The Survival Analysis And Pattern Of Traditional Chinese Medicine Prescription In Colorectal Cancer Patients Of Taiwan Area

ObjectiveTaiwan since March 1,1995 begin implementation of the National Health Insurance, which was mandatory insurance welfare policy and have improved patient health insurance database.It allow research institutions and academics use this healthcare database to do epidemiological analysis. The purpose of this study is using the Taiwan Health Insurance Database to investigate the effectiveness of colorectal cancer patients in Taiwan who have combine used Chinese medical outpatient treatment and analysis It’s commonly used prescription drugs. The result will be as a reference for combined Chinese and western medical treatment.MethodsWe used the Taiwanese National Health Insurance Research Database to perform a nationwide population-based cohort study. Our study included colorectal cancer patients (ICD-9-CODE 153> 154) in Taiwan, diagnosed between 2000 and 20110. We divided patients’as the use of traditional Chinese medical treatment (TCMT) group and non TCMT group. TCMT usage behavior defined as after colorectal cancer diagnosis, when the traditional Chinese medicine has a first outpatient records and within three consecutive months as those who use more than three times the use of traditional Chinese medical treatment has actors. We compare data according to age, sex, Charlson Comorbidity Index (CCI) score, calculate survival rates and compared the Hazard Ratios (HR) of TCHT group and non-TCMT users, as well as characterized trends of prescriptions mode and ranking (including unilateral and compound). The data were analysis by SAS for windows 13.0 soft ware.ResultThe incidence rate of colorectal cancer patients(ICD-9-CODE 153、154) in Taiwan were 34.2～64.6 per 100,000 population and there is a tendency to rise year after year. Colorectal cancer patients with the use of traditional Chinese medical behavior accounted for 45.51%. Men use traditional Chinese medical actors than women, about women 1.2 times and senior high recognition of the traditional Chinese medical.We found that the cumulative incidence of death of TCMT group (21.4‰,CI: 19.1-23.6) was significantly lower compared to non-TCMT groups (56.6‰, CI: 52.3-60.9) hazard ratio(HR)=0.4, P< 0.001. We also found that the TCMT group was significantly lower HR=0.37 (CI:0.29-0.47; P< 0.001) compared to non-TCMT groups with multivariate survival analysis by Cox proportional hazards model. After adjusted the impact of gender and comorbidity index, the TCMT group had a lower relative risk of death.The top three single herbs most commonly used at Chinese medicine clinics in’ colorectal cancer patients is Salvia (1.93%), Corydalis (1.92%) and rhubarb (1.67%) and 20 front usage accounted for 27.01% of the total use. The top three compound Chinese medicine preparations are Xiang Sha Liu Jun Zi Tang(2.42%), Shu Ching Huo Hsieh Tang(2.42%), Shao You Gan Tsao Tang(2.13%) and 20 front usage accounted for 33.66% of the total use. The top three Chinese medicine preparations efficacy are Nourishing agents (14.68%), Settlement agent (8.77%) and Heat purging fire agent (8.5%).ConclusionTreatment of colorectal cancer in Taiwan is still dominated western medicine and Chinese medicine with a supporting role in the cancer treatment. The results, confirmed the use of traditional Chinese medical treatment can indeed increase the body overall resistance to disease, delaying the age of onset of the disease, improve the survival rate of colorectal cancer. The results of this study can be used as a reference treatment of colorectal cancer research and clinical application.