Concurrent Chinese and Western medication use and risk of acute exacerbations in chronic obstructive pulmonary disease: A national cohort study.

Background: This study examined whether concurrent use of Chinese medications (CMs) and Western medications (WMs) was associated with a reduced risk of acute exacerbation (AE) in patients with chronic obstructive pulmonary disease (COPD). Methods: Using Taiwan's National Health Insurance Research Database (2003-2019), we identified patients aged ≥40 years with COPD receiving specific medications. CM users were matched with nonusers using propensity score matching. The primary outcome was the occurrence of moderate or severe AE within 730 days. Cox proportional hazard models were used to estimate AE risks. Results: A total of 86,510 CM users were matched with 346,034 nonusers. The incidence of AE was lower in the CM users (9.7%) than in the nonusers (10.7%) as was the incidence of severe AE (2.78% vs. 3.79%). Kaplan-Meier analysis showed significantly lower risks of AE in the CM users (p < 0.001). In multivariate models, CM use was consistently associated with a reduced risk of AE (adjusted hazard ratios: 0.76 to 0.91). Subgroup analyses confirmed these benefits across all subgroups. Conclusions: Concurrent CM-WM use is associated with a decreased risk of AE in patients with COPD. Integrating CM into conventional management may offer clinical benefits, though further studies are needed to elucidate the underlying mechanisms.