Chinese herbal medicine and acupuncture use after acute skin burn and its association with mental health-related symptoms and mortality: A nationwide retrospective matched cohort study in Taiwan.

Abstract

Acute skin burn is a condition that often treated by Western medicine. The use of traditional Chinese medicine (TCM) on patients with skin burns in Taiwan is still unclear. This study investigates TCM use along with anxiety and/or depression symptoms and mortality risks in patients with acute burns. Using the Taiwan National Health Insurance Research Database (2001-2020), we conducted a retrospective propensity score-matched (1:1) cohort study. Acute burn patients were categorized as TCM users or non-users. Outcomes were: TCM use, anxiety symptoms, depression symptoms, and mortality risk. A total of 8784 patients were matched (TCM: 4392; non-TCM: 4392). Frequently used herbs included Yan-Hu-Suo, Gan Cao, and Da-Huang; frequently used formulas were Jia-Wei-Xiao-Yao-San, Shu-Jing-Huo-Xue-Tang, and Shao-Yao-Gan-Cao-Tang. Acupuncture was less frequently used. TCM users had significantly lower all-cause mortality (adjusted HR: 0.68; 95% CI: 0.60, 0.78; p < 0.001). However, TCM users had higher risks of anxiety symptoms (adjusted HR: 2.29; 95% CI: 2.01, 2.62) and depression symptoms (adjusted HR: 2.03; 95% CI: 1.66, 2.48; both p < 0.001). TCM use was associated with improved survival in burn patients but increased risks of anxiety and depression symptoms. Notably, patients receiving 7-12 acupuncture sessions did not show elevated risks for these psychological outcomes.