Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2012, Article ID 617918, 9 pages doi:10.1155/2012/617918 Research Article Use of Chinese Medicine and Subsequent Surgery in Women with Uterine Fibroid: A Retrospective Cohort Study Shan-Yu Su, 1, 2 Chih-Hsin Muo, 3, 4 and Donald E. Morisky 5 1 Department of Chinese Medicine, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung 40447, Taiwan 2 School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan 3 Department of Public Health, China Medical University, Taichung 40402, Taiwan 4 Management Office for Health Data, China Medical University Hospital, Taichung 40402, Taiwan 5 Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA 90095-1772, USA Correspondence should be addressed to Shan-Yu Su, shanyusu@yahoo.com.tw Received 18 June 2012; Revised 1 September 2012; Accepted 3 September 2012 Academic Editor: Tat leang Lee Copyright © 2012 Shan-Yu Su et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Chinese medicine (CM) has been used to relieve symptoms relevant to uterine fibroids. Objective. This study investigated the association between the use of CM and the incidence of uterine surgery in women with uterine fibroids. Subjects and Methods. This retrospective cohort study extracted records for 16,690 subjects diagnosed with a uterine fibroid between 2000 and 2003 from the National Health Insurance reimbursement database. The risk factors for surgery were examined via Cox proportional hazard analysis, and the difference in incidence of surgery between CM users and nonusers was compared using incidence rate ratios (IRRs) derived from Poisson’s models. Results. After an average follow-up period of 4.5 years, the cumulative incidence of uterine surgery was significantly lower in CM users than CM nonusers (P< 0.0001). Compared to CM nonusers, CM users were more unlikely to undergo uterine surgery (adjusted hazard ratio = 0.18, 95% confidence interval (CI) = 0.17, 0.19). The incidence of surgery in CM users was dramatically different from that for CM nonusers (IRR = 0.17, 95% CI = 0.16, 0.18). Conclusion. The risk of uterine surgery among fibroid patients who used CM was significantly decreased, implying an effective treatment of fibroid-related symptoms provided by CM. 1. Introduction Uterine fibroids, also known as leiomyoma, are the most commonly occurring benign tumors of the female repro- ductive system, with a cumulative incidence of more than 60% in women over the age of 45 years [1]. They are the leading indication for hysterectomy all over the world and are associated with a substantial economic impact on health care systems, including associated costs of $4–9 billion per year in the United States alone [2]. These tumors grow frequently in women of reproductive age, regressing after menopause [3], and can cause various symptoms including infertility, pregnancy complications [4], pelvic pain [5], and abnormal or heavy bleeding that can lead to anemia [6]. Surgery has traditionally been the gold standard for the treatment of symptomatic uterine fibroids. Hysterectomy is indicated in women who have completed childbearing, particularly in those who are expected to go into menopause soon, while myomectomy is indicated in women who wish to preserve their fertility [7]. For asymptomatic patients, on the other hand, serial followups (without surgery) to monitor the size of the tumor and check for related symptoms are advisable [8]. Surgery is an invasive treatment that can cause even more severe complications than a fibroid itself. Potential short-term complications of surgery include febrile morbidity, blood loss, and organ injuries [9], while possible long-term complications, such as fistula formation, adhesion, and sexual dysfunctions [10], can last for many years, even beyond menopause, when a uterine leiomyoma is no longer a threat to health [3]. Consequently, alternative treatments to surgery for the management of fibroid-related symptoms have been sought and evaluated for years to minimize surgery in patients [11].