Evidence map›Paper›PMID 35998204›Full record

ArticlePloS one2022

Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events.

Shuo-Min Hsu, Hung-Jen Lin, Yi-Wei Kao, Te-Mao Li, Ben-Chang Shia, Sheng-Teng Huang

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Increasing risk of hemorrhage following concurrent use ofTherapeutic advances in drug safety · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Shuo-Min HsuSchool of Chinese Medicine, China Medical University, Taichung, Taiwan.
Hung-Jen LinSchool of Chinese Medicine, China Medical University, Taichung, Taiwan.
Yi-Wei KaoGraduate Institute of Business Administration, Fu Jen Catholic University, Taipei, Taiwan.ORCID 0000-0002-7891-9514
Te-Mao LiSchool of Chinese Medicine, China Medical University, Taichung, Taiwan.
Ben-Chang ShiaGraduate Institute of Business Administration, Fu Jen Catholic University, Taipei, Taiwan.ORCID 0000-0003-2854-8361
Sheng-Teng HuangSchool of Chinese Medicine, China Medical University, Taichung, Taiwan.ORCID 0000-0002-7495-6115
China Medical University · TWFu Jen Catholic University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis retrospective cohort study investigated the risk of major bleeding events during the concurrent use of Chinese herbal medicine (CHM) and anticoagulants in clinical practice.

methodsA total of 4,470 patients receiving anticoagulant drugs were selected from Taiwan's National Health Insurance Research Database (NHIRD). Half (n = 2,235) were also using CHMs (CHM cohort); the other half were not (non-CHM cohort). Each cohort was matched 1:1 using the propensity score. Chi-square testing and the Student's t-test were used to examine differences between two cohorts. Cox proportional hazard regression analysis assessed the risks for major bleeding events in each cohort, as well as bleeding risks associated with specific CHM formulas and herbs. Cumulative incidence curves for major bleeding events were calculated using Kaplan-Meier analysis.

resultsCompared with the non-CHM cohort, the CHM cohort had a lower risk of overall bleeding events (p < 0.001) including hemorrhagic stroke (p = 0.008), gastrointestinal (GI) bleeding (p < 0.001), urogenital bleeding (p ≤ 0.001) and nasal/ear/eye bleeding (p = 0.004). Single herbs, such as Glycyrrhiza uralensis et Rhizoma, Panax notoginseng, Panax ginseng, Platycodon grandiflorum, Eucommia ulmoides Oliver and formulas, such as Shu Jing Huo Xue Tang, Shao Yao Gan Cao Tang and Ji Sheng Shen Qi Wan were associated with a lower risk of major bleeding events.

conclusionUsing CHMs with anticoagulants appeared to decrease the risk of major bleeding, especially CHMs products containing Glycyrrhiza uralensis et Rhizoma, Panax notoginseng, Panax ginseng, Platycodon grandiflorum and Eucommia ulmoides Oliver. Further investigations are needed to determine whether CHM can maintain the therapeutic efficacy of anticoagulants while simultaneously reducing potential side effects.

Indexed as

AnticoagulantsDrugs, Chinese HerbalHemorrhageHumansMedicine, Chinese TraditionalRetrospective StudiesTaiwanAnticoagulantsDrugs, Chinese Herbal

Identifiers

PMID35998204
PMCPMC9398017
OpenAlexW4292767225

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.