Prescription Patterns of Wu Lin San Concentrated Extract Product for Cystitis in Taiwan: A Population-Based Study

The indications for the concentrated extract product (CEP) of Wu Lin San (WLS) are urethritis, cystitis, and gonorrhea. In clinical settings, WLS is combined with other CEPs used. However, there are no prescribed guidelines of CEPs in Taiwan. In this study, we would establish the CEP-prescribed applications of WLS for cystitis according to the clinical prescription patterns and ancient traditional medicine books. The prescription patterns of WLS were analyzed from the National Health Insurance Research Database of Taiwan for the period from 2000 to 2015. The results show that WLS was most frequently prescribed for cystitis (17.12% of a total prescriptions), and its prescribed dosage was 3∼5 g per day. Among them, 62.53% were for patients >40 years, and 72.45% were for women. Moreover, prescription patterns of WLS for cystitis were divided into 4 types: Type 1, WLS combined with Pa Cheng San (PCS) and Ti Tang Tang (29.75%); Type 2, WLS combined with PCS and dandelion (13.89%); Type 3, WLS combined with PCS and Tao Ho Cheng Chi Tang (6.63%); and Type 4, WLS combined with PCS (2.75%). According to lectures, review revealed the following principles of WLS application. WLS only should be adopted for simple heat strangury, while Type 4 should be applied for excess heat and dampness strangury. For patients with heat strangury coupled with an early-stage blood amassment pattern in lower jiao (abdomen), Type 3 could be administered. Type 2 should be used for heat strangury accompanied by dampness toxicity with infection. By contrast, Type 1 should be applied to patients with severe blood stasis. The application principles of WLS with other CEPs could serve as a reference for cystitis treatment in clinical settings.