title: Reduction of surgery rate in endometriosis patients who take Chinese medicine: a population-based retrospective cohort study.
abstract: OBJECTIVE
  Female patients have frequently utilized Chinese medicine (CM) to treat symptoms that could possibly be related to endometriosis. The objective of this population-based retrospective cohort study was to evaluate the relationship between CM use and subsequent surgery among patients with endometriosis.
  
  
  METHODS
  A total of 8,283 CM users were identified among the 22,488 endometriosis patients found in the National Health Insurance reimbursement database between 2000 and 2010. A control group was identified and consisted of 8,283 matched nonusers with the same disease. A Cox proportional regression analysis was performed in order to assess risk factors for surgery for the CM users and nonusers.
  
  
  RESULTS
  When compared to nonusers, CM users were significantly less likely to undergo surgery, with a hazard ratio of 0.47 (95% CI=0.421, 0.534) after adjusting for age, occupation, childbirth status, hypermenorrhea, iron-deficient anemia, dysmenorrhea, and amount of conventional medications. Among patients who had undergone surgery, the follow-up time was longer for CM users than for CM nonusers (p<0.001). Moreover, the most frequently used CM single and formula were Cyperus rotundus and Gui-zhi-fu-ling-wan, respectively.
  
  
  CONCLUSIONS
  These results suggest that whatever the underlying reason, CM provides an alternative option that reduces the incidence rate of surgery in endometriosis patients.
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan; School of Post-baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan. Electronic address: shanyusu@yahoo.com.tw.
authors.forename: Shan-Yu
authors.initials: SY
authors.lastname: Su
authors.affiliation: School of Medicine, China Medical University, Taichung 40402, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung 40402, Taiwan.
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.affiliation: Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University.
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.affiliation: Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90095-1772, USA.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Morisky
mesh_terms: D000328:Adult; D000368:Aged; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Chinese medicine; Endometriosis; Surgery