Identifying Prescription Patterns and Iron Supplementation With Chinese Herbal Medicine for Uterine Myoma in Taiwan: A Social Network Analysis of the Chang Gung Research Database

Abstract

Background: Uterine myoma is a common gynecological disease in women of reproductive age. Owing to surgery and treatment-related complications, many patients opt for alternative therapy, such as traditional Chinese medicine (TCM). However, there is no standard treatment protocol for TCM. This study aimed to investigate the prescription patterns of TCM for uterine myoma and compare differences between the Chang Gung Research Database (CGRD) and the National Health Insurance Research Database (NHIRD). Methods: Data of 217040 patients newly diagnosed with uterine myoma between 2005 and 2014 were retrieved from the CGRD using the International Classification of Diseases, Ninth Revision, Clinical Modification code for myoma and related symptoms. We analyzed patient demographics, frequencies and average daily doses of prescribed Chinese herbal formulas and single herbs, and iron supplementation doses. Associations between Chinese herbal formulas and single herbs commonly used for uterine myoma were analyzed by association rule mining (ARM) and social network analysis (SNA).Results: In total 45,436 patients used TCM. Most participants (49.1%) were aged 30–44 years. Jia-Wei-Xiao-Yao-San (28.2%; average daily dose 4.85 g) and Xiang-Fu (22.0%; average daily dose 1.10 g) were the most frequently prescribed herbal formula and single herb, respectively. Additionally, the Si-Wu-Tang decoction was often used for uterine fibroids. Common prescription patterns and herbal pairs were identified. Western medicine (WM) outpatient visits (12 ± 19.6) and iron supplement prescriptions (prescription code PLB001M, 62.5 ± 115.3 pills; PLB012M, 24.6 ± 78 pills) were more prevalent in the combined therapy group than in the WM-only group (outpatient visits: 5.9 ± 6.7 times; iron supplements: PLB001M, 48.3 ± 98.4 pills; PLB012M, 20.9 ± 67.5) in the CGRD. Conclusions: We characterized the prescription patterns for uterine myoma in the CGRD. Chinese herbal medicine prescriptions may aim to improve anemia related to hypermenorrhea caused by uterine myoma. Ours is the first study of TCM myoma treatment within the CGRD, and we compared our findings to the TCM NHIRD myoma study results. ARM and SNA of TCM prescription patterns provide an evidence base to inform medical education and medical decision-making.