title: Characteristics of Chinese herbal medicine usage in ischemic heart disease patients among type 2 diabetes and their protection against hydrogen peroxide-mediated apoptosis in H9C2 cardiomyoblasts.
abstract: Evidence for long-term use of Chinese herbal medicine (CHM) as an adjuvant treatment in patients with type 2 diabetes (T2D) remains limited. This study aimed to assess the frequency of use, utilization patterns, and therapeutic effects of adjuvant CHM for ischemic heart disease (IHD) in patients with T2D in Taiwan. We identified 4620 IHD patients with T2D. After matching for age, gender, and insulin use, 988 subjects each were allocated to a CHM group and a non-CHM group. There were no differences in baseline characteristics except for comorbidities. The CHM group contained more cases with chronic obstructive pulmonary disease, hepatitis, ulcer disease, and hyperlipidemia. The cumulative survival probability was higher in CHM users than in matched non-CHM users aged 60 years or older (P < .0001, log rank test) regardless of gender (P = .0046 for men, P = .0010 for women, log rank test). Among the top 12 CHM combinations, Shu-Jing-Huo-Xue-Tang and Shao-Yao-Gan-Cao-Tang (13.6%) were the most common. This dual combination improved antiapoptotic activity in H2O2-exposed H9C2 cells by enhancing phosphorylation of glycogen synthase kinase-3β and p38 mitogen-activated protein kinase and could increase the survival of myocardial cells. Our study suggests that adjuvant CHM therapy may increase the survival probability and provides a comprehensive list for future investigations of the safety and efficacy of CHM for IHD patients with T2D.
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan.|Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.|Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan.
authors.forename: Fuu-Jen
authors.initials: FJ
authors.lastname: Tsai
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan.|Division of Chinese Medicine, China Medical University Beigang Hospital, Yunlin County, Taiwan.|Division of Chinese Medicine, Tainan Municipal An-Nan Hospital-China Medical University, Tainan, Taiwan.
authors.forename: Tsung-Jung
authors.initials: TJ
authors.lastname: Ho
authors.affiliation: Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Chi-Fung
authors.initials: CF
authors.lastname: Cheng
authors.affiliation: Heart Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Yi-Tzone
authors.initials: YT
authors.lastname: Shiao
authors.affiliation: Biostatistics Center, College of Management, Taipei Medical University, Taipei, Taiwan.
authors.forename: Wen-Kuei
authors.initials: WK
authors.lastname: Chien
authors.affiliation: Biostatistics Center, College of Management, Taipei Medical University, Taipei, Taiwan.|School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Chen
authors.affiliation: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Xiang
authors.initials: X
authors.lastname: Liu
authors.affiliation: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Hsinyi
authors.initials: H
authors.lastname: Tsang
authors.affiliation: Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ting-Hsu
authors.initials: TH
authors.lastname: Lin
authors.affiliation: Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chiu-Chu
authors.initials: CC
authors.lastname: Liao
authors.affiliation: Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shao-Mei
authors.initials: SM
authors.lastname: Huang
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan.|Rheumatism Research Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ju-Pi
authors.initials: JP
authors.lastname: Li
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Wen
authors.initials: CW
authors.lastname: Lin
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Jaung-Geng
authors.initials: JG
authors.lastname: Lin
authors.affiliation: Department of Health Risk Management, China Medical University, Taichung, Taiwan.
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Lan
authors.affiliation: Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.|Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Yu-Huei
authors.initials: YH
authors.lastname: Liu
authors.affiliation: Graduate Institute of Clinical Medical Science, Chang-Gung University, Taipei, Taiwan.
authors.forename: Chien-Hui
authors.initials: CH
authors.lastname: Hung
authors.affiliation: School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
authors.forename: Jung-Chun
authors.initials: JC
authors.lastname: Lin
authors.affiliation: Department of Cosmetic Science, Providence University, Taichung, Taiwan.
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Microbiology and Immunology, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chih-Ho
authors.initials: CH
authors.lastname: Lai
authors.affiliation: Department of Microbiology and Immunology, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Wen-Miin
authors.initials: WM
authors.lastname: Liang
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan.|Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ying-Ju
authors.initials: YJ
authors.lastname: Lin
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000187:drug effects*; D044466:Asian People; D015153:Blotting, Western; D002460:Cell Line; D002470:Cell Survival / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D000071679:Glycogen Synthase Kinase 3 beta / Q000378:metabolism; D006801:Humans; D006861:Hydrogen Peroxide / Q000494:pharmacology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008516:Medicine, Chinese Traditional / Q000706:statistics & numerical data; D008875:Middle Aged; D032386:Myoblasts, Cardiac / Q000187:drug effects* / Q000378:metabolism; D017202:Myocardial Ischemia / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology; D016877:Oxidants / Q000494:pharmacology; D010766:Phosphorylation / Q000187:drug effects; D008517:Phytotherapy / Q000379:methods / Q000706:statistics & numerical data; D051381:Rats; D013624:Taiwan; D048051:p38 Mitogen-Activated Protein Kinases / Q000378:metabolism
chemical_list: D004365:Drugs, Chinese Herbal; D016877:Oxidants; D006861:Hydrogen Peroxide; D000071679:Glycogen Synthase Kinase 3 beta; C000605508:Gsk3b protein, rat; D048051:p38 Mitogen-Activated Protein Kinases
keywords: Chinese herbal medicine; cardiomyoblasts; ischemic heart disease; oxidative stress; type 2 diabetes