Identifying Chinese herbal medicine for premenstrual syndrome: implications from a nationwide database

Hsing-Yu Chen, Ben-Shian Huang, Yi-Hsuan Lin, Irene H Su, Sien-Hung Yang, Jiun-Liang Chen, Jen-Wu Huang, Yu-Chun Chen, Hsing-Yu Chen, Ben-Shian Huang, Yi-Hsuan Lin, Irene H Su, Sien-Hung Yang, Jiun-Liang Chen, Jen-Wu Huang, Yu-Chun Chen

Abstract

Background: Premenstrual syndrome (PMS) occurs in women during their reproductive age with a quite negative impact on their daily lives. Women with PMS experience a wide range of physical or psychological symptoms and seek treatment for them. Chinese herb medicine (CHM) is commonly used for PMS and the goal of this study is to investigate the prescription patterns of CHM for PMS by using a nationwide database.

Methods: Prescriptions of CHM were obtained from two million beneficiaries randomly sampled from the National Health Insurance Research Database, a nationwide database in Taiwan. The ICD-9 code 625.4 was used to identify patients with PMS. Association rule mining and social network analysis were used to explore both the combinations and the core treatments for PMS.

Results: During 1998-2011, a total of 14,312 CHM prescriptions for PMS were provided. Jia-Wei-Xiao-Yao-San (JWXYS) was the CHM which had the highest prevalence (37.5% of all prescriptions) and also the core of prescription network for PMS. For combination of two CHM, JWXYS with Cyperus rotundus L. was prescribed most frequently, 7.7% of all prescriptions, followed by JWXYS with Leonurus heterophyllus Sweet, 5.9%, and Cyperus rotundus L. with Leonurus heterophyllus Sweet, 5.6%.

Conclusions: JWXYS-centered CHM combinations were most commonly prescribed for PMS. To the best of our knowledge, this is the first pharmaco-epidemiological study to review CHM treatments for PMS. However, the efficacy and safety of these commonly used CHM were still lacking. The results of this study provide valuable references for further clinical trials and bench studies.

Figures

Figure 1
Figure 1
Social network analysis on associations between commonly used CHM (top 10). Abbreviations: JWXYS: Jia-Wei-Xiao-Yao-San; GZFLW: Gui-Zhi-Fu-Ling-Wan. *JWXYS was the center of the CHM network prescribed for PMS and became the core treatment for PMS. **Larger circle represents higher prevalence, and thicker connection line represents more common combination.

References

    1. Yonkers KA, O’Brien PM, Eriksson E. Premenstrual syndrome. Lancet. 2008;371:1200–1210.
    1. Hartlage SA, Freels S, Gotman N, Yonkers K. Criteria for premenstrual dysphoric disorder: secondary analyses of relevant data sets. Arch Gen Psychiatry. 2012;69:300–305.
    1. Campbell EM, Peterkin D, O’Grady K, Sanson-Fisher R. Premenstrual symptoms in general practice patients. Prevalence and treatment. J Reprod Med. 1997;42:637–646.
    1. Borenstein J, Chiou CF, Dean B, Wong J, Wade S. Estimating direct and indirect costs of premenstrual syndrome. J Occup Environ Med. 2005;47:26–33.
    1. Halbreich U, Borenstein J, Pearlstein T, Kahn LS. The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD) Psychoneuroendocrinology. 2003;28(Suppl 3):1–23.
    1. Rapkin AJ, Winer SA. Premenstrual syndrome and premenstrual dysphoric disorder: quality of life and burden of illness. Expert Rev Pharmacoecon Outcomes Res. 2009;9:157–170.
    1. Rapkin AJ, Edelmuth E, Chang LC, Reading AE, McGuire MT, Su TP. Whole-blood serotonin in premenstrual syndrome. Obstet Gynecol. 1987;70:533–537.
    1. Freeman EW, Rickels K, Sondheimer SJ, Polansky M. A double-blind trial of oral progesterone, alprazolam, and placebo in treatment of severe premenstrual syndrome. JAMA. 1995;274:51–57.
    1. Smith MJ, Adams LF, Schmidt PJ, Rubinow DR, Wassermann EM. Abnormal luteal phase excitability of the motor cortex in women with premenstrual syndrome. Biol Psychiatry. 2003;54:757–762.
    1. Schmidt PJ, Nieman LK, Danaceau MA, Adams LF, Rubinow DR. Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. N Engl J Med. 1998;338:209–216.
    1. Wyatt K, Dimmock P, Jones P, Obhrai M, O’Brien S. Efficacy of progesterone and progestogens in management of premenstrual syndrome: systematic review. BMJ. 2001;323:776–780.
    1. Rickels K, Freeman E, Sondheimer S. Buspirone in treatment of premenstrual syndrome. Lancet. 1989;1:777.
    1. Marjoribanks J, Brown J, O'Brien PMS, Wyatt K. Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database Syst Rev. 2013. p. CD001396. doi:10.1002/14651858.CD001396.pub3.
    1. Hu XH, Bull SA, Hunkeler EM, Ming E, Lee JY, Fireman B, Markson LE. Incidence and duration of side effects and those rated as bothersome with selective serotonin reuptake inhibitor treatment for depression: patient report versus physician estimate. J Clin Psychiatry. 2004;65:959–965.
    1. Jing Z, Yang X, Ismail KMK, Chen XY, Wu T. Chinese herbal medicine for premenstrual syndrome. Cochrane Database Syst Rev. 2009. p. CD006414. doi:10.1002/14651858.CD006414.pub2.
    1. Kim SY, Park HJ, Lee H, Lee H. Acupuncture for premenstrual syndrome: a systematic review and meta-analysis of randomised controlled trials. BJOG. 2011;118:899–915.
    1. Jang S, Kim D, Choi MS. Effects and treatment methods of acupuncture and herbal medicine for premenstrual syndrome/premenstrual dysphoric disorder: systematic review. BMC Complement Altern Med. 2014;14:11.
    1. Chang LC, Huang N, Chou YJ, Lee CH, Kao FY, Huang YT. Utilization patterns of Chinese medicine and Western medicine under the National Health Insurance Program in Taiwan, a population-based study from 1997 to 2003. BMC Health Serv Res. 2008;8:170.
    1. Yang SH, Chen HY, Lin YH, Chen YC. The Exploration of Disease Pattern, Zheng, for Differentiation of Allergic Rhinitis in Traditional Chinese Medicine Practice. Evid Based Complement Alternat Med. 2012;2012:7.
    1. Chen HY, Lin YH, Su IH, Chen YC, Yang SH, Chen JL. Investigation on Chinese herbal medicine for primary dysmenorrhea: implication from a nationwide prescription database in Taiwan. Complement Ther Med. 2014;22:116–125.
    1. Lin YH, Chen YC, Hu S, Chen HY, Chen JL, Yang SH. Identifying core herbal treatments for urticaria using Taiwan’s nationwide prescription database. J Ethnopharmacol. 2013;148:556–562.
    1. Chen HY, Lin YH, Thien PF, Chang SC, Chen YC, Lo SS, Yang SH, Chen JL. Identifying core herbal treatments for children with asthma: implication from a chinese herbal medicine database in Taiwan. Evid Based Complement Alternat Med. 2013;2013:125943.
    1. Li J, Lu C, Jiang M, Niu X, Guo H, Li L, Bian Z, Lin N, Lu A. Traditional chinese medicine-based network pharmacology could lead to new multicompound drug discovery. Evid Based Complement Alternat Med. 2012;2012:149762.
    1. Chen HY, Lin YH, Wu JC, Chen YC, Yang SH, Chen JL, Chen TJ. Prescription patterns of Chinese herbal products for menopausal syndrome: analysis of a nationwide prescription database. J Ethnopharmacol. 2011;137:1261–1266.
    1. Chen HY, Lin YH, Wu JC, Chen YC, Thien PF, Chen TJ, Yang SH, Chen JL, Lo SS. Characteristics of pediatric traditional Chinese medicine users in Taiwan: a nationwide cohort study. Pediatrics. 2012;129:e1485–1492.
    1. Dickerson LM, Mazyck PJ, Hunter MH. Premenstrual syndrome. Am Fam Physician. 2003;67:1743–1752.
    1. Johnson SR. Premenstrual syndrome, premenstrual dysphoric disorder, and beyond: a clinical primer for practitioners. Obstet Gynecol. 2004;104:845–859.
    1. Gao Y, Liu Z, Wang CJ, Fan XS, Xie JY. Chinese medicine formula network analysis for core herbal discovery. Brain Informatics. 2012;7670:255–264.
    1. Tai YM, Chiu HW. Comorbidity study of ADHD: applying association rule mining (ARM) to National Health Insurance Database of Taiwan. Int J Med Inf. 2009;78:e75–83.
    1. Zhang Y, Han M, Liu Z, Wang J, He Q, Liu J. Chinese herbal formula xiao yao san for treatment of depression: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med. 2012;2012:931636.
    1. Qin F, Huang X, Ren P. Chinese herbal medicine modified xiaoyao san for functional dyspepsia: meta-analysis of randomized controlled trials. J Gastroenterol Hepatol. 2009;24:1320–1325.
    1. Hsiao MC, Liu CY, Chen KC, Hsieh TT. Characteristics of women seeking treatment for premenstrual syndrome in Taiwan. Acta Psychiatr Scand. 2002;106:150–155.
    1. Yazdanparast R, Ardestani A. In vitro antioxidant and free radical scavenging activity of Cyperus rotundus. J Med Food. 2007;10:667–674.
    1. Kilani S, Ledauphin J, Bouhlel I, Ben Sghaier M, Boubaker J, Skandrani I, Mosrati R, Ghedira K, Barillier D, Chekir-Ghedira L. Comparative study of Cyperus rotundus essential oil by a modified GC/MS analysis method. Evaluation of its antioxidant, cytotoxic, and apoptotic effects. Chem Biodivers. 2008;5:729–742.
    1. Matkowski A, Piotrowska M. Antioxidant and free radical scavenging activities of some medicinal plants from the Lamiaceae. Fitoterapia. 2006;77:346–353.
    1. Henkes H, Franz M, Kendall O, Monroe J, Legaspi A, LeDoux J, Haese C, Williams D, McCall S, Johnson AD, Ceremuga TE. Evaluation of the anxiolytic properties of tetrahydropalmatine, a Corydalis yanhusuo compound, in the male Sprague-Dawley rat. AANA J. 2011;79:S75–80.
    1. Cao FL, Shang GW, Wang Y, Yang F, Li CL, Chen J. Antinociceptive effects of intragastric dl-tetrahydropalmatine on visceral and somatic persistent nociception and pain hypersensitivity in rats. Pharmacol Biochem Behav. 2011;100:199–204.
    1. Imanshahidi M, Hosseinzadeh H. The pharmacological effects of Salvia species on the central nervous system. Phytother Res. 2006;20:427–437.
    1. Feng Y, You Z, Yan S, He G, Chen Y, Gou X, Peng C. Antidepressant-like effects of salvianolic acid B in the mouse forced swim and tail suspension tests. Life Sci. 2012;90:1010–1014.
    1. Isacchi B, Fabbri V, Galeotti N, Bergonzi MC, Karioti A, Ghelardini C, Vannucchi MG, Bilia AR. Salvianolic acid B and its liposomal formulations: anti-hyperalgesic activity in the treatment of neuropathic pain. Eur J Pharm Sci. 2011;44:552–558.
    1. Zhang YA, Li X, Wang ZZ. Antioxidant activities of leaf extract of Salvia miltiorrhiza Bunge and related phenolic constituents. Food Chem Toxicol. 2010;48:2656–2662.
    1. Sun S, Yin Y, Yin X, Cao F, Luo D, Zhang T, Li Y, Ni L. Anti-nociceptive effects of Tanshinone IIA (TIIA) in a rat model of complete Freund’s adjuvant (CFA)-induced inflammatory pain. Brain Res Bull. 2012;88:581–588.
    1. Luo J, Tian C, Xu J, Sun Y. Studies on the antioxidant activity and phenolic compounds of enzyme-assisted water extracts from Du-zhong (Eucommia ulmoides Oliv.) leaves. J Enzyme Inhib Med Chem. 2009;24:1280–1287.
    1. Park SA, Choi MS, Jung UJ, Kim MJ, Kim DJ, Park HM, Park YB, Lee MK. Eucommia ulmoides Oliver leaf extract increases endogenous antioxidant activity in type 2 diabetic mice. J Med Food. 2006;9:474–479.
    1. Park SW, Kim YK, Lee JG, Kim SH, Kim JM, Yoon JS, Park YK, Lee YK, Kim YH. Antidepressant-like effects of the traditional Chinese medicine kami-shoyo-san in rats. Psychiatry Clin Neurosci. 2007;61:401–406.
    1. Oh JK, Kim Y-S, Park H-J, Lim E-M, Pyun K-H, Shim I. Antidepressant effects of Soyo-san on immobilization stress in ovariectomized female rats. Biol Pharm Bull. 2007;30:1422–1426.
    1. Yasui T, Yamada M, Uemura H, Ueno S, Numata S, Ohmori T, Tsuchiya N, Noguchi M, Yuzurihara M, Kase Y, Irahara M. Changes in circulating cytokine levels in midlife women with psychological symptoms with selective serotonin reuptake inhibitor and Japanese traditional medicine. Maturitas. 2009;62:146–152.
    1. Toriizuka K, Kamiki H, Ohmura NY, Fujii M, Hori Y, Fukumura M, Hirai Y, Isoda S, Nemoto Y, Ida Y. Anxiolytic effect of Gardeniae Fructus-extract containing active ingredient from Kamishoyosan (KSS), a Japanese traditional Kampo medicine. Life Sci. 2005;77:3010–3020.
    1. Park HJ, Shim HS, Chung SY, Lee TH, Shim I. Soyo-san reduces depressive-like behavior and proinflammatory cytokines in ovariectomized female rats. BMC Complement Altern Med. 2014;14:34.
    1. Xu F, Peng D, Tao C, Yin D, Kou J, Zhu D, Yu B. Anti-depression effects of Danggui-Shaoyao-San, a fixed combination of Traditional Chinese Medicine, on depression model in mice and rats. Phytomedicine. 2011;18:1130–1136.
    1. Stefek M, Benes L. In vitro studies on the activity of japanese kampo herbal medicines Oren-Gedoku-To (TJ-15) and Toki-Shakuyaku-San (TJ-23) as scavengers of free radicals. Drug Metabol Drug Interact. 1994;11:25–36.
    1. Koike K, Ohno S, Takahashi N, Suzuki N, Nozaki N, Murakami K, Sugiura K, Yamada K, Inoue M. Efficacy of the herbal medicine Unkei-to as an adjunctive treatment to hormone replacement therapy for postmenopausal women with depressive symptoms. Clin Neuropharmacol. 2004;27:157–162.
    1. Duvan CI, Cumaoglu A, Turhan NO, Karasu C, Kafali H. Oxidant/antioxidant status in premenstrual syndrome. Arch Gynecol Obstet. 2011;283:299–304.
    1. Scheid V. Traditional Chinese medicine–what are we investigating? The case of menopause. Complement Ther Med. 2007;15:54–68.
    1. Chini F, Pezzotti P, Orzella L, Borgia P, Guasticchi G. Can we use the pharmacy data to estimate the prevalence of chronic conditions? a comparison of multiple data sources. BMC Public Health. 2011;11:688.
    1. Zhang LD, Zhang YL, Xu SH, Zhou G, Jin SB. Traditional Chinese medicine typing of affective disorders and treatment. Am J Chin Med. 1994;22:321–327.
    1. Scheid V. Depression, constraint, and the liver: (dis)assembling the treatment of emotion-related disorders in Chinese medicine. Cult Med Psychiatry. 2013;37:30–58.
    1. Scheid V, Ward T, Tuffrey V. Comparing TCM textbook descriptions of menopausal syndrome with the lived experience of London women at midlife and the implications for Chinese medicine research. Maturitas. 2010;66:408–416.

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