Concurrent Use in Taiwan of Chinese Herbal Medicine Therapies among Hormone Users Aged 55 Years to 79 Years and Its Association with Breast Cancer Risk: A Population-Based Study

Background. The purpose of the present study was to analyze the concurrent use of Chinese herbal products (CHPs) among women aged 55 to 79 years who had also been prescribed hormonal therapies (HT) and its association with breast cancer risk. Methods. The use, frequency of service, and CHP prescribed among 17,583 HT users were evaluated from a random sample of 1 million beneficiaries from the National Health Insurance Research Database. A logistic regression method was used to identify the factors that were associated with the coprescription of a CHP and HT. Cox proportional hazards regressions were performed to calculate the hazard ratios (HRs) of breast cancer between the TCM nonusers and women who had undergone coadministration of HT and a CHP or CHPs. Results. More than one out of every five study subjects used a CHP concurrently with HT (CHTCHP patients). Shu-Jing-Huo-Xie-Tang was the most commonly used CHP coadministered with HT. In comparison to HT-alone users, the HRs for invasive breast cancer among CHTCHP patients were not significantly increased either in E-alone group or in mixed regimen group. Conclusions. The coadministration of hormone regimen and CHPs did not increase the risk of breast cancer

Increased Risk for Invasive Breast Cancer Associated with Hormonal Therapy: A Nation-Wide Random Sample of 65,723 Women Followed from 1997 to 2008

BACKGROUND: Hormonal therapy (HT) either estrogen alone (E-alone) or estrogen plus progesterone (E+P) appears to increase the risk for breast cancer in Western countries. However, limited information is available on the association between HT and breast cancer in Asian women characterized mainly by dietary phytoestrogens intake and low prevalence of contraceptive pills prescription. METHODOLOGY: A total of 65,723 women (20-79 years of age) without cancer or the use of Chinese herbal products were recruited from a nation-wide one-million representative sample of the National Health Insurance of Taiwan and followed from 1997 to 2008. Seven hundred and eighty incidents of invasive breast cancer were diagnosed. Using a reference group that comprised 40,052 women who had never received a hormone prescription, Cox proportional hazard models were constructed to determine the hazard ratios for receiving different types of HT and the occurrence of breast cancer. CONCLUSIONS: 5,156 (20%) women ever used E+P, 2,798 (10.8%) ever used E-alone, and 17,717 (69%) ever used other preparation types. The Cox model revealed adjusted hazard ratios (HRs) of 2.05 (95% CI 1.37-3.07) for current users of E-alone and 8.65 (95% CI 5.45-13.70) for current users of E+P. Using women who had ceased to take hormonal medication for 6 years or more as the reference group, the adjusted HRs were significantly elevated and greater than current users and women who had discontinued hormonal medication for less than 6 years. Current users of either E-alone or E+P have an increased risk for invasive breast cancer in Taiwan, and precautions should be taken when such agents are prescribed

Bian Zheng Lun Zhi

Background. Limited scientific evidence supports the positive effects of traditional Chinese medicine (TCM) for treating dysmenorrhea. Thus, an observation period of 3 months could verify the ancient indication that TCM treatments effectively alleviate menstrual cramps in women with primary dysmenorrhea or endometriosis. Methods. A prospective, nonrandomized study (primary dysmenorrhea and endometriosis groups) was conducted in women with dysmenorrhea for more than three consecutive menstrual cycles. All patients received TCM prescriptions based on bian zheng lun zhi theory 14 days before menstruation for a period of 12 weeks. Pain intensity was evaluated using a 10-cm visual analogue scale and two validated questionnaires (the Menstrual Distress Questionnaire and the World Health Organization Quality of Life questionnaire). Results. Of the initial 70 intent-to-treat participants, the women with dysmenorrhea reported significant alleviation of cramps during menstruation after the 12-week TCM treatment. Mixed model analysis revealed that TCM prescriptions were more effective in alleviating fatigue, hot flashes, dizziness, painful breasts, excitement, and irritability in the primary dysmenorrhea group (N=36) than in the endometriosis group (N=34). Conclusion. TCM prescriptions based on syndrome differentiation theory might be a potentially viable choice for treating painful menstruation and premenstrual symptoms after ruling out endometriosis

The Prescription Pattern of Chinese Herbal Products Containing Ginseng

Background. The purpose of our study is to analyze the association between prescribed Chinese herbal products (CHPs) containing Ginseng and the risk of endometrial cancer among tamoxifen (TMX) users and to identify any possible interactive effects between Ginseng and TMX with respect to preventing the development of subsequent endometrial cancer in an estrogen-dependent breast cancer population in Taiwan. Methods. All patients newly diagnosed with invasive breast cancer receiving tamoxifen treatment from January 1, 1998, to December 31, 2008, were selected from the National Health Insurance Research Database. The usage, frequency of service, and CHP-Ginseng prescribed across the 30,556 TMX-treated breast cancer (BC) survivors were evaluated. Logistic regression was employed to estimate the odds ratios (ORs) for the utilization of CHP-Ginseng. Cox’s proportional hazard regression was performed to calculate the hazard ratios (HRs) for endometrial cancer associated with Ginseng use among the TMX-treated BC cohort. Results. The HR for the development of endometrial cancer among breast cancer survivors who had ever taken Ginseng after TXM treatment was significantly decreased compared to those who never used CHP. Conclusion. A significant inhibitory relationship between Ginseng consumption and subsequent endometrial cancer less than 2 years after TMX treatment was detected among BC survivors

Endometriosis Patients in Taiwan: A Population-Based Study

Background. Traditional Chinese medicine (TCM), when given for symptom relief, has gained widespread popularity among women with endometriosis. The aim of this study was to analyze the utilization of TCM among women with endometriosis in Taiwan. Methods. The usage, frequency of service, and the Chinese herbal products prescribed for endometriosis, among endometriosis patients, were evaluated using a randomly sampled cohort of 1,000,000 beneficiaries recruited from the National Health Insurance Research Database. Results. Overall, 90.8% (N = 12, 788) of reproductive age women with endometriosis utilized TCM and 25.2% of them sought TCM with the intention of treating their endometriosis-related symptoms. Apart from the usage of either analgesics or more than one type of medical treatment, the odds of using TCM and Western medicine were similar in all types of conventional endometriosis treatment. However, endometriosis patients suffering from symptoms associated with endometriosis were more likely to seek TCM treatment than those with no symptoms. There were 21,056 TCM visits due to endometriosis and its related symptoms, of which more than 98% were treated with Chinese herbal products (CHPs). Conclusion. Gui-Zhi-Fu-Ling-Wan (Cinnamon Twig and Poria Pill) containing sedative and anti-inflammatory agents is the most commonly prescribed Chinese herbal formula mainly for the treatment of endometriosis-related symptomatic discomfort and the effects of these TCMs should be taken into account by healthcare providers

Is Duhuo Jisheng Tang containing Xixin safe? A four-week safety study

<p>Abstract</p> <p>Background</p> <p>Though the nephrotoxicity and carcinogenicity of aristolochic acid (AA) are known, its safety in clinical usage is not clear. This study aims to evaluate the safety of <it>Duhuo Jisheng Tang </it>(DJT) in a four-week study to treat osteoarthritis (OA) of the knee.</p> <p>Methods</p> <p>A qualitative and quantitative investigations on DJT were conducted. A list of adverse events (AEs), complete blood counts, and liver and kidney function tests were measured for participants with knee OA at their scheduled hospital visits. Each detected AEs was independently assessed for severity and causality by site investigators (Chinese medical doctors) and study nurses.</p> <p>Results</p> <p>A total of 71 eligible subjects were included in the clinical study where 287 AEs were reported. DJT did not contain detectable aristolochic acid (AA) under thin-layer chromatography (TLC) analysis and gas chromatography coupled with mass spectrometry (GC-MS). There were no significant changes in liver or kidney functions.</p> <p>Conclusion</p> <p>In four-week use of DJT, no renal tubular damage, no severe incidences of AEs and adverse drug reactions (ADRs) were observed. The present study obtained safety data from active surveillance of DJT.</p

Non-Typhoidal Salmonella and the Risk of Kawasaki Disease: A Nationwide Population-Based Cohort Study

ObjectiveThe aim of this study was to investigate the relationship between non-typhoidal Salmonella (NTS) infection and the risk of Kawasaki disease (KD) by using a nationwide population-based data set in Taiwan.MethodsIn this retrospective cohort study, we enrolled 69,116 patients under 18 years of age, with NTS from January 1st, 2000, to December 31st, 2013, using the population-based National Health Insurance Research Database of Taiwan. A comparison group without NTS was matched (at a 1:4 ratio) by propensity score. The two cohorts were followed from the initial diagnosis of NTS until the date of KD development or December 31st, 2013. Cox proportional hazard regression analysis was conducted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after adjusting for covariates. Also, we conducted sensitivity analyses to examine our findings.ResultsAfter adjusting for covariates, the risk of KD for the children with NTS was significantly higher than that of the comparison group (hazard ratio = 1.31; 95% confidence interval = 1.03-1.66; p &lt; 0.01). Stratified analysis showed that the associated risk of the investigated outcome was significant in children aged ≤2 years (aHR= 1.31, 95% C.I. 1.02-1.69), in female patients (aHR= 1.46, 95% C.I. 1.03-2.08), and in those without allergic diseases.ConclusionsNTS is associated with an increased risk of KD in Taiwanese children