# The role of traditional Chinese medicine on fracture surgery, hospitalization, and total mortality risks in diabetic patients with osteoporosis

**Authors:** Yi-Chen Liu, Chi-Hsiang Chung, Chien-Jung Lin, Sheng-Chiang Su, Feng-Chih Kuo, Jhih-Syuan Liu, Peng-Fei Li, Chia-Luen Huang, Li-Ju Ho, Chun-Yung Chang, Ming-Shiun Lin, Chih-Ping Lin, An-Che Cheng, Chien-Hsing Lee, Chang-Hsun Hsieh, Yi-Jen Hung, Hsin-Ya Liu, Chieh-Hua Lu, Wu-Chien Chien, Tsung-Tai Chen, Tsung-Tai Chen, Tsung-Tai Chen, Tsung-Tai Chen, Tsung-Tai Chen

PMC · DOI: 10.1371/journal.pone.0289455 · 2024-05-02

## TL;DR

This study shows that traditional Chinese medicine may reduce surgery, hospitalization, and mortality risks in diabetic patients with osteoporosis.

## Contribution

The study provides longitudinal evidence of TCM's effectiveness in reducing health risks for patients with type 2 diabetes and osteoporosis.

## Key findings

- TCM treatment was associated with significantly lower fracture surgery rates compared to the control group.
- Patients receiving TCM had reduced risks of hospitalization and all-cause mortality.
- Kaplan-Meier analysis confirmed significant differences in cumulative risk between TCM and control groups.

## Abstract

Studies have confirmed that osteoporosis has been considered as one of the complications of diabetes, and the health hazards to patients are more obvious. This study is mainly based on the Taiwan National Health Insurance Database (TNHID). Through the analysis of TNHID, it is shown that the combined treatment of traditional Chinese medicine (TCM) medicine in patients of diabetes with osteoporosis (T2DOP) with lower related risks.

According to the study design, 3131 patients selected from TNHID who received TCM treatment were matched by 1-fold propensity score according to gender, age, and inclusion date as the control group. Cox proportional hazards analyzes were performed to compare fracture surgery, hospitalization, and all-cause mortality during a mean follow-up from 2000 to 2015.

A total of 1055/1469/715 subjects (16.85%/23.46%/11.42%) had fracture surgery/inpatient/all-cause mortality of which 433/624/318 (13.83%/19.93%/10.16%) were in the TCM group) and 622/845/397 (19.87%/26.99%/12.68%) in the control group. Cox proportional hazards regression analysis showed that subjects in the TCM group had lower rates of fracture surgery, inpatient and all-cause mortality (adjusted HR = 0.467; 95% CI = 0.225–0.680, P<0.001; adjusted HR = 0.556; 95% CI = 0.330–0.751, P<0.001; adjusted HR = 0.704; 95% CI = 0.476–0.923, P = 0.012). Kaplan-Meier analysis showed that the cumulative risk of fracture surgery, inpatient and all-cause mortality was significantly different between the case and control groups (all log-rank p<0.001).

This study provides longitudinal evidence through a cohort study of the value of integrated TCM for T2DOP. More research is needed to fully understand the clinical significance of these results.

## Linked entities

- **Diseases:** diabetes (MONDO:0005015), osteoporosis (MONDO:0005298)

## Full-text entities

- **Diseases:** osteoporosis (MESH:D010024), fracture (MESH:D050723), TNHID (OMIM:603663), diabetes (MESH:D003920)
- **Chemicals:** Chinese medicine (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

9 figures with captions in the complete paper: https://tomesphere.com/paper/PMC11065294/full.md

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Source: https://tomesphere.com/paper/PMC11065294