title: Complementary traditional Chinese medicine use in Children with cerebral palsy: a nationwide retrospective cohort study in Taiwan.
abstract: BACKGROUND
  Complementary traditional Chinese medicine (TCM) has been used to treat patients with cerebral palsy (CP). However, large-scale surveys examining its use in the treatment of CP and associated disorders are lacking.
  
  
  METHODS
  We enrolled 11,218 patients ≤ 18 years of age with CP in the Taiwanese National Health Insurance Research Database from 1995 to 2011. Patients were categorized as TCM users (n = 6,997; 62.37%) and non-TCM users (n = 4,221; 37.63%) based on the inclusion of TCM in their treatment plan.
  
  
  RESULTS
  Children with higher proportions of complementary TCM use were male, younger, and lived in urbanized areas. Most TCM users (n = 5332, 76.2%) visited TCM outpatient departments more than 20 times per year. In both groups, the three most common reasons for clinical visits were problems of the nervous system, respiratory system, and digestive system. Acupuncture was commonly used in problems of injury, musculoskeletal system and connective tissue, and nervous system. Chinese herbal medicine was used to improve the primary symptoms of CP in patients, as well as its associated disorders. The incidence rate ratios in allergic rhinitis, dyspepsia, menstrual disorders, and musculoskeletal system and connective tissue diseases among TCM users were significantly higher than non-TCM users. Although patients receiving complementary TCM therapies had higher medical expenditure for utilizing outpatient clinical consultations, their medical costs for visiting ER and hospitalization were significantly lower than that of non-TCM user within one year of the diagnosis of CP.
  
  
  CONCLUSIONS
  This study was a large-scale survey to characterize patterns of complementary TCM use among children with CP. The complementary use of TCM in children with CP was considerably high. Future clinical trials and basic researches can be developed based on the findings of this study.
authors.affiliation: Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.|Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, NO. 2, Min-Sheng Road. Dalin Town, Chiayi, Taiwan, Republic of China.
authors.forename: Hou-Hsun
authors.initials: HH
authors.lastname: Liao
authors.affiliation: Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.|Department of Chinese Medicine, China Medical University Hospital, 2 Yude Road, North District, Taichung, 404, Taiwan.|Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan.|Research Center for Chinese Herbal Medicine, China Medical University, Taichung, Taiwan.|Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hung-Rong
authors.initials: HR
authors.lastname: Yen
authors.affiliation: Management Office for Health Data, China Medical University Hospital, 2 Yude Road, North District, Taichung, 404, Taiwan.
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, 2 Yude Road, North District, Taichung, 404, Taiwan.|Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, 91 Hsueh-Shih Road, North District, Taichung, Taiwan.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Mei-Yao
authors.initials: MY
authors.lastname: Wu
authors.affiliation: Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, 91 Hsueh-Shih Road, North District, Taichung, Taiwan.|Department of Physical Medicine and Rehabilitation, China Medical University Hospital, 2 Yude Road, North District, Taichung, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Chou
authors.affiliation: Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.|Department of Chinese Medicine, China Medical University Hospital, 2 Yude Road, North District, Taichung, 404, Taiwan.
authors.forename: Mao-Feng
authors.initials: MF
authors.lastname: Sun
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, 2 Yude Road, North District, Taichung, 404, Taiwan. tchang0604@yahoo.com.tw.|School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. tchang0604@yahoo.com.tw.
authors.forename: Tung-Ti
authors.initials: TT
authors.lastname: Chang
mesh_terms: D015670:Acupuncture Therapy; D000293:Adolescent; D002547:Cerebral Palsy / Q000188:drug therapy / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D012189:Retrospective Studies; D013624:Taiwan
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Acupuncture; Cerebral palsy; Epidemiology; Medical expenditure; National health insurance research database; Rehabilitation; Traditional Chinese medicine