Abstract:
We evaluated the long-term risks of overall cancer and all-cause mortality associated with five types of phytopharmaceuticals and the most commonly used estrogen-progestogen medications for the treatment of postmenopausal syndrome in women. Using data from Taiwan\'s National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2018, we conducted a 1:2 matched cohort study with 12,087 eligible patients. We compared phytopharmaceuticals -only users (n = 4029, phytopharmaceuticals group) with HRT-only users (n = 8058, HRT group) with a washout period of ≥6 months. The phytopharmaceuticals group had significantly lower risks of overall cancer and all-cause mortality than the HRT group (adjusted hazard ratio [95% confidence interval]: 0.60 [0.40-0.9] and 0.40 [0.16-0.99], respectively) after over 180 days of use. Bupleurum and Peony Formula were associated with lower risks of overall cancer and all-cause mortality (aHR: 0.57 [0.36-0.92] and 0.33 [0.11-1.05], respectively). In conclusion, phytopharmaceuticals may serve as an alternative therapy to HRT for alleviating menopausal symptoms and reducing health risks, leading to more favorable long-term health outcomes. Further randomized control trials are necessary to validate the findings of this study.
摘要:
我们评估了与五种类型的植物药物和最常用的雌激素-孕激素药物治疗女性绝经后综合征相关的总体癌症和全因死亡率的长期风险。使用2000年1月1日至2018年12月31日台湾国家健康保险研究数据库(NHIRD)的数据,我们对12,087名符合条件的患者进行了1:2匹配的队列研究。我们比较了仅植物药使用者(n=4029,植物药组)和仅HRT使用者(n=8058,HRT组)的清除期≥6个月。与HRT组相比,植物药组的总体癌症和全因死亡率的风险显着降低(调整后的风险比[95%置信区间]:0.60[0.40-0.9]和0.40[0.16-0.99],分别)在使用超过180天后。柴胡和牡丹配方与较低的总体癌症风险和全因死亡率相关(aHR:0.57[0.36-0.92]和0.33[0.11-1.05],分别)。总之,植物药物可以作为HRT的替代疗法,以减轻更年期症状并降低健康风险,导致更有利的长期健康结果。需要进一步的随机对照试验来验证本研究的结果。