Prescribed Renoprotective Chinese Herbal Medicines Were Associated with a Lower Risk of All-Cause and Disease-Specific Mortality among Patients with Chronic Kidney Disease: A Population-Based Follow-Up Study in Taiwan
Prescribed Renoprotective Chinese Herbal Medicines Were Associated with a Lower Risk of All-Cause and Disease-Specific Mortality among Patients with Chronic Kidney Disease: A Population-Based Follow-Up Study in Taiwan
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DOI：
10.1155/2017/5632195
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发表时间：
2017-01-01
影响因子：
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通讯作者：
Yang, Chen-Chang
中科院分区：
文献类型：
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作者：
Hsieh, Chuan-Fa;Chang, Huan-Cheng;Yang, Chen-Chang
含有马兜铃酸（AA）的中草药（CHMs）与慢性肾脏疾病（CKD）有关，但一些处方CHMs已被证明具有肾脏保护作用。我们进行了一项全国性的回顾性队列研究，以描述处方的CHMs对CKD进展的作用。肾保护性CHM（RPCHM）定义为含有冬虫夏草（Cordyceps sinensis（Berk.）Sacc.），大黄（Rheum palmatum L.）、黄芪（Astragalus membranaceus）、丹参（Salvia miltiorrhiza Bge.）、和当归（Angelica sinensis（Oliv.）Diels）或属于特定的混合草药制剂（益肾胶囊、Saireito或温脾汤）。排除了曾使用含AA的CHM、在CKD诊断前患有癌症或HIV或在CKD诊断的第一个月内死亡的受试者。共11，625例患者为合格受试者。在接受含当归的RPCHM和接受其他RPCHM的受试者中，全因死亡率的校正风险比（aHR）分别为0.6（p < 0.001）和0.6（p = 0.013）。对于CKD相关死亡率，接受含当归RPCHM的受试者的aHR为0.6（p = 0.025）。使用特定的RPCHM，特别是含有当归的RPCHM，与CKD患者的死亡风险降低相关。
Chinese herbal medicines (CHMs) containing aristolochic acid (AA) are associated with chronic kidney disease (CKD), but some prescribed CHMs have been shown to possess renoprotective effects. We conducted a nationwide retrospective cohort study to delineate the role of prescribed CHMs on the CKD progression. Renoprotective CHM (RPCHM) was defined if a CHM contained dong chong xia cao (Cordyceps sinensis (Berk.) Sacc.), da huang (Rheum palmatum L), huang qi (Astragalus membranaceus), dan shen (Salvia miltiorrhiza Bge.), and dong quai (Angelica sinensis (Oliv.) Diels) or belonged to specific mixture herbal formulations (Yishen capsule, Saireito, or Wen Pi Tang). Subjects who had ever used AA-containing CHMs, had cancer or HIV prior to CKD diagnosis, or died within the first month of CKD diagnosis were excluded. A total of 11,625 patients were eligible subjects. The adjusted hazard ratio (aHR) for all-cause mortality was 0.6 (p < 0.001) and 0.6 (p = 0.013) among subjects receiving RPCHMs containing Angelica sinensis and those receiving other RPCHMs, respectively. For CKD-related mortality, the aHR among subjects receiving RPCHMs containing Angelica sinensis was 0.6 (p = 0.025). The use of specific RPCHMs, especially those that contained Angelica sinensis, was associated with a lower risk of mortality among CKD patients.