Decreased overall mortality rate with Chinese herbal medicine usage in patients with decompensated liver cirrhosis in Taiwan

Abstract

Background: Liver cirrhosis is one of the main causes of the morbidity and mortality in liver diseases. Chinese herbal medicine (CHM) has long been used for the clinical treatment of liver diseases. This study was designed to explore the usage frequency and prescription patterns of CHM for patients with decompensated liver cirrhosis and to evaluate the long-term effects of CHM on overall mortality. Methods: Two thousand four hundred sixty-seven patients with decompensated liver cirrhosis (ICD-9-CM code: 571.2, 571.5, and 571.6) diagnosed between 2000 and 2009 in Taiwan were identified from the registry for catastrophic illness patients. Of these, 149 CHM users and 298 CHM non-users were matched for age, gender, and Charlson comorbidity index score. The chi-squared test, paired Student's t-test, Cox proportional hazard model, and Kaplan-Meier method were applied for various comparisons between these groups of patients. Results: CHM-treated patients showed a lower overall mortality risk compared with non-treated patients (Multivariable: p < 0.0001; HR: 0.54, 95% CI: 0.42-0.69). The cumulative incidence of overall mortality was lower in the CHM-treated group (stratified log-rank test, p = 0.0002). The strongest CHM co-prescription pattern-Yin-Chen-Hao-Tang (YCHT) → Long-Dan-Xie-Gan-Tang (LDXGT) had the highest support, followed by Zhi-Zi (ZZ) → Yin-Chen-Wu-Ling-San (YCWLS) and Bai-Hua-She-She-Cao (BHSSC) → Da-Huang (DaH). Conclusion: CHM, as adjunct therapy, might decrease the risk of overall mortality in patients with decompensated liver cirrhosis. CHM co-prescription patterns and network analysis showed that comprehensive herbal medicines have a protective role against liver fibrosis. Further studies are required to enhance the knowledge of safety and efficacy of CHM in patients with decompensated liver cirrhosis.

Ethnobotanical Survey on Bitter Tea in Taiwan

“…Therefore, Taiwanese bitter tea is used to reduce "liver fire" and improve liver health. Other commonly used traditional Chinese medicines with bitter flavor for treating liver diseases include Gentiana scabra Bunge, Artemisia capillaris, and S. baicalensis (Tsai et al, 2020). In addition, bitterness-imparting compounds have been extracted from Artemisia absinthium L., a medicinal plant with hepatoprotective effects and a strong bitter taste that has been traditionally used in Europe.…”

“…The heat-clearing and dampessdraining effects provided by the bitter taste are used to combat the discomfort caused by the summer rainy season (Wu, 2005). Moreover, according to a previous study, the administration of bitter drugs can help treat liver disease (Tsai et al, 2020). For example, Gentiana scabra Bunge, Artemisia capillaris Thunb., and Scutellaria baicalensis Georgi are the most classical and commonly used traditional Chinese medicines for liver disease (Tsai et al, 2020).…”

Effect of Chinese Herbal Medicine Therapy on Risks of Overall, Diabetes-Related, and Cardiovascular Diseases-Related Mortalities in Taiwanese Patients With Hereditary Hemolytic Anemias

“…In this study, the CHM clusters were investigated by network analysis as previously described ( Tsai et al, 2019a ; Cheng et al, 2019b ; Tsai et al, 2019b ; Chen CJ. et al, 2020 ; Tsai et al, 2020 ) using version 3.7.0 of Cytoscape ( https://cytoscape.org/ ). The red circle, the green circle, and the circle size indicate the herbal formula, a single herb, and the CHM prescription frequency, respectively.…”

Effect of Chinese Herbal Medicine Therapy on Overall and Cancer Related Mortality in Patients With Advanced Nasopharyngeal Carcinoma in Taiwan

“…The CHM prescription profile was investigated using association rule mining ( Yang et al, 2013 ). The association rule was also implemented as previously described for paired CHM combinations ( Tsai et al, 2019b ; Cheng et al, 2019 ; Tsai et al, 2019c ; Chen et al, 2021 ; Tsai et al, 2020 ) using SAS software (version 9.4; SAS Institute, Cary, NC, USA). The strength of association between paired CHM combinations (CHM products X and Y) was shown using the support value (X) (%), confidence value (CHM_X→ CHM_Y; %), and lift value as previously described ( Tsai et al, 2019c ; Chen et al, 2021 ; Tsai et al, 2020 ) ( Table 4 ).…”

“…Network analysis for CHM clusters was accomplished as previously described ( Tsai et al, 2019b ; Cheng et al, 2019 ; Tsai et al, 2019c ; Chen et al, 2021 ; Tsai et al, 2020 ) using Cytoscape ( https://cytoscape.org/ , version 3.7.0). The herbal formula is shown as a red circle, and a single herb is expressed as a green circle.…”