Traditional Chinese medicine attenuates hospitalization and mortality risks in diabetic patients with carcinoma in situ in Taiwan

Li-Jen Tsai; Chi-Hsiang Chung; Chien-Jung Lin; Sheng-Chiang Su; Feng-Chih Kuo; Jhih-Syuan Liu; Kuan-Chan Chen; Li-Ju Ho; Chih-Chun Kuo; Chun-Yung Chang; Ming-Hsun Lin; Nain-Feng Chu; Chien-Hsing Lee; Chang-Hsun Hsieh; Yi-Jen Hung; Po-Shiuan Hsieh; Fu-Huang Lin; Chieh-Hua Lu; Wu-Chien Chien

doi:10.1016/j.imr.2021.100831

Traditional Chinese medicine attenuates hospitalization and mortality risks in diabetic patients with carcinoma in situ in Taiwan

Integr Med Res. 2022 Jun;11(2):100831. doi: 10.1016/j.imr.2021.100831. Epub 2021 Dec 28.

Authors

Li-Jen Tsai¹, Chi-Hsiang Chung^{2

3}, Chien-Jung Lin⁴, Sheng-Chiang Su⁵, Feng-Chih Kuo⁵, Jhih-Syuan Liu⁵, Kuan-Chan Chen⁵, Li-Ju Ho⁵, Chih-Chun Kuo⁵, Chun-Yung Chang⁵, Ming-Hsun Lin⁵, Nain-Feng Chu⁵, Chien-Hsing Lee^{5

6}, Chang-Hsun Hsieh⁵, Yi-Jen Hung^{5

7}, Po-Shiuan Hsieh^{6

8}, Fu-Huang Lin², Chieh-Hua Lu^{5

6}, Wu-Chien Chien^{2

6}

Affiliations

¹ Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan (Province of China).
² School of Public Health, National Defense Medical Center, Taipei, Taiwan (Province of China).
³ Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan (Province of China).
⁴ Department of Chinese Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China).
⁵ Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China).
⁶ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China).
⁷ Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China).
⁸ Department of Physiology and Biophysics, National Defense Medical Center, Taipei, Taiwan (Province of China).

Abstract

Background: Diabetic patients are at high risk of developing cancer. Traditional Chinese medicine (TCM) has become increasingly popular as an adjuvant treatment for patients with chronic diseases, and some studies have identified its beneficial effect in diabetic patients with cancer. The purpoes of this study was to outline the potential of TCM to attenuate hospitalization and mortality rates in diabetic patients with carcinoma in situ (CIS).

Methods: A total of 6,987 diabetic subjects with CIS under TCM therapy were selected from the National Health Insurance Research Database of Taiwan, along with 38,800 of 1:1 sex-, age-, and index year-matched controls without TCM therapy. Cox proportional hazard analysis was conducted to compare hospitalization and mortality rates during an average of 15 years of follow-up.

Results: A total of 3,999/1,393 enrolled-subjects (28.62%/9.97%) had hospitalization/mortality, including 1,777/661 in the TCM group (25.43%/9.46%) and 2,222/732 in the control group (31.80%/10.48%). Cox proportional hazard regression analysis showed a lower rate of hospitalization and mortality for subjects in the TCM group (adjusted HR=0.536; 95% CI=0.367-0.780, P<0.001; adjusted HR=0.783; 95% CI=0.574-0.974, P = 0.022). Kaplan-Meier analysis showed that the cumulative risk of hospitalization and mortality in the case and control groups was significantly different (log rank, P<0.001 and P = 0.011, respectively).

Conclusions: Diabetic patients with CIS under TCM therapy were associated with lower hospitalization and mortality rates compared to those without TCM therapy. Thus, TCM application may reduce the burden of national medical resources.

Keywords: National Health Insurance Research Database; Traditional Chinese medicine; carcinoma in situ; diabetes; mortality.