Adjunctive Chinese Herbal Medicine therapy improves survival of patients with chronic myeloid leukemia: a nationwide population-based cohort study.
Adjunctive Chinese Herbal Medicine therapy improves survival of patients with chronic myeloid leukemia: a nationwide population-based cohort study.
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DOI：
10.1002/cam4.627
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发表时间：
2016-04
期刊：
影响因子：
4
通讯作者：
Yen HR
中科院分区：
文献类型：
--
作者：
Fleischer T;Chang TT;Chiang JH;Chang CM;Hsieh CY;Yen HR
尽管现有药物的临床效果良好，但仍然有充分的理由寻找其他疗法来治疗慢性粒细胞白血病 (CML)。迄今为止，中草药（CHM）一直被研究人员忽视，并且没有关于该主题的数据。我们研究了辅助性 CHM 对 CML 病程的影响，使用死亡率作为主要结果衡量标准。我们利用台湾国民健康保险研究数据库进行了一项全国范围内的人群队列研究。我们的研究包括 2000 年至 2010 年间诊断的 CML 患者。我们根据年龄、性别、查尔森合并症指数 (CCI) 评分和伊马替尼的使用情况进行分组，并比较中药组和非中药组使用者的风险比 (HR)，以及用于治疗 CML 的处方的特征趋势。在检查年份中，共有 1371 名患者被诊断患有 CML，其中 466 名患者被纳入本研究。我们发现，CHM 组的 HR 显着低于非 CHM 组（0.32，95% CI 0.22–0.48，P < 0.0001）。我们还确定，心率降低之间的这种关联是剂量依赖性的，中药使用者接受处方的时间越长，心率就越低（P < 0.01）。我们还分析了最常用的草药产品以及与其使用相关的人力资源，从而提供未来的研究候选者。我们的结果提供了强有力的理由来假设，当由经过适当培训的医生进行治疗时，CHM 可能会对 CML 的治疗产生重大的积极影响。
Despite good clinical results of current drugs, a good reason still exists to search for additional therapies for the management of Chronic Myeloid Leukemia (CML). Chinese Herbal Medicine (CHM) has thus far been overlooked by researchers and no data exists on the subject. We studied the impact of adjunctive CHM on the disease course of CML, using mortality as the major outcome measurement. We used the Taiwanese National Health Insurance Research Database to perform a nationwide population‐based cohort study. Our study included CML patients diagnosed between 2000 and 2010. We matched groups according to age, sex, Charlson Comorbidity Index (CCI) score and use of imatinib, and compared the Hazard Ratios (HR) of CHM group and non‐CHM users, as well as characterized trends of prescriptions used for treating CML. 1371 patients were diagnosed with CML in the years examined, of which 466 were included in to this study. We found that the HR of CHM group was significantly lower compared to non‐CHM groups (0.32, 95% CI 0.22–0.48, P < 0.0001). We also established that this association between reduced HR was dose‐dependent, and the longer CHM users received prescriptions, the lower the HR (P < 0.01). We also analyzed the most commonly used herbal products as well as the HR associated to their use, thus providing future research candidates. Our results supply a strong reason to assume that when administered by properly trained physicians, CHM may have a substantial positive impact on the management of CML.