title: Effect of Chinese herbal medicine on stroke patients with type 2 diabetes.
abstract: BACKGROUND
  Complications of type 2 diabetes (T2D) include stroke, which is a cerebrovascular disturbance characterized by reduced blood flow in the brain, leading to death or physical disability. Chinese herbal medicine (CHM) has been widely used in ancient China for the treatment of diabetes and stroke by supplementing Qi and activating blood circulation.
  
  
  OBJECTIVE
  This study aimed to investigate the frequencies and patterns of CHM treatment for stroke patients with T2D and the outcomes of long-term use in Taiwan.
  
  
  METHODS
  We identified 3079 stroke patients (ICD-9-CM: 430-438) with T2D. We allocated 618 stroke patients, matched for age, gender, and T2D-to-stroke duration, to both CHM and non-CHM groups. Chi-square test, conditional multivariable logistic regression, Kaplan-Meier method, and the log-rank test were used in this study.
  
  
  RESULTS
  The CHM group was characterized by more cases of chronic obstructive pulmonary disease, ulcer disease, hyperlipidemia, tobacco use, and higher income. The cumulative survival probability was higher in the CHM group (P<0.001, log rank test); after adjusting for comorbidities, income, and urbanization level, this group also exhibited a lower mortality hazard ratio (0.37, 95% confidence interval [0.25-0.55]). Shu-Jing-Huo-Xue-Tang, Xue-Fu-Zhu-Yu-Tang, and Du-Huo-Ji-Sheng-Tang; and Dan-Shen, Niu-Xi, and Yan-Hu-Suo represented the top three formulas and herbs, respectively.
  
  
  CONCLUSIONS
  The use of CHM as adjunctive therapy may improve the overall survival (OS) of stroke patients with T2D. The list of the comprehensive herbal medicines that they used might be useful in future large-scale, randomized clinical investigations of agent effectiveness, safety, and potential interactions with conventional treatments in stroke 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; 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, 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: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Xiang
authors.initials: X
authors.lastname: Liu
authors.affiliation: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 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: 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: Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan. Electronic address: wmliang@mail.cmu.edu.tw.
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. Electronic address: yjlin.kath@gmail.com.
authors.forename: Ying-Ju
authors.initials: YJ
authors.lastname: Lin
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Chinese herbal medicine; Stroke; Type 2 diabetes