Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study

Yu-Chiang Hung; Ying-Jung Tseng; Wen-Long Hu; Hsuan-Ju Chen; Tsai-Chung Li; Pei-Yuan Tsai; Hsin-Ping Chen; Meng-Hsuan Huang; Fang-Yen Su

doi:10.1371/journal.pone.0137058

Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study

PLoS One. 2015 Aug 31;10(8):e0137058. doi: 10.1371/journal.pone.0137058. eCollection 2015.

Authors

Yu-Chiang Hung¹, Ying-Jung Tseng², Wen-Long Hu³, Hsuan-Ju Chen⁴, Tsai-Chung Li⁵, Pei-Yuan Tsai², Hsin-Ping Chen², Meng-Hsuan Huang², Fang-Yen Su²

Affiliations

¹ 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.
² 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.
³ 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; Fooyin University College of Nursing, No.151, Chinhsueh Rd., Ta-liao Dist., Kaohsiung City 831, Taiwan; Kaohsiung Medical University College of Medicine, No.100, Shihcyuan 1st Rd., Sanmin Dist., Kaohsiung City 807, Taiwan.
⁴ Management Office for Health Data, China Medical University Hospital, No.2 Yude Road, Taichung 40447, Taiwan; College of Medicine, China Medical University, No.91, Hsueh-Shih Road, Taichung 40402, Taiwan.
⁵ Graduate Institute of Biostatistics, College of Public Health, China Medical University, No.91, Hsueh-Shih Road, Taichung 40402, Taiwan; Department of Healthcare Administration, College of Health Science, Asia University, No.500, Lioufeng Rd., Wufeng, Taichung 41354, Taiwan.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
Databases, Factual
Demography
Drug Combinations
Drug Prescriptions
Drugs, Chinese Herbal / therapeutic use*
Humans
Medicine, Chinese Traditional / methods
Middle Aged
Myocardial Ischemia / drug therapy*
Plants, Medicinal / chemistry
Practice Patterns, Physicians'
Salvia miltiorrhiza / chemistry
Taiwan

Substances

Drug Combinations
Drugs, Chinese Herbal
Xue-Fu-Zhu-Yu decoction
fructus schizandrae, radix ginseng, radix ophiopogonis drug combination

Grants and funding

The use of National Health Insurance Research Database (NHIRD) was supported by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW104-TDU-B-212-113002), China Medical University Hospital, Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM104010092), NRPB Stroke Clinical Trial Consortium (MOST 103-2325-B-039-006), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, Katsuzo and Kiyo Aoshima Memorial Funds, Japan, and the Ministry of Science and Technology of Taiwan (National Science Council) (NSC101-2632-B-039-001-MY3). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.