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BMC Complementary Medicine and Therapies

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Open Access 01-12-2017 | Research article

The utilization of traditional Chinese medicine in patients with dysfunctional uterine bleeding in Taiwan: a nationwide population-based study

Authors: Yi-Rong Lin, Mei-Yao Wu, Jen-Huai Chiang, Hung-Rong Yen, Su-Tso Yang

Published in: BMC Complementary Medicine and Therapies | Issue 1/2017

Abstract

Background

Many patients with gynecological disorders seek traditional medicine consultations in Asian countries. This study intended to investigate the utilization of traditional Chinese medicine (TCM) in patients with dysfunctional uterine bleeding (DUB) in Taiwan.

Methods

We analyzed a cohort of one million individuals randomly selected from the National Health Insurance Research Database in Taiwan. We included 46,337 subjects with newly diagnosed DUB (ICD-9-CM codes 626.8) from January 1, 1997 to December 31, 2010. The patients were categorized into TCM seekers and non-TCM seekers according to their use of TCM.

Results

Among the subjects, 41,558 (89.69%) were TCM seekers and 4,779 (10.31%) were non-TCM seekers. Patients who were younger tended to be TCM seekers. Most of the patients had also taken Western medicine, especially tranexamic acid and non-steroidal anti-inflammatory drugs (NSAIDs). More than half of TCM seekers (55.41%) received combined treatment with both Chinese herbal remedies and acupuncture. The most commonly used TCM formula and single herb were Jia-Wei-Xiao-Yao-San (Bupleurum and Peony Formula) and Yi-Mu-Cao (Herba Leonuri), respectively. The core pattern of Chinese herbal medicine for DUB patients consisted of Jia-Wei-Xiao-Yao-San, Xiang-Fu (Rhizoma Cyperi), and Yi-Mu-Cao (Herba Leonuri).

Conclusions

TCM use is popular among patients with DUB in Taiwan. Further pharmacological investigations and clinical trials are required to validate the efficacy and safety of these items.

Pitkin J. Dysfunctional uterine bleeding. BMJ. 2007;334(7603):1110–1.CrossRefPubMedPubMedCentral

Munro MG, Critchley HO, Broder MS, Fraser IS. Disorders FWGoM: FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113(1):3–13.CrossRefPubMed

Jensen JT, Lefebvre P, Laliberte F, Sarda SP, Law A, Pocoski J, Duh MS. Cost burden and treatment patterns associated with management of heavy menstrual bleeding. J Women's Health (Larchmt). 2012;21(5):539–47.CrossRef

Cote I, Jacobs P, Cumming D. Work loss associated with increased menstrual loss in the United States. Obstet Gynecol. 2002;100(4):683–7.PubMed

Bradley LD, Gueye NA. The medical management of abnormal uterine bleeding in reproductive-aged women. Am J Obstet Gynecol. 2016;214(1):31–44.CrossRefPubMed

Bongers MY, Mol BW, Brolmann HA. Current treatment of dysfunctional uterine bleeding. Maturitas. 2004;47(3):159–74.CrossRefPubMed

Ray S, Ray A. Non-surgical interventions for treating heavy menstrual bleeding (menorrhagia) in women with bleeding disorders. Cochrane Database Syst Rev. 2016;11:CD010338.PubMed

Zhou J, Qu F. Treating gynaecological disorders with traditional Chinese medicine: a review. Afr J Tradit Complement Altern Med. 2009;6(4):494–517.PubMedPubMedCentral

Yen HR, Chen YY, Huang TP, Chang TT, Tsao JY, Chen BC, Sun MF. Prescription patterns of Chinese herbal products for patients with uterine fibroid in Taiwan: a nationwide population-based study. J Ethnopharmacol. 2015;171:223–30.CrossRefPubMed

10.

National Health Insurance Administration. National Health Insurance Annual Report 2015–2016. Taipie, Taiwan: National Health Insurance Administration, Ministry of Health and Welfare; 2015.

11.

Bensky D, Clavey S, Stoger E. Chinese Herbal Medicine: Materia Medica 3rd Ed. Seatle, WA, U.S.A.: Eastland Press; 2004.

12.

Scheid V, Bensky D, Ellis A, Barolet R. Chinese herbal medicine: formulas & strategies. Calfornia, U.S.A.: Eastland Press; 2009.

13.

Chan K, Shaw D, Simmonds MS, Leon CJ, Xu Q, Lu A, Sutherland I, Ignatova S, Zhu YP, Verpoorte R, et al. Good practice in reviewing and publishing studies on herbal medicine, with special emphasis on traditional Chinese medicine and Chinese materia medica. J Ethnopharmacol. 2012;140(3):469–75.CrossRefPubMed

14.

Huang MC, Pai FT, Lin CC, Chang CM, Chang HH, Lee YC, Sun MF, Yen HR. Characteristics of traditional Chinese medicine use in patients with rheumatoid arthritis in Taiwan: a nationwide population-based study. J Ethnopharmacol. 2015;176:9–16.CrossRefPubMed

15.

Liu C-Y, Hung Y, Chuang Y, Chen Y, Weng W, Liu J, Liang K. Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey. J Health Manag. 2006;4(1):1–22.

16.

Shih CC, Liao CC, Su YC, Tsai CC, Lin JG. Gender differences in traditional Chinese medicine use among adults in Taiwan. PLoS One. 2012;7(4):e32540.CrossRefPubMedPubMedCentral

17.

Pan JC, Tsai YT, Lai JN, Fang RC, Yeh CH. The traditional Chinese medicine prescription pattern of patients with primary dysmenorrhea in Taiwan: a large-scale cross sectional survey. J Ethnopharmacol. 2014;152(2):314–9.CrossRefPubMed

18.

Ushiroyama T, Ikeda A, Sakuma K, Ueki M. Changes in serum tumor necrosis factor (TNF-alpha) with kami-shoyo-san administration in depressed climacteric patients. Am J Chin Med. 2004;32(4):621–9.CrossRefPubMed

19.

Park DM, Kim SH, Park YC, Kang WC, Lee SR, Jung IC: The comparative clinical study of efficacy of Gamisoyo-San (Jiaweixiaoyaosan) on generalized anxiety disorder according to differently manufactured preparations: multicenter, randomized, double blind, placebo controlled trial. J Ethnopharmacol 2014, 158 Pt A:11–17.

20.

Xu F, Peng D, Tao C, Yin D, Kou J, Zhu D, Yu B. Anti-depression effects of Danggui-Shaoyao-san, a fixed combination of traditional Chinese medicine, on depression model in mice and rats. Phytomedicine. 2011;18(13):1130–6.CrossRefPubMed

21.

Hsu CS, Yang JK, Yang LL. Effect of "dang-qui-Shao-Yao-san" a Chinese medicinal prescription for dysmenorrhea on uterus contractility in vitro. Phytomedicine. 2006;13(1–2):94–100.CrossRefPubMed

22.

Usuki S, Higa TN, Soreya K. The improvement of luteal insufficiency in fecund women by tokishakuyakusan treatment. Am J Chin Med. 2002;30(2–3):327–38.CrossRefPubMed

23.

Namiki T, Sato H, Matsumoto Y, Kakikura H, Ueno K, Chino A, Okamoto H, Hisanaga A, Kaneko A, Kita T, et al. Identification of a predictive biomarker for the beneficial effect of keishibukuryogan, a kampo (Japanese traditional) medicine, on patients with climacteric syndrome. Evid Based Complement Alternat Med. 2014;2014:962109.CrossRefPubMedPubMedCentral

24.

Sun L, Liu L, Zong S, Wang Z, Zhou J, Xu Z, Ding G, Xiao W, Kou J. Traditional Chinese medicine Guizhi Fuling capsule used for therapy of dysmenorrhea via attenuating uterus contraction. J Ethnopharmacol. 2016;191:273–9.CrossRefPubMed

25.

Liao ZG, Liang XL, Zhu JY, Zhao GW, Yang M, Wang GF, Jiang QY, Chen XL. Correlation between synergistic action of radix Angelica Dahurica extracts on analgesic effects of corydalis alkaloid and plasma concentration of dl-THP. J Ethnopharmacol. 2010;129(1):115–20.CrossRefPubMed

26.

Chu H, Jin G, Friedman E, Zhen X. Recent development in studies of tetrahydroprotoberberines: mechanism in antinociception and drug addiction. Cell Mol Neurobiol. 2008;28(4):491–9.CrossRefPubMed

27.

Kim HG, Hong J, Huh Y, Park C, Hwang DS, Choi JH, Oh MS. Cyperi Rhizoma inhibits the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine- induced reduction in nigrostriatal dopaminergenic neurons in estrogen-deprived mice. J Ethnopharmacol. 2013;148(1):322–8.CrossRefPubMed

28.

Cheng H, Bo Y, Shen W, Tan J, Jia Z, Xu C, Li F. Leonurine ameliorates kidney fibrosis via suppressing TGF-beta and NF-kappaB signaling pathway in UUO mice. Int Immunopharmacol. 2015;25(2):406–15.CrossRefPubMed

29.

Huang H, Xin H, Liu X, Xu Y, Wen D, Zhang Y, Zhu YZ. Novel anti-diabetic effect of SCM-198 via inhibiting the hepatic NF-kappaB pathway in db/db mice. Biosci Rep. 2012;32(2):185–95.CrossRefPubMed

30.

Zhang Y, Guo W, Wen Y, Xiong Q, Liu H, Wu J, Zou Y, Zhu Y. SCM-198 attenuates early atherosclerotic lesions in hypercholesterolemic rabbits via modulation of the inflammatory and oxidative stress pathways. Atherosclerosis. 2012;224(1):43–50.CrossRefPubMed

31.

Liu X, Pan L, Gong Q, Zhu Y. Leonurine (SCM-198) improves cardiac recovery in rat during chronic infarction. Eur J Pharmacol. 2010;649(1–3):236–41.CrossRefPubMed

32.

Zhang JM, Li J, Liu EW, Wang H, Fan GW, Wang YF, Zhu Y, Ma SW, Gao XM. Danshen enhanced the estrogenic effects of Qing E formula in ovariectomized rats. BMC Complement Altern Med. 2016;16:181.CrossRefPubMedPubMedCentral

33.

Fan G, Zhu Y, Guo H, Wang X, Wang H, Gao X. Direct vasorelaxation by a novel phytoestrogen tanshinone IIA is mediated by nongenomic action of estrogen receptor through endothelial nitric oxide synthase activation and calcium mobilization. J Cardiovasc Pharmacol. 2011;57(3):340–7.CrossRefPubMed

34.

Fan GW, Gao XM, Wang H, Zhu Y, Zhang J, Hu LM, Su YF, Kang LY, Zhang BL. The anti-inflammatory activities of Tanshinone IIA, an active component of TCM, are mediated by estrogen receptor activation and inhibition of iNOS. J Steroid Biochem Mol Biol. 2009;113(3–5):275–80.CrossRefPubMed

35.

Nizamutdinova IT, Lee GW, Son KH, Jeon SJ, Kang SS, Kim YS, Lee JH, Seo HG, Chang KC, Kim HJ. Tanshinone I effectively induces apoptosis in estrogen receptor-positive (MCF-7) and estrogen receptor-negative (MDA-MB-231) breast cancer cells. Int J Oncol. 2008;33(3):485–91.PubMed

36.

Quan W, Liu F, Zhang Y, Xie C, Wu B, Yin J, Wang L, Zhang W, Zhang X, Wu Q. Antidepressant-like effects of magnesium lithospermate B in a rat model of chronic unpredictable stress. Pharm Biol. 2015;53(8):1168–75.CrossRefPubMed

37.

Chen HY, Huang BS, Lin YH, Su IH, Yang SH, Chen JL, Huang JW, Chen YC. Identifying Chinese herbal medicine for premenstrual syndrome: implications from a nationwide database. BMC Complement Altern Med. 2014;14:206.CrossRefPubMedPubMedCentral

Title: The utilization of traditional Chinese medicine in patients with dysfunctional uterine bleeding in Taiwan: a nationwide population-based study
Authors: Yi-Rong Lin
Mei-Yao Wu
Jen-Huai Chiang
Hung-Rong Yen
Su-Tso Yang
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Complementary Medicine and Therapies / Issue 1/2017
Electronic ISSN: 2662-7671
DOI: https://doi.org/10.1186/s12906-017-1939-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The utilization of traditional Chinese medicine in patients with dysfunctional uterine bleeding in Taiwan: a nationwide population-based study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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