Utilization of Chinese medicine for respiratory discomforts by patients with a medical history of tuberculosis in Taiwan

Yang, Su-Tso; Lin, Yi-Rong; Wu, Mei-Yao; Chiang, Jen-Huai; Yang, Pei-Shan; Hsia, Te-Chun; Yen, Hung-Rong

Due to the side effects of the drugs [6, 7] , poor medication compliance and the problem of development of drug-resistant TB, global investment in TB research is needed [8] . Among the first-line anti-TB drugs, side effects of hepatotoxicity have been reported to be associated with isoniazid, rifampin and pyrazinamide; cutaneous reactions with isoniazid, pyrazinamide and ethambutol; gastrointestinal intolerance with rifampin; retrobulbar neuritis with ethambutol; and ototoxicity with streptomycin [9] [10] [11] . Long-term respiratory symptoms and impairment of pulmonary function affect patients' quality of life after completing TB treatment. The respiratory comorbidities were identified in more than half of microbiologically cured TB patients [12] . Despite successful treatment of TB, residual impairments persist, and chronic complications or sequelaes can arise from structural or vascular alterations at disease sites [13, 14] . Many patients with chronic illness may seek complementary therapies [15] , especially Chinese Medicine (CM) in Asian countries [16, 17] . CM, which originated in ancient China, is defined as comprehensive healthcare skills and practice for the maintenance of health and treatment of disease based on the beliefs of holism [18] and experiences of pattern identification/ syndrome differentiation handed down from generation to generation [19] . In Taiwan, CM is important and popular among different categories of complementary therapies, and is regarded as one of the mainstream therapies with coverage of the National Health Insurance (NHI) program [17] . "CM" usually refers to the overall treatment modalities, and services of CM covered by the NHI program, which includes Chinese medicines, acupuncture, moxibustion and Chinese traumatology therapy [20] . "Chinese medicines" usually refers to herbs or herbal products which can be classified into single-herb products and herbal formulas (multi-herb products) [21] . In Taiwan, herbal products (concentrated scientific herbal granules) covered by the NHI program are manufactured by GMP-certified pharmaceutical companies [22] .