Integrated Chinese and Western Medicine for Coronary Heart Disease Prevention in Polycystic Ovary Syndrome: A 19-Year Nationwide Cohort Study

Chung-Chih Liao; Chi-Hsien Chien; Teng-Shun Yu; Jung-Miao Li

doi:10.2147/JMDH.S442816

Integrated Chinese and Western Medicine for Coronary Heart Disease Prevention in Polycystic Ovary Syndrome: A 19-Year Nationwide Cohort Study

J Multidiscip Healthc. 2023 Dec 8:16:3959-3973. doi: 10.2147/JMDH.S442816. eCollection 2023.

Authors

Chung-Chih Liao^{1

2}, Chi-Hsien Chien¹, Teng-Shun Yu³, Jung-Miao Li^{4

5}

Affiliations

¹ Department of Post-Baccalaureate Veterinary Medicine, College of Medical and Health Science, Asia University, Taichung, 41354, Taiwan.
² Chuyuan Chinese Medicine Clinic, Taichung, 40455, Taiwan.
³ Management Office for Health Data, China Medical University Hospital, Taichung, 40459, Taiwan.
⁴ School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan.
⁵ Department of Chinese Medicine, China Medical University Hospital, Taichung, 40447, Taiwan.

Abstract

Background: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Chinese herbal medicine (CHM), a major branch of traditional Chinese medicine, has been reported to exert beneficial effects on PCOS symptoms. However, the relationship between CHM use and the risk of coronary heart disease (CHD) in patients with PCOS remains unclear. The study aimed to investigate the potential protective role of CHM on CHD incidence in patients with PCOS and to understand CHM prescription patterns for PCOS treatment.

Methods: This retrospective cohort study was performed using data from Taiwan's Longitudinal Health Insurance Database 2000 (LHID2000). Patients with PCOS were identified, and data on their demographic characteristics, comorbidities, and medication use were extracted. The patients were then divided into CHM and non-CHM users.

Results: Propensity score matching yielded two balanced cohorts of 2913 individuals each. CHM users demonstrated a 94% reduced risk of CHD compared to non-CHM users (adjusted hazard ratio, 0.06; 95% confidence interval, 0.04-0.1) during the 19-year follow-up period. Stratified analysis confirmed the benefits of CHM treatment on the incidence of CHD across various subgroups. The key elements identified in the CHM prescription patterns associated with reduced CHD risk were Xiang Fu, Yi Mu Cao, Jia Wei Xiao Yao San, and Gui Zhi Fu Ling Wan.

Conclusion: This study provides evidence that CHM may protect against CHD development in patients with PCOS. It is also highlight the most frequently prescribed CHM for mitigating CHD risk among patients with PCOS. These findings lay the groundwork for future studies to confirm and elucidate CHM's therapeutic mechanisms in PCOS-related CHD prevention, offering a significant contribution to the field.

Keywords: Chinese herbal medicine; coronary heart disease; polycystic ovary syndrome; prescription pattern; retrospective cohort study.

Grants and funding

This study is supported in part by the Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW112-TDU-B-212-144004), China Medical University Hospital (DMR-112-087). The funders had no role in the study design, data collection and analysis, the decision to publish, or preparation of the manuscript. No additional external funding was received for this study.