Characteristics of traditional Chinese medicine use in patients with rheumatoid arthritis in Taiwan: A nationwide population-based study.
BACKGROUND
Large-scale study of traditional Chinese medicine (TCM) usage among patients with rheumatoid arthritis (RA) is lacking. The aim of this study is to evaluate the TCM usage among RA patients in Taiwan.


METHODS
We examined the "registry for catastrophic illness patient dataset" of the National Health Insurance Research Database (NHIRD; n=23 million people) in Taiwan. Patients (n=25,263) newly diagnosed as RA in 2001-2009 were included and then followed-up until the end of 2011. Based on the medical utilization, they were further categorized into TCM users (n= 6891; 27.3%) and non-TCM users (n=18,372; 72.7%). The demographic data and core prescription patterns of the TCM users were analyzed.


RESULTS
Compared to non-TCM user, TCM users were younger (mean age: 49.6 versus 54.0 years), had a higher female/male ratio (82.7%/17.3% versus 74.1%/25.9%), resided in more urbanized area. Herbal remedies were the most commonly used therapeutic approach (76.4%), followed by combining acupuncture (21.1%). The frequency of outpatient visits in TCM users was higher across all disease categories except circulatory system. The most commonly prescribed formula and herb was Shang-Jong-Shiah-Tong-Yong-Tong-Feng-Wan and Rhizoma Corydalis, respectively. The analysis of core pattern revealed that Dang-Gui-Nian-Tong-Tang, Shu-Jing-Huo-Xie-Tang, Gui-Zhi-Shao-Yao-Zhi-Mu-Tang, Myrrha and Olibanum, were among the most frequently used combinations. RA patients who had anxiety and depression, allergic rhinitis, osteoporosis, menstrual disorder, and menopausal syndrome were prone to have more TCM visits compared to non-TCM users.


CONCLUSIONS
Our population-based study revealed the high prevalence and specific usage patterns of TCM in the RA patients in Taiwan. The information could be used for further pharmacological investigation and clinical trials.
Graduate Institute of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan.
Ming-Cheng
MC
Huang
Graduate Institute of Clinical Medicine, and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Fu-Tzu
FT
Pai
Health Data Management Office, China Medical University Hospital, Taichung 404, Taiwan.
Che-Chen
CC
Lin
Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; Graduate Institute of Clinical Medicine, and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Ching-Mao
CM
Chang
Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
Hen-Hong
HH
Chang
Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; Graduate Institute of Acupuncture Science, China Medical University, Taichung 404, Taiwan.
Yu-Chen
YC
Lee
Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
Mao-Feng
MF
Sun
Graduate Institute of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; School of Chinese Medicine, China Medical University, Taichung 404, Taiwan. Electronic address: hungrongyen@gmail.com.
Hung-Rong
HR
Yen
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002947:Cities; D004363:Drug Utilization / Q000706:statistics & numerical data; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D008517:Phytotherapy; D013624:Taiwan; D014505:Urban Population; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D004365:Drugs, Chinese Herbal
National health insurance research database; Rheumatoid arthritis; Rhizoma Corydalis; Shang-Jong-Shiah-Tong-Yong-Tong-Feng-Wan; Traditional Chinese medicine; complementary and alternative medicine