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、多因素代谢紊乱性疾病，占全球糖尿病病例的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、引发发病与死亡的关键诱因。目前，2型糖尿病合并高血压人群的中药（Chinese herbal medicine, CHM）处方模式尚未得到系统阐释。因此本研究旨在明确此类患者的中药处方模式，并评估中药的临床效应。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100万例病例作为队列，用以探究中药使用者的总体生存率及处方模式。在按照年龄、性别、高血压确诊日期对中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。中药使用者的糖尿病发病至高血压确诊的间隔时间略长，且高脂血症患者占比更高。中药使用者的累积生存概率显著高于非使用者组。在本次研究涉及的前12味中药中，六味地黄丸（Liu-Wei-Di-Huang-Wan）、加味逍遥散（Jia-Wei-Xiao-Yao-San）、丹参（Dan-Shen）与葛根（Ge-Gen）为最常用药物，且可在体外抑制平滑肌细胞收缩。本研究同时提供了一份综合性中药清单，可为未来针对2型糖尿病合并高血压患者的中药安全性与有效性研究提供参考依据。