The Utilization of Chinese Herbal Products for Hyperthyroidism in National Health Insurance System (NHIRD) of Taiwan: A Population-Based Study

Chang, Chiz Tzung; Wu, Shu-Chun; Lai, Yun-Ru; Hung, Yu‐Chiang; Hsu, Chung Y.; Chen, Hsuan-Ju; Chu, Cheng‐Chung; Cheng, Jai-Hong; Hu, Wen-Long; Kuo, Chun-En

doi:10.1155/2022/5500604

Cited by 3 publications

(2 citation statements)

References 41 publications

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“…Patients aged 20 years or older with newly diagnosed hyperthyroidism were identified using validated International Classification of Diseases, Ninth Revision ( ICD-9 ) or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision ( ICD-10 ) codes for hyperthyroidism. 8 , 16 , 17 , 20 , 25 The same diagnosis code had to occur twice in the inpatient or outpatient setting between 2011 and 2020 to confirm each patient’s diagnosis. Eligible codes for Graves disease, toxic nodular disease, and unspecified hyperthyroidism are listed in eTable 1 in Supplement 1 .…”

Section: Methodsmentioning

confidence: 99%

MACE and Hyperthyroidism Treated With Medication, Radioactive Iodine, or Thyroidectomy

Peng,

Lin,

Lee

et al. 2024

JAMA Netw Open

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ImportanceExcessive thyroid hormones from hyperthyroidism increase cardiovascular risks. Among 3 available treatments for hyperthyroidism, comparisons of long-term outcomes associated with antithyroid drugs (ATDs), radioactive iodine (RAI), and surgery to treat newly diagnosed hyperthyroidism are lacking.ObjectiveTo compare risks of major adverse cardiovascular events (MACE) and all-cause mortality among patients with hyperthyroidism treated with ATDs, RAI, or surgery.Design, Setting, and ParticipantsThis nationwide cohort study used the Taiwan National Health Insurance Research Database. Patients aged 20 years or older with newly diagnosed hyperthyroidism between 2011 and 2020 were enrolled. Treatment groups were determined within 18 months from diagnosis, with follow-up until the development of MACE, death, or the end date of the database, whichever came first. Data were analyzed from October 2022 through December 2023.ExposuresThe ATD group received ATDs only. RAI and surgery groups could receive ATDs before treatment. Anyone who underwent thyroid surgery without RAI was classified into the surgery group and vice versa.Main Outcomes and MeasuresThe primary outcomes included MACE (a composite outcome of acute myocardial infarction, stroke, heart failure, and cardiovascular mortality) and all-cause mortality.ResultsAmong 114 062 patients with newly diagnosed hyperthyroidism (mean [SD] age, 44.1 [13.6] years; 83 505 female [73.2%]), 107 052 patients (93.9%) received ATDs alone, 1238 patients (1.1%) received RAI, and 5772 patients (5.1%) underwent surgery during a mean (SD) follow-up of 4.4 (2.5) years. Patients undergoing surgery had a significantly lower risk of MACE (hazard ratio [HR] = 0.76; 95% CI, 0.59-0.98; P = .04), all-cause mortality (HR = 0.53; 95% CI, 0.41-0.68; P &lt; .001), heart failure (HR = 0.33; 95% CI, 0.18-0.59; P &lt; .001), and cardiovascular mortality (HR = 0.45; 95% CI, 0.26-0.79; P = .005) compared with patients receiving ATDs. Compared with ATDs, RAI was associated with lower MACE risk (HR = 0.45; 95% CI, 0.22-0.93; P = .03). Risks for acute myocardial infarction and stroke did not significantly differ between treatment groups.Conclusions and RelevanceIn this study, surgery was associated with lower long-term risks of MACE and all-cause mortality, while RAI was associated with a lower MACE risk compared with ATDs.

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Section: Methodsmentioning

confidence: 99%

MACE and Hyperthyroidism Treated With Medication, Radioactive Iodine, or Thyroidectomy

Peng,

Lin,

Lee

et al. 2024

JAMA Netw Open

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“…The mechanism of CHMs in treating hyperthyroidism has also been widely explored ( 19 ). In a population-based study in Taiwan, CHMs were reported to be used in 73% of the patients with hyperthyroidism, and Jiawei-Xiaoyao-San (JWXYS) was the most commonly chosen prescription for hyperthyroidism ( 20 ). Many previous clinical studies have shown that the combination of JWXYS with ATDs in the treatment of hyperthyroidism can improve clinical effectiveness or reduce the dose and side effects of ATDs, and in particular, can significantly relieve symptoms ( 21 , 22 ). Furthermore, some case reports indicate that JWXYS may be a possible alternative treatment for ATDs in the presence of contraindications ( 16 , 23 , 24 ).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and potential mechanism of Jiawei-Xiaoyao-San for hyperthyroidism: a systematic review

Ma,

Zhang,

Zhao

et al. 2023

Front. Endocrinol.

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ObjectivesTo evaluate the effectiveness and potential mechanism of traditional Chinese medicine Jiawei-Xiaoyao-San (JWXYS) as an adjunct or mono- therapy for antithyroid drugs (ATDs) in the treatment of hyperthyroidism.MethodsEight databases and three trial registries were searched from inception until May 2023. Randomized controlled trials (RCTs) were included and meta-analysis was conducted using RevMan 5.4 and Stata 14.0. The Cochrane risk of bias (ROB) tool 1.0 and GRADE tool was used for quality appraisal. The findings from case reports using mono-JWXYS and pharmacological studies were summarized in tables.ResultsThirteen RCTs with 979 participants were included. The majority of the included studies were assessed as high risk of bias in one ROB domain. Compared with ATDs, JWXYS plus ATDs resulted in lower free triiodothyronine (FT3) (MD = -1.31 pmol/L, 95% CI [-1.85, -0.76]; low-certainty), lower free thyroxine (MD = -3.24 pmol/L, 95% CI [-5.06, -1.42]; low-certainty), higher thyroid stimulating hormone (MD = 0.42 mIU/L, 95% CI [0.26, 0.59]; low-certainty), higher effectiveness rate of traditional Chinese medicine syndrome (RR = 1.28, 95% CI [1.08, 1.52]; low-certainty), lower goiter score (MD = -0.66, 95% CI [-1.04, -0.29]; very low-certainty), lower thyrotrophin receptor antibody (SMD = -0.44, 95% CI [-0.73, -0.16]; low-certainty) and fewer adverse events (AEs) (RR = 0.34, 95% CI [0.18, 0.67]; moderate-certainty). Compared with regular dosage of ATDs, JWXYS plus half-dose ATDs resulted in fewer AEs (RR = 0.24, 95% CI [0.10, 0.59]; low-certainty). Compared with ATDs in 1 trial, JWXYS resulted in higher FT3, lower goiter score and fewer AEs. Three case reports showed that the reasons patients sought TCM-only treatment include severe AEs and multiple relapses. Three pharmacological studies demonstrated that JWXYS restored Th17/Treg balance, lowered deiodinases activity, regulated thyroid cell proliferation and apoptosis, and alleviated liver oxidative stress in mouse or rat models.ConclusionJWXYS may enhance the effectiveness of ATDs for hyperthyroidism, particularly in relieving symptoms and reducing AEs. Mono-JWXYS is not recommended except in patients intolerant to ATDs. The findings should be interpreted with caution due to overall high risk of bias. Further pharmacological studies with more reliable models are needed.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023394923.

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Study on fresh processing key technology and quality influence of Cut Ophiopogonis Radix based on multi-index evaluation

Cai

Hong-mei

et al. 2023

Open Life Sciences

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The purpose of this study was to ascertain the fresh processing technology of Cut Ophiopogonis Radix using a multi-index evaluation. This study comprehensively evaluated the fresh processing technology of sliced Cut Ophiopogonis Radix by investigating the cutting methods, cutting thickness, and drying conditions, and referring to The Chinese Pharmacopoeia 2020 edition. The appearance traits, internal quality (extract, total saponins, total flavonoids, total polysaccharides), and drying efficiency were used as evaluation indexes. The physical attributes of Cut Ophiopogonis Radix were found to vary based on the processing techniques employed. The shape, surface characteristics, texture, and color were observed to differ across the different methods. Notably, the apparent quality of Cut Ophiopogonis Radix was superior in samples processed using A1B1C1, A1B2C2, and A3B1C3 techniques. Drying time and energy consumption of Cut Ophiopogonis Radix produced by the A1B2C2 and A2B1C2 processes were less than those of other treatments, making them the optimal process for fresh processing Cut Ophiopogonis Radix. The impact of the cutting method and thickness on the extract was found to be statistically insignificant (P > 0.05). However, the drying method was observed to have a significant impact on the extract (P < 0.05). The cutting method, Cut thickness, and drying method did not affect the total saponin content (P > 0.05), but they had significant effects on the total polysaccharide and flavonoid contents (P < 0.01). Total polysaccharides were most affected by the cutting method, while total flavonoids were most affected by the drying condition. Based on the characteristics and internal quality, the fresh processing technology for Cut Ophiopogonis Radix was determined: fresh Ophiopogonis Radix was sliced to a thickness of 2–4 mm and dried at 55°C or a low temperature. The feasibility of Cut Ophiopogonis Radix is improved through its fresh processing. According to the evaluation indices, it is recommended to utilize the novel processing technique involving “fresh Ophiopogonis Radix” with fresh cuts, a cut thickness ranging from 2 to 4 mm, and drying at a temperature of 55℃ or through low-temperature drying. The Cut Ophiopogonis Radix exhibited favorable appearance and internal characteristics, thereby furnishing a scientific basis and innovative insights for the production of ophiopogon decoction slices.

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The Utilization of Chinese Herbal Products for Hyperthyroidism in National Health Insurance System (NHIRD) of Taiwan: A Population-Based Study

Cited by 3 publications

References 41 publications

MACE and Hyperthyroidism Treated With Medication, Radioactive Iodine, or Thyroidectomy

MACE and Hyperthyroidism Treated With Medication, Radioactive Iodine, or Thyroidectomy

Effectiveness and potential mechanism of Jiawei-Xiaoyao-San for hyperthyroidism: a systematic review

Study on fresh processing key technology and quality influence of Cut Ophiopogonis Radix based on multi-index evaluation

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