Reduction of surgery rate in endometriosis patients who take Chinese medicine: a population-based retrospective cohort study

- Among endometriosis patients, the incidence rate of surgery is lower in Chinese medicine (CM) users than in CM nonusers.
- The difference of surgery rate between CM users and nonusers exists in almost all socio-demographic sub-groups.
- The diagnosis-to-surgery duration is longer in CM users than that in CM nonusers.
- The most frequently prescribed CM single and formula are Cyperus rotundus and Gui-zhi-fu-ling-wan, respectively.

SummaryObjectivesFemale patients have frequently utilized Chinese medicine (CM) to treat symptoms that could possibly be related to endometriosis. The objective of this population-based retrospective cohort study was to evaluate the relationship between CM use and subsequent surgery among patients with endometriosis.DesignA total of 8,283 CM users were identified among the 22,488 endometriosis patients found in the National Health Insurance reimbursement database between 2000 and 2010. A control group was identified and consisted of 8,283 matched nonusers with the same disease. A Cox proportional regression analysis was performed in order to assess risk factors for surgery for the CM users and nonusers.ResultsWhen compared to nonusers, CM users were significantly less likely to undergo surgery, with a hazard ratio of 0.47 (95% CI = 0.421, 0.534) after adjusting for age, occupation, childbirth status, hypermenorrhea, iron-deficient anemia, dysmenorrhea, and amount of conventional medications. Among patients who had undergone surgery, the follow-up time was longer for CM users than for CM nonusers (p < 0.001). Moreover, the most frequently used CM single and formula were Cyperus rotundus and Gui-zhi-fu-ling-wan, respectively.ConclusionsThese results suggest that whatever the underlying reason, CM provides an alternative option that reduces the incidence rate of surgery in endometriosis patients.