Chinese herbal medicine treatment improves the overall survival rate of individuals with hypertension among type 2 diabetes patients and modulates in vitro smooth muscle cell contractility

Type 2 diabetes (T2D) is a chronic, multifactorial, and metabolic disorder accounting for 90% diabetes cases worldwide. Among them, almost half of T2D have hypertension, which is responsible for cardiovascular disease, morbidity, and mortality in these patients. The Chinese herbal medicine (CHM) prescription patterns of hypertension individuals among T2D patients have yet to be characterized. This study, therefore, aimed to determine their prescription patterns and evaluate the CHM effect. A cohort of one million randomly sampled cases from the National Health Insurance Research Database (NHIRD) was used to investigate the overall survival rate of CHM users, and prescription patterns. After matching CHM and non-CHM users for age, gender and date of diagnosis of hypertension, 980 subjects for each group were selected. The CHM users were characterized with slightly longer duration time from diabetes to hypertension, and more cases for hyperlipidaemia. The cumulative survival probabilities were higher in CHM users than in non-CHM users. Among these top 12 herbs, Liu-Wei-Di-Huang-Wan, Jia-Wei-Xiao-Yao-San, Dan-Shen, and Ge-Gen were the most common herbs and inhibited in vitro smooth muscle cell contractility. Our study also provides a CHM comprehensive list that may be useful in future investigation of the safety and efficacy for individuals with hypertension among type 2 diabetes patients.

2型糖尿病（Type 2 diabetes, T2D）是一种慢性、多因素代谢性疾病，占全球糖尿病总病例的90%。其中，近半数2型糖尿病患者合并高血压，而高血压是此类患者罹患心血管疾病、引发不良预后及死亡的关键诱因。目前，2型糖尿病合并高血压患者的中草药（Chinese herbal medicine, CHM）处方模式仍未得到明确阐释。因此，本研究旨在明确该人群的中草药处方模式，并评估中草药的治疗效应。本研究从国民健康保险研究数据库（National Health Insurance Research Database, NHIRD）中随机抽取100万例病例构建队列，用以分析中草药使用者的总体生存率与处方模式。在按年龄、性别及高血压确诊日期对中草药使用者与非使用者进行匹配后，每组各纳入980名研究对象。结果显示，中草药使用者从确诊糖尿病至确诊高血压的病程略长，且合并高脂血症的病例占比更高。中草药使用者的累积生存概率显著高于非使用者。在本次研究涉及的前12味中草药中，六味地黄丸、加味逍遥散、丹参及葛根最为常用，且上述药物可在体外抑制平滑肌细胞收缩。本研究同时提供了一份中草药综合清单，可为未来针对2型糖尿病合并高血压患者的中草药安全性与有效性研究提供参考依据。