Identifying Core Herbal Treatments for Children with Asthma: Implication from a Chinese Herbal Medicine Database in Taiwan

Abstract

Asthma is one of the most common allergic respiratory diseases around the world and places great burden on medical payment. Chinese herbal medicine (CHM) is commonly used for Taiwanese children to control diseases. The aim of this study is to analyze the CHM prescriptions for asthmatic children by using a nationwide clinical database. The National Health Insurance Research Database (NHIRD) was used to perform this study. Medical records from 1997 to 2009 with diagnosis with asthma made for children aged 6 to 18 were included into the analysis. Association rule mining and social network analysis were used to analyze the prevalence of single CHM and its combinations. Ma-Xing-Gan-Shi-Tang (MXGST) was the most commonly used herbal formula (HF) (20.2% of all prescriptions), followed by Xiao-Qing-Long-Tang (13.1%) and Xing-Su-San (12.8%). Zhe Bei Mu is the most frequently used single herb (SH) (14.6%), followed by Xing Ren (10.7%). MXGST was commonly used with Zhe Bei Mu (3.5%) and other single herbs capable of dispelling phlegm. Besides, MXGST was the core formula to relieve asthma. Further studies about efficacy and drug safety are needed for the CHM commonly used for asthma based on the result of this study.

Clinical effectiveness and safety of montelukast in asthma. What are the conclusions from clinical trials and meta-analyses?

“…The management of asthma may be suboptimal in Asia because myths and fallacies regarding Western medicine and corticosteroids are prevalent and lead to nonadherence of treatment 15–19. Also, use of traditional and proprietary herbal medicines for atopic diseases is popular 20,21. Noncorticosteroid-based medications such as montelukast may play a role in better control for various atopic diseases in some of these cities 22,23…”

Analysis of the Medical Market Share of Traditional East Asian Medicine (TEAM) in Taiwan Using National Health Insurance Research Database (NHIRD)

“…Upper respiratory infection In 2009, 9.92% of upper respiratory infection(including influenza) patients used TEAM 72) Rhinosinusitis In 2000∼2011, 29% of newly diagnosed choronic rhinosinustis patients used TEAM 73) Allergic rhinitis In 2002, 2.4% of patients used western medicine, 1.4% of patients used TEAM to treat allergic rhinitis 74) In 2009∼2010, 80.5% used only western medicine, 12.73% used only TEAM, 6.77% used western medicine and TEAM in combination to treat allergic rhinitis 75) In 2009, 80.2% used only western medicine, 12.93% used only TEAM, 6.82% used western medicine and TEAM in combination to treat allergic rhinitis 76) In 2002∼2010, 63.11% of newly diagnosed child allergic rhinitis patients used TEAM 77) Asthma In 1997∼2008, 85.7% of newly diagnosed adult asthma patients used TEAM 78) In 1997∼2009, Herbal medicine was prescribed at 35.28% of total visits in school age (6∼18 years old) 79) In 2002∼2010, 57.95% of child asthma patients used TEAM 80) In 2000∼2011, Despite the gradual increase in asthma patients, the use of TEAM decreased from 38.58% to 29.26% 81) In 2005∼2010, 18.7∼23.2% of child asthma patients used TEAM 82) Diseases of the digestive system (8.30%) . 뿐만 아니라 국민건강보험제도 등 의료제도적 94) In 1997∼2011, 14.28% of the patients visited the TEAM clinic for SLE treatment 95) Diseases of the genitourinary system (16.49%) Menopausal syndrome In 1997∼2004, 64.9% of 45∼55 year old women had experience using TEAM 96) In 2002, 75.1% of patients diagnosed with menopausal syndrome had experience using TEAM 97) Infertility In 2000∼2011, 96.17% of patients diagnosed with infertility had experience using TEAM 98) Renal 104) *In parentheses, frequency of use of TEAM for Western medicine use by ICD-9 disease classification.…”

Complementary Therapy with Traditional Chinese Medicine for Childhood Asthma

“…Medication for asthma is mainly divided into two categories: controller medications and reliever (rescue) medications [2]. Controller medications, such as inhaled corticosteroids (ICS) and long-acting beta-adrenoceptor agonists (LABA), are used for regular maintenance treatment [24][25][26]. These medications reduce airway inflammation, control symptoms, and reduce future risks, such as exacerbations and decreased lung function.…”

“…These medications reduce airway inflammation, control symptoms, and reduce future risks, such as exacerbations and decreased lung function. Reliever medications, such as short-acting beta-2-adrenoceptor agonists (SABA), are provided to all patients for asneeded relief of breakthrough symptoms, including during worsening of asthma or exacerbations [24][25][26]. They are also recommended for short-term prevention of exercise-induced bronchoconstriction [2].…”