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Open Access Research article

Chinese herbal prescriptions for osteoarthritis in Taiwan: analysis of national health insurance dataset

Fang-Pey Chen12, Ching-Mao Chang1, Shinn-Jang Hwang23*, Yu-Chun Chen4 and Fun-Jou Chen5

Author Affiliations

1 Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan

2 School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan

3 Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 11217, Beitou District, Taiwan

4 Department of Research and Education, National Yang-Ming University Hospital, I-Lan 26042, Taiwan

5 School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan

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BMC Complementary and Alternative Medicine 2014, 14:91  doi:10.1186/1472-6882-14-91

Published: 7 March 2014

Abstract

Background

Chinese herbal medicine (CHM) has been commonly used for treating osteoarthritis in Asia for centuries. This study aimed to conduct a large-scale pharmaco-epidemiologic study and evaluate the frequency and patterns of CHM used in treating osteoarthritis in Taiwan.

Methods

A complete database (total 22,520,776 beneficiaries) of traditional Chinese medicine (TCM) outpatient claims offered by the National Health Insurance program in Taiwan for the year 2002 was employed for this research. Patients with osteoarthritis were identified according to the diagnostic code of the International Classification of Disease among claimed visiting files. Corresponding prescription files were analyzed, and an association rule was applied to evaluate the co-prescription of CHM for treating osteoarthritis.

Results

There were 20,059 subjects who visited TCM clinics for osteoarthritis and received a total of 32,050 CHM prescriptions. Subjects between 40 and 49 years of age comprised the largest number of those treated (19.2%), followed by 50-59 years (18.8%) and 60-69 years group (18.2%). In addition, female subjects used CHMs for osteoarthritis more frequently than male subjects (female: male = 1.89: l). There was an average of 5.2 items prescribed in the form of either an individual Chinese herb or formula in a single CHM prescription for osteoarthritis. Du-zhong (Eucommia bark) was the most commonly prescribed Chinese single herb, while Du-huo-ji-sheng-tang was the most commonly prescribed Chinese herbal formula for osteoarthritis. According to the association rule, the most commonly prescribed formula was Du-huo-ji-sheng-tang plus Shen-tong-zhu-yu-tang, and the most commonly prescribed triple-drug combination was Du-huo-ji-sheng-tang, Gu-sui-pu (Drynaria fortune (Kunze) J. Sm.), and Xu-Duan (Himalaya teasel). Nevertheless, further clinical trials are needed to evaluate the efficacy and safety of these CHMs for treating osteoarthritis.

Conclusions

This study conducted a large scale pharmaco-epidemiology survey of Chinese herbal medicine use in OA patients by analyzing the NHIRD in Taiwan in year 2002.

Keywords:
Association rule; Chinese herbal medicine; National health insurance; Osteoarthritis; Pharmaco-epidemiology; Traditional Chinese medicine