To explore the effects of herbal medicine among cancer patients in Taiwan: A cohort study.

BACKGROUND: Traditional Chinese medicine (TCM) is widely used by ethnic Chinese communities. TCM is covered by Taiwan's National Health Insurance (NHI) program. We evaluated the efficacy and outcomes of complementary Chinese herbal medicine (CHM) therapy in patients with cancer. METHODS: This population-based cohort study was conducted using the data of patients who received a cancer diagnosis between 2005 and 2015 in Taiwan. Eligible patients were divided into standard and complementary CHM therapy groups. The complementary CHM therapy group was further divided into low cumulative dosage (LCD), medium cumulative dosage (MCD), and high cumulative dosage (HCD) subgroups. Overall survival (OS), mortality risk, cancer recurrence, and metastasis were analyzed for all cancers and five major cancers (lung, liver, breast, colorectal, and oral cancers). RESULTS: We included 5707 patients with cancer (standard therapy, 4797 [84.1%]; complementary CHM therapy, 910 [15.9%]; LCD, 449 [7.9%]; MCD, 374 [6.6%], and HCD, 87 [1.5%]). For the LCD, MCD, and HCD subgroups, the mortality risk was 0.83, 0.64, and 0.45, and the 11-year OS, 5-year cumulative cancer recurrence, and 5-year cumulative cancer metastasis rates were 6.1 ± 0.2, 6.9 ± 0.2, and 8.2 ± 0.4 years; 39.2%, 31.5%, and 18.8%; and 39.5%, 32.8%, and 16.6%, respectively. The cumulative cancer recurrence and metastasis rates of the standard therapy group were 40.9% and 32.8%, respectively. The cumulative recurrence and metastasis rates of all cancers, lung cancer, and liver cancer and all cancers, colorectal cancer, and breast cancer, respectively, were significantly lower in the HCD subgroup than in the other subgroups and standard therapy group ( p < 0.05). CONCLUSION: Patients receiving complementary CHM therapy may have prolonged OS and reduced risks of mortality, recurrence, and metastasis. A dose-response relationship was noted between CHM therapy and mortality risk: increased dosage was associated with improved OS and reduced mortality risk.

The effects of a Chinese herbal medicine (VGHBPH0) on patients with benign prostatic hyperplasia: A pilot study.

BACKGROUND: The current Western medicine treatment options for benign prostatic hyperplasia (BPH) have various degrees of documented effectiveness. However, the uses of these interventions are limited to specific patient populations or have certain side effects that interfere with patient quality of life. This study evaluated the clinical effects of a Chinese herbal medicine (CHM) on patients with BPH. METHODS: This was a single-arm pilot study. Twenty BPH patients were enrolled, and they were required to take the investigated CHM three times a day for 8 weeks, along with their Western medicine. Patients returned to clinics as scheduled and completing international prostate symptoms scores (IPSS), aging male symptoms score, international index of erectile function, and body constitution questionnaire of traditional Chinese medicine. Uroflowmetry and sonography were also applied to evaluate the changes in urinary velocity and post-voiding residual urine volume from the baseline to the end of the study. RESULTS: The mean IPSS total score was significantly decreased by 2.5 points after 8 weeks of treatment with the CHM (from 17.5 to 15.0, p = 0.03). The mean IPSS voiding subscore was decreased by 1.7 points (from 10.1 to 8.4, p = 0.02), and the mean incomplete emptying subscore was decreased by 0.8 points (from 2.9 to 2.1, p = 0.02), with both decreases being statistically significant. A descending trend in the post-voiding residual urine volume was also observed (from 52.9 to 30.8 mL, p = 0.07). CONCLUSION: This trial indicated that the add-on CHM treatment (VGHBPH0) might be a potential treatment for improving the lower urinary tract symptoms of BPH patients.

The utilization of complementary and alternative medicine in Taiwan: An internet survey using an adapted version of the international questionnaire (I-CAM-Q).

BACKGROUND: In Taiwan, numerous studies have been conducted to investigate the use of complementary and alternative medicine (CAM). However, most of them focused on specific diseases or the use of particular methods. Therefore, the results of those studies were quite different and difficult to compare with those of studies from other countries. The International CAM Questionnaire (I-CAM-Q), meanwhile, is a unified tool that can provide comparable results for studies conducted worldwide. Thus, the aim of this study was to discover the proportions of people in Taiwan receiving CAM treatments from different types of health care providers by using an adapted version of I-CAM-Q (I-CAM-QT). METHODS: I-CAM-QT was developed by translating the Korean version of I-CAM-Q (I-CAM-QK) into traditional Chinese language because of the similarity of CAM usage and doctor licensing system. This study had two stages: the first was a pretest survey used to adjust the questionnaire, while the second was an internet-based survey used to collect data from the community. RESULTS: Of the 1200 survey respondents, 37% and 37.7% were prescribed or advised to use Chinese herbal medicine (CHM) by Western medicine (WM) physicians and traditional Chinese medicine (TCM) doctors, respectively. Other than CHM, dietary supplements and massage were the forms of CAM most commonly prescribed or recommended by WM physicians or TCM doctors. Overall, walking and relaxation techniques were the most commonly used self-help practices (used by 61.9% and 40.4% of the respondents, respectively). Additionally, 70.3% of the respondents had used at least one kind of dietary supplement in the past 12 months. CONCLUSION: Regarding the utilization of CAM in Taiwan, this internet-based survey revealed that CHM, dietary supplements, and massage were the types of CAM most commonly prescribed or recommended by WM physicians or TCM doctors.

A bibliometric analysis of acupuncture research in Taiwan from 1988 to 2017.

BACKGROUND: Since Taiwan's national health insurance system provides residents with easy and affordable access to clinical acupuncture treatment, this study sought to analyze trends in the publication of acupuncture-related research in Taiwan from 1988 to 2017, using a bibliometric method. METHODS: Data on the scholarly literature from 1988 to 2017 were retrieved through Web of Science searches for the keywords acupunct*, acupoint*, electroacupunct*, electro-acupunct*, acupre*, auricular acupunc*, and auricular needle* in study titles. RESULTS: A total of 539 acupuncture-related articles published from 1988 to 2017 were identified and analyzed. The articles had an h-index of 38 and were cited in subsequent studies 7250 times, meaning that Taiwan ranked sixth in the production of such publications among countries/regions globally. Among those articles, 99 (18.4%) had no subsequent citations, six (1.1%) were highly cited (over 100 citations), and 141 (26.1%) were cited 4 to 10 times. The highly cited articles discussed the possible pathways of acupuncture stimulation and efficacy, and received 1103 (15.2%) of the citations. CONCLUSION: The China Medical University in Taichung, Taiwan, was the most active educational institution in Taiwan in terms of acupuncture-related research. Professor Lin Jaung-Geng was the leading acupuncture-related researcher, having the most publications, citations, and the highest h-index value. These results provided a context for analyzing the strengths of the existing research and informing prospective strategies for further studies.

Trends in global acupuncture publications: An analysis of the Web of Science database from 1988 to 2015.

BACKGROUND: Acupuncture is a rapidly growing medical specialty worldwide. This study aimed to analyze the acupuncture publications from 1988 to 2015 by using the Web of Science (WoS) database. Familiarity with the trend of acupuncture publications will facilitate a better understanding of existing academic research in acupuncture and its applications. METHODS: Academic articles published focusing on acupuncture were retrieved and analyzed from the WoS database which included articles published in Science Citation Index-Expanded and Social Science Citation Indexed journals from 1988 to 2015. RESULTS: A total of 7450 articles were published in the field of acupuncture during the period of 1988-2015. Annual article publications increased from 109 in 1988 to 670 in 2015. The People's Republic of China (published 2076 articles, 27.9%), USA (published 1638 articles, 22.0%) and South Korea (published 707 articles, 9.5%) were the most abundantly prolific countries. According to the WoS subject categories, 2591 articles (34.8%) were published in the category of Integrative and Complementary Medicine, followed by Neurosciences (1147 articles, 15.4%), and General Internal Medicine (918 articles, 12.3%). Kyung Hee University (South Korea) is the most prolific organization that is the source of acupuncture publications (365 articles, 4.9%). Fields within acupuncture with the most cited articles included mechanism, clinical trials, epidemiology, and a new research method of acupuncture. CONCLUSION: Publications associated with acupuncture increased rapidly from 1988 to 2015. The different applications of acupuncture were extensive in multiple fields of medicine. It is important to maintain and even nourish a certain quantity and quality of published acupuncture papers, which can play an important role in developing a medical discipline for acupuncture.

Effects of Kuan-Sin-Yin decoction on immunomodulation and tumorigenesis in mouse tumor models.

BACKGROUND: Complementary therapies are widely used among cancer patients. Kuan-Sin-Yin (KSY) decoction, a popular qi-promoting herbal medicine, was constituted with several herbs known to exhibit immunomodulating or anticancer activity. After combining these herbs as a compound formula, it is necessary to reassess the immunomodulation effects, the effects on tumor growth, and possible toxicity of KSY. METHODS: The anti-cancer effects of KSY in vivo were determined by measuring the tumor volumes, anticancer-associated cytokines (IFN-gamma, TNF-alpha, IL-2, and IL-12), accumulation of tumor infiltrating leukocytes (TILs), proliferation and apoptosis-related molecular markers (Ki-67, p53, p21, activated caspase 3, and cleaved PARP), and an in situ TUNEL assay. The body weight and serum chemistry of treated mice were also assessed. In vitro, the effects of KSY were evaluated using MTT assay, BrdU incorporation assay and cell growth curve. RESULTS: In vivo, KSY suppressed bladder or lung cancer growth but did not promote the production of cytokines nor increase the accumulation of TILs. The expression of p53 and p21 in KSY-treated mice were increased. The numbers of apoptotic tumor cells and the expression of apoptosis marker proteins (Caspase 3 and cleaved PARP) were not significantly elevated after KSY treatment. In vitro, the viability and proliferation of tumor cells, but not normal cells, were suppressed by KSY treatment. No significant toxicity was found in KSY-treated mice. CONCLUSIONS: KSY suppressed the tumor growth in vivo and in vitro, which resulted from its cytostatic effects on cancer cells, rather than the induction of anti-cancer immunity. Under these experimental conditions, no apparent toxicity was observed.