Chen Wei-Jen, Livneh Hanoch, Li Hsin-Hua, Wang Yu-Han, Lu Ming-Chi, Tsai Tzung-Yi, Chien Kuei-Yu
Department of Chinese Medicine, Dalin Tzu chi Hospital, The Buddhist Tzu chi Medical Foundation, Chiayi, 62247, Taiwan.
Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, 33301, Taiwan.
Int J Gen Med. 2023 Aug 7;16:3345-3354. doi: 10.2147/IJGM.S416705. eCollection 2023.
With population aging, sarcopenia and its accompanying risk of osteoporotic fracture has drawn increased attention. Nowadays, while Chinese herbal medicine (CHM) is often used as complementary therapy for many medical conditions, its effect against likelihood of osteoporotic fracture among sarcopenia subjects was not fully elucidated yet. We therefore conducted a population-level study to compare osteoporotic fracture risk for sarcopenia persons with or without CHM use.
Using the patient record from a nationwide insurance database, we recruited persons with newly diagnosed sarcopenia and simultaneously free of osteoporotic fracture between 2000 and 2010. Propensity score matching was then applied to randomly select sets of CHM users and non-CHM users. All of them were tracked until end of 2013 to measure the incidence and adjusted hazard ratios (HRs) for new new-onset fracture in multivariable Cox proportional hazards model.
Compared to non-CHM users, the CHM users indeed had a lower incidence of osteoporotic fracture (121.22 vs 156.61 per 1000 person-years). Use of CHM correlated significantly with a lower fracture likelihood after adjusting for potential covariates, and those receiving CHM treatment for more than two years experienced a remarkably lower risk by 73%. Uses of several herbal formulae were correlated to reduced risk of osteoporotic fracture, such as Caulis Spatholobi, Xuduan, Duzhong, Danshen, Shu-Jing-Huo-Xue-Tang, Du-Huo-Ji-Sheng-Tang, Shao-Yao-Gan-Cao-Tang, and Shen-Tong-Zhu-Yu -Tang.
Our study depicted that cumulative CHM exposure was inversely associated with osteoporotic fracture risk in a duration-dependent manner, implying that CHM treatment may be embraced as routine care in preventing incident osteoporotic fracture.
随着人口老龄化,肌肉减少症及其伴随的骨质疏松性骨折风险日益受到关注。如今,虽然中草药常被用作许多疾病的辅助治疗方法,但其对肌肉减少症患者骨质疏松性骨折可能性的影响尚未完全阐明。因此,我们进行了一项基于人群的研究,以比较使用或未使用中草药的肌肉减少症患者的骨质疏松性骨折风险。
利用全国保险数据库中的患者记录,我们招募了2000年至2010年间新诊断为肌肉减少症且同时无骨质疏松性骨折的患者。然后应用倾向评分匹配法随机选择中草药使用者和非使用者组。对所有患者进行跟踪,直至2013年底,以测量多变量Cox比例风险模型中新发骨折的发病率和调整后的风险比(HRs)。
与非中草药使用者相比,中草药使用者的骨质疏松性骨折发病率确实较低(每1000人年分别为121.22例和156.61例)。在调整潜在协变量后,使用中草药与较低的骨折可能性显著相关,接受中草药治疗超过两年的患者风险显著降低73%。几种草药配方的使用与降低骨质疏松性骨折风险相关,如鸡血藤、续断、杜仲、丹参、舒筋活血汤、独活寄生汤、芍药甘草汤和身痛逐瘀汤。
我们的研究表明,累积的中草药暴露与骨质疏松性骨折风险呈负相关,且与暴露时长有关,这意味着中草药治疗可作为预防骨质疏松性骨折的常规护理方法。