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

In Taiwan, patients with a diagnosis of TB are required to receive pharmacological therapy to control TB infection with monitoring by local health officers based on the government's health policy [46] . The included patients who had been diagnosed with TB should have received standard anti-TB treatment. In Taiwan, recommended standard treatment for adult respiratory TB consists of a regimen of isoniazid, rifampicin, pyrazinamide, and ethambutol for 2 months, followed by isoniazid, rifampicin, and ethambutol for 4 months with monitoring by local health officers according to governmental policy [46] . The total treatment course takes approximately 6 months in newly diagnosed patients [46] . The median duration between newly diagnosed TB and the first CM consultation was 1068 days. During the follow-up period, patients might seek CM consultation due to symptoms of respiratory discomfort or complications. In addition to respiratory illness, they may also experience other symptoms related to the anti-TB treatment, such as skin rash or drug fever, GI intolerance, nausea, vomiting, visual toxicity, hearing disturbances and arthralgia [9, [47] [48] [49] . The NHI insurance coverage for CM treatments may play a considerable role in patients' tendency to seek CM consultations. Medical services in both Western medicine and CM have been promoted due to the high coverage of the NHI program. Furthermore, the cost of co-payment for concentrated scientific herbal granules is approximately $15 U.S. dollars per month under the NHI Program in Taiwan. The tendency of patients to seek CM may continue to increase since the co-payment for Chinese medicines is relatively low [50] [51] [52] [53] . Among patients with TB, most CM users (94.78%) received only Chinese medicines, which is consistent with previous studies investigating other respiratory diseases for which herbal products are frequently used as treatment in CM visits in Taiwan [52, 54] . In patients with adult-onset asthma, 76.7% patients who visited CM physicians received Chinese medicines [54] , and 97.1% of the CM-treated rhinosinusitis subjects were prescribed Chinese medicines [52] .