Lin Sheng-Shing, Tsai Hsin-Hui, Tsai Daniel Hsiang-Te, Tsai Chiu-Lin, Itokazu Nanae, Lin Jaung-Geng, Lai Edward Chia-Cheng, Lin Hsiang-Wen, Hou Yu-Chang
Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
BMC Complement Med Ther. 2025 Jul 2;25(1):216. doi: 10.1186/s12906-025-04945-4.
The patterns of Chinese medicine prescriptions, corresponding diagnoses, co-morbidities, and Western medication (WM) use among patients with cardiac or vascular-related diseases are uncertain. This research aimed to examine the patterns of Chinese medications (CMs, specifically in terms of extract granules), corresponding diagnoses, co-morbidities, and the use of WMs within specified follow-up periods among patients with potential of recurrent cardiac or vascular-related diseases and relevant outcomes.
We conducted a retrospective cohort study using Taiwan's National Health Insurance Research Database. We enrolled patients with newly diagnosed cardiac or vascular-related diseases without cancer(s), transplantation, bleeding diagnoses, or catastrophic illness during the 2-year period prior to the corresponding diagnosis. Prior and non-prior CM users were matched based on their propensity scores. Finally, we compared the CM and WM patterns prescribed by physicians, and co-morbidities in the 6 months following the diagnosis and the secondary cardiac or vascular-related events in the 2 years following the diagnosis between the two groups using the standardized mean difference.
Of 191,025 patients with newly diagnosed cardiac or vascular-related diseases, 39,341 (20.60%) were prescribed CMs. Moreover, after propensity score matching, we identified 39,168 prior CM users and 39,168 non-prior CM users. Regardless of prior CM use, both groups had a relatively high rate of comorbidities; CM or specific WM use; and incidence of severe cardiovascular, cerebrovascular, or thromboembolic events (33.81% vs. 31.97%) and severe bleeding (18.32% vs. 16.57%). Only CM exposure within 6 months after the index date differed significantly between the groups (73.51% vs. 30.34%).
We found that over 30% of patients with newly diagnosed cardiac or vascular disease initiated CM use, while 73.5% of prior CM users continued. This finding highlights the need for healthcare professionals to carefully assess the risk-to-benefit ratio of CM use alongside WMs for patients with cardiac or vascular-related diseases.
患有心脏或血管相关疾病的患者使用中药方剂、相应诊断、合并症及西药的模式尚不确定。本研究旨在探讨有复发性心脏或血管相关疾病潜在风险的患者在特定随访期内的中药（具体为中药配方颗粒）使用模式、相应诊断、合并症、西药使用情况及相关结局。
我们利用台湾地区全民健康保险研究数据库进行了一项回顾性队列研究。我们纳入了在相应诊断前两年内新诊断为心脏或血管相关疾病且无癌症、移植、出血诊断或重大疾病的患者。根据倾向得分对既往使用中药和未使用中药的患者进行匹配。最后，我们使用标准化均值差比较了两组在诊断后6个月内医生开具的中药和西药模式、合并症以及诊断后2年内继发的心脏或血管相关事件。
在191,025例新诊断为心脏或血管相关疾病的患者中，39,341例（20.60%）使用了中药。此外，经过倾向得分匹配后，我们确定了39,168例既往使用中药的患者和39,168例未使用中药的患者。无论是否既往使用中药，两组的合并症发生率、中药或特定西药的使用率、严重心血管、脑血管或血栓栓塞事件的发生率（33.81%对31.97%）以及严重出血的发生率（18.32%对16.57%）都相对较高。两组之间仅在索引日期后6个月内的中药暴露情况存在显著差异（73.51%对30.34%）。
我们发现，超过30%新诊断为心脏或血管疾病的患者开始使用中药，而73.5%的既往使用中药患者继续使用。这一发现凸显了医疗保健专业人员需要仔细评估心脏或血管相关疾病患者使用中药与西药时的风险效益比。
