A retrospective analysis of cirrhotic patients receiving Chinese herbal medicine in addition to conventional care: Survival and safety

Hsueh, Tun-Pin; Kao, Chao-Wei; Liang, Chih-Ming; Chen, Shin-Yu; Hung, Yu‐Chiang; Tsai, Ming-Yen

doi:10.1016/j.eujim.2014.11.003

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…The observed m / z transition of geniposide was m / z 406 (M + NH 4 ) + instead m / z 389 (M + H) + indicates an adduct as (M + NH 4 ) + due to the containing ammonium acetate in the mobile phase. The fragmentation pattern of target compounds in the study to determine the bioactive compounds in the pharmaceutical herbal product and the subsequent pharmacokinetic studies are compatible with previous reports for quantitative mass transitions of these analytes [ 26 , 32 , 33 ]. The optimization of the chromatographic condition to separate the analytes was conducted with respect to mobile phase composition, column and elution.…”

Section: Resultssupporting

confidence: 86%

Preclinical Pharmacokinetics of Scoparone, Geniposide and Rhein in an Herbal Medicine Using a Validated LC-MS/MS Method

Hsueh

Tsai

2018

Molecules

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The herbal formula Yin-Chen-Hao-Tang has been reported to have anti-fibrosis properties. The aim of this study was to reveal the pharmacokinetic characteristics of bioactive compounds in this herbal formula. A new high-performance liquid chromatography-tandem mass spectrometry method was developed and validated for simultaneous determination of scoparone, geniposide and rhein in rat plasma. A pharmaceutical herbal powder was administered to rats at doses of 1 g/kg and 3 g/kg orally. The method showed excellent linearity (r2 > 0.999) and validation was successfully conducted for the pharmacokinetic study. The results show that the Cmax values and areas under the curve of scoparone, geniposide and rhein were higher and not proportional to the dose in rat plasma, while the Tmax and half-life values were consistent in the group that received 1 g/kg. The clearance of the higher dose (3 g/kg) did not decrease proportionally to that of the low dose. The results showed the nonlinear pharmacokinetic properties of scoparone, geniposide and rhein in Yin-Chen-Hao-Tang that suggested possible accumulation of bioactive compounds through oral administration. This pharmacokinetic study reveals that an increased dose of this herbal formula would largely increase the maximum concentration and bioavailability of scoparone, geniposide and rhein.

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Section: Resultssupporting

confidence: 86%

Preclinical Pharmacokinetics of Scoparone, Geniposide and Rhein in an Herbal Medicine Using a Validated LC-MS/MS Method

Hsueh

Tsai

2018

Molecules

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“…YCHT is also the basic composition formula of Yin-Chen-Wu-Ling-San (YCWLS), which was the fourth leading herbal formula prescribed for chronic hepatitis in Taiwan [ 34 ]. YCWLS is also the chosen formula for the damp-heat pattern that is frequently observed in cirrhosis [ 73 ].…”

Section: Pharmacokinetics Of Herbal Medicines Used For Chronic Hepatitismentioning

confidence: 99%

Pharmacokinetic interactions of herbal medicines for the treatment of chronic hepatitis

Hsueh

Lin

Tsai

2017

Journal of Food and Drug Analysis

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Chronic liver disease is a serious global health problem, and an increasing number of patients are seeking alternative medicines or complementary treatment. Herbal medicines account for 16.8% of patients with chronic liver disease who use complementary and alternative therapies. A survey of the National Health Insurance Research Database in Taiwan reported that Long-Dan-Xie-Gan-Tang, Jia-Wei-Xia-Yao-San, and Xiao-Chai-Hu-Tang (Sho-saiko-to) were the most frequent formula prescriptions for chronic hepatitis used by traditional Chinese medicine physicians. Bioanalytical methods of herbal medicines for the treatment of chronic hepatitis were developed to investigate pharmacokinetics properties, but multicomponent herbal formulas have been seldom discussed. The pharmacokinetics of herbal formulas is closely related to efficacy, efficiency, and patient safety of traditional herbal medicines. Potential herbal formula-drug interactions are another essential issue during herbal formula administration in chronic hepatitis patients. In a survey with the PubMed database, this review article evaluates the existing evidence-based data associated with the documented pharmacokinetics profiles and potential herbal-drug interactions of herbal formulas for the treatment of chronic hepatitis. In addition, the existing pharmacokinetic profiles were further linked with clinical practice to provide insight for the safety and specific use of traditional herbal medicines.

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“…Huang et al found patients with head and neck cancers under radiotherapy or chemo‐radiation had increased appetite and less weight loss while receiving TCM 8 . Drawing on laboratory data, Hsueh et al reported on the short‐term safety of TCM used in patients undergoing conventional cirrhosis treatment 9 . Due to the wide use of CGRD data in TCM studies, we consider CGRD an important data source for establishing real‐world evidence regarding TCM.…”

Section: Introductionmentioning

confidence: 99%

The Chang Gung Research Database: Multi‐institutional real‐world data source for traditional Chinese medicine in Taiwan

Shao

Lai

Huang

et al. 2021

Pharmacoepidemiology and Drug

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Background The Chang Gung Research Database (CGRD), the largest multi‐institutional electronic medical records collection in Taiwan, has been used to establish real‐world evidence related to traditional Chinese medicine (TCM). We aimed to evaluate patient characteristics and representativeness of TCM patients in CGRD. Methods We identified a cohort of patients who had TCM records both from CGRD and from Taiwan's National Health Insurance Database (NHIRD) during 2010–2015 to investigate the representativeness of CGRD for TCM uses. The NHIRD was considered as reference because it covers all medical claims from 99.9% of the entire Taiwanese population. We investigated the coverage rates of TCM patients within CGRD compared to NHIRD, and compared the characteristics of patients between CGRD and NHIRD including age, sex, and 15 health conditions. Results We identified 71 002 average annual patients within the CGRD, which accounted for 1.1% of the patients from the NHIRD. The patients from CGRD were older than those from NHIRD (≥65: 16.6% vs. 9.9% for CGRD vs. NHIRD). The ratios of female over male patients were 1.7 vs. 1.5 for CGRD vs. NHIRD. We found higher patient coverage rates for patients with major comorbidities in CGRD, specifically for neoplasm (9.2%) and mental disorders (6.0%). The most frequently prescribed Chinese herbal medicines in CGRD included Jia‐Wei‐Xiao‐Yao‐San, Xiang‐Sha‐Liu‐Jun‐Zi‐Tang and Gui‐Lu‐Er‐Xian‐Jiao. Conclusion Higher patient coverage rates were found in CGRD for TCM patients with major comorbidities. Investigators should note possible selection bias since TCM patient disorders may be more severe in CGRD than in the NHIRD.

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A retrospective analysis of cirrhotic patients receiving Chinese herbal medicine in addition to conventional care: Survival and safety

Cited by 6 publications

References 36 publications

Preclinical Pharmacokinetics of Scoparone, Geniposide and Rhein in an Herbal Medicine Using a Validated LC-MS/MS Method

Preclinical Pharmacokinetics of Scoparone, Geniposide and Rhein in an Herbal Medicine Using a Validated LC-MS/MS Method

Pharmacokinetic interactions of herbal medicines for the treatment of chronic hepatitis

The Chang Gung Research Database: Multi‐institutional real‐world data source for traditional Chinese medicine in Taiwan

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