Association of Traditional Chinese Medicine Therapy with Risk of Total Hip Replacement in Patients with Nontraumatic Osteonecrosis of the Femoral Head: A Population-Based Cohort Study

Abstract

Background. Osteonecrosis of the femoral head (ONFH) contributes to 45% of total hip replacements (THRs) annually in Taiwan. Nontraumatic ONFH (NONFH) is multifactorial; no effective Western medicine is available to delay the disease process. This population-based cohort study investigated the association of traditional Chinese medicine (TCM) therapy with risk of THR in patients with NONFH. Methods. This retrospective study was conducted using claims data from all insured residents covered by the National Health Insurance from 2000 to 2010. We enrolled 1,680 newly diagnosed ONFH patients who had not undergone THR, before or within 6 months after diagnosis of ONFH; these patients did not exhibit hip fracture or dislocation before the endpoint. In total, 595 propensity score-matched pairs were selected from among 1,028 TCM users and 652 non-TCM users. The association between TCM use and risk of THR was analyzed using a Cox proportional hazard model. Kaplan-Meier and log rank tests were performed to plot the cumulative incidence of THR. Results. The mean follow-up periods were 5.00 years and 3.57 years for TCM and non-TCM cohorts, respectively. Compared to the non-TCM cohort, the TCM cohort had fewer patients undergoing THR surgery (25.4% vs. 18.2%, adjusted hazard ratio: 0.60, p<0.0001). The risk of reduction was noted in the group aged 30–59 years (adjusted hazard ratio: 0.56, p<0.0001), but there was no association with gender nor socioeconomic status. There was a significantly lower cumulative incidence of THR in TCM users (p<0.0001). Shu-Jing-Huo-Xue-Tang and Yan Hu Suo were the most frequently prescribed formula and single herb, respectively. Conclusions. NONFH patients using TCM had a lower risk of THR; the risk of reduction was noted in the group aged 30–59 years but was not associated with gender nor socioeconomic status. TCM might be useful in conservative treatment for NONFH.

Network Pharmacology-Based Prediction of the Active Ingredients and Potential Targets of Chinese Herbal Danyu Gukang Pills for Application to Osteonecrosis of the Femoral Head Disease

“…Accumulating evidence indicated that TCM may bene t the treatment of ONFH [11,24,25]. Nevertheless, this characteristic of TCM may make it di cult to further study of the underlying mechanisms.…”

Research Trends of Randomized Controlled Trial Studies on the Herbal Treatment of Avascular Necrosis of the Femoral Head Using China National Knowledge Infrastructure Database

“…대조군은 서양 약물 치료, 실험군은 탕약 치료를 시 행한 연구는 1편의 논문 26) 에서만 진행되어 메타분석을 수행하지 못하였다. 또는 경피적 천공과 같은 시술을 시행하고 있으나 그 효과에 대해서는 여전히 의문이 제기되고 있다 3,30,32) .…”

Tongue Manifestation in Patients with Osteonecrosis of the Femoral Head: A Cross‐sectional Study

“…3,4 While ONFH has become a serious challenge of public health, there is still a lack of standard treatment regimen to slow the disease progression currently. 5,6 In fact, several studies have shown that Traditional Chinese Medicine (TCM) can improve the quality of life in ONFH patients. [6][7][8][9] Tongue manifestation used as an important diagnostic skill is the vital component of the TCM diagnosis system to examine the disease conditions and pathological changes, which has been repeatedly verified by clinical TCM practitioners for more than 2000 years owing to its simple, noninvasive and valuable diagnostic procedure.…”