中醫藥在阿茲海默症的應用--利用健保資料庫分析

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题名:	中醫藥在阿茲海默症的應用--利用健保資料庫分析 Characteristics of traditional Chinese medicine use in patients with Alzheimer’s disease in Taiwan: A nationwide population-based study
作者:	賴慶元;Ching-Yuan Lai
贡献者:	中醫學系博士班
关键词:	阿茲海默症;國民健康保險研究數據庫;丹參;炙甘草湯;中醫用戶;Alzheimer's disease;National Health Insurance Research Database (NHIRD);Radix Salviae miltiorrhizae;traditional Chinese medicine (TCM);zhi-gan-cao-tang
日期:	2018-08-21
上传时间:	2018-12-25
出版者:	中國醫藥大學
摘要:	背景: 癡呆症是老年化社會嚴重的經濟負擔。利用健保資料庫分析其常見的原因。瞭解傳統中國醫藥的使用，並分析其應用成效。材料和方法: 以一氧化碳(CO) 為例，選取在2000至2011年，9042名新診斷為CO中毒的成年人根據年齡，性別和住院年份， 1：4頻率匹配，作為世代研究。進一步分析新診斷的阿茲海默症(AD)病患，列入隨後調查患者（n = 1939），區分中醫用戶（N = 528; 29.11％）和非中醫用戶（N = 1286; 70.89％）。分析他們用藥的種類與模式。結果: CO中毒痴呆的風險有2.68倍。AD中醫的用戶年齡小於非中醫用戶（75.66與79.26年歲）。中醫用戶，60.61％為女性。診斷為AD和第一次中醫諮詢之間的中間間隔為7.92個月。大多數中醫用戶（63.64％）只接受中藥治療，只有3.41％中醫用戶只使用針灸或傷科治療，而32.95％使用聯合療法。最常見的處方配方及單味藥分別是炙甘草湯和丹參。AD中有白內障合併症傾向於有更多的中藥的諮詢，而那些有糖尿病，高血壓，中風，失眠則較少有中醫諮詢。結論: 中醫藥治療阿爾茨海默病的高患病率和特定使用模式。該信息可用於進一步的藥理學研究和臨床試驗。利用這些數據進一步分析阿爾茨海默病患者的中藥應用程度。 Background Dementia is a heavy burden in aging society. We analyzed the causes of dementia. Alzheimer disease (AD) is one of the most common types of dementia. Large-scale study of traditional Chinese medicine (TCM) usage among patients with AD is lacking. We look at the further detail of application. Materials and Methods. Used a total of 9042 adults newly diagnosed with CO poisoning were enrolled from the National Health Insurance Research Database (NHIRD) in Taiwan. The control (non- CO poisoning) cohort was 1:4 frequency-matched by age, sex, and the year of hospitalization and analyzed using a Cox proportional hazards model. Further we selected newly diagnosed patients (n = 1,939) and divided them into two categories: TCM users (n = 528; 29.11%) and non-TCM users (n = 1,286; 70.89%). Results. CO adjusted HR = 2.68 to Dementia. TCM users were younger than non-TCM users (75.66 vs. 79.26 years old). Among the TCM users, 60.61% were female. The median interval between diagnosis and the first TCM consultation was 7.92 months. The majority of the TCM users (63.64%) received only Chinese herbal remedies, 3.41% of TCM users were treated only with acupuncture or traumatology, and 32.95% used combined therapies. Zhi-gan-cao-tang and danshen (Radix Salviae miltiorrhizae) were the most frequently prescribed formula and single herb, respectively. Regarding the incidence rate ratio, patients with Alzheimer’s disease who had comorbid cataracts were prone to have more TCM visits, whereas those with diabetes mellitus, hypertension, stroke, or insomnia tended to have fewer TCM visits. Conclusions. This study revealed that CO is related Dementia, and the high prevalence and specific usage patterns of TCM in the treatment of Alzheimer’s disease. The information can utilize for further pharmacological investigation and clinical trials. We will try to use these data further analyze the extent and Traditional Chinese Medicine Application in Alzheimer patients.
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