2016年基于全国人口的数据库，调查了中药作为辅助疗法对AA患者是否有益。通过Kaplan-Meier生存分析和Cox比例风险模型估计患者生存率。与未使用中药的患者相比，使用中药的患者总体死亡和贫血相关死亡风险较低。AA患者中使用中药的患者总体死亡风险为0.70倍[调整后风险比（aHR）：0.70，95%置信区间（CI）：0.66 - 0.74，P < 0.001]。与未使用中药的患者相比，使用中药的患者贫血相关死亡风险较低（aHR：0.46，95%CI：0.32 - 0.67，P < 0.001）。关联规则分析显示，中药配伍为半枝莲（BZL；Scutellaria barbata D. Don）→白花蛇舌草（BHSSC；Hedyotis diffusa (Willd.) Roxb.），其次是当归（DG；Angelica sinensis (Oliv.) Diels）→黄芪（HQi；Astragalus membranaceus (Fisch.) Bunge），以及仙鹤草（XHC；Agrimonia pilosa Ledeb. var. japonica (Kitag.) Chu）→归脾汤（GPT）。网络分析表明，BZL、BHSSC、DG、HQi、XHC、GPT和丹参（DanS；Salvia miltiorrhiza (H.Lév.) C.Y.Wu）是AA患者常用的中药。因此，需要对这些常用草药进行进一步研究，以探讨其在造血刺激作用方面的功能，并在骨髓衰竭相关疾病中开展大规模随机对照试验（RCT）。
