Prescription Pattern and Related Influence Factors of Chinese Herbal Medicine for Chronic Liver Diseases in Taiwan

台灣慢性肝病使用之中藥處方類型和相關影響因子研究

林雲蓮(Yun-Lian Lin) ； 陳俊男(Jiun-Nan Chen) ； 吳聰能(Trong-Neng Wu) ； 林以正(Yii-Jeng Lin)

《中醫藥雜誌》 26卷1期 (2015/06) Pp. 1-11

https://doi.org/10.3966/101764462015062601001

摘要

中藥是我國慢性肝病患者普遍使用之輔助醫療的藥物。為了鑑別用於治療慢性肝病中藥處方如何調配，本研究用藥物的有效性作為中藥處方分類標準，探討藥物有效性之處方類型及影響此類型之因子。使用國家健保資料庫分析2008年中醫門診用於治療慢性肝病的資料進行分析藥物流行病學研究。經統計分析顯示在2008年間有43,119慢性肝病患者曾經使用中藥治療，中藥處方中最普遍使用的處方是和解（harmonize, 63.7%）和清熱瀉火（40.8%）。較年輕（45.4歲）和較年長（52.0歲）患者分別以發表和驅風處方為主。男性患者的處方以補陽、清熱瀉火和理血藥為主；女性患者開的處方以和解表裡和潤燥作用為主。本研究顯示用於治療慢性肝病的中藥處方類型受性別和年紀的影響。

關鍵字

慢性肝病 ； 中藥 ； 藥物流行病學 ； 國家健康保險 ； 處方類型

並列摘要

Chinese herbal medicine (CHM) is a commonly used complementary and alternative medicine for patients with chronic liver diseases in Taiwan. In order to identify how CHM is prescribed for patients with chronic liver diseases, the drug effectiveness was used to classify the herbal formulae. The aim of this study is to explore the prescription pattern of drug effectiveness and the factors that affect this pattern. The National Health Insurance (NHI) database was analyzed for the pharmacoepidemiology study. Traditional Chinese medicine (TCM) outpatients who were identified by Gastroenterology with chronic liver diseases in the year of 2008 were included. Statistics and data mining tools were employed to explore CHM prescription pattern and factors that affect the pattern in terms of drug effectiveness, respectively. Among the 43,119 subjects treated chronic liver diseases with CHM, herbal formulae that has the effect of He Jie (harmonize, 63.7%) and Qing Re Xie Huo (clear heat and drain fire, 40.8%) were most commonly prescribed. Subjects prescribed for formulae with the effects of Fa Biao (release exterior, 45.4 years) and Qu Feng (expel wind 52.0 years) were the youngest and eldest, respectively. Male were more commonly prescribed for Bu Yang (tonify and nourish), Qing Re Xie Huo, and Li Xue (regulate blood); female were more commonly prescribed for He Jie, Biao Li (exterior and interior), and Ren Zao (moisture dryness). This study shows the prescription pattern of CHM in terms of drug effectiveness for chronic liver diseases. Gender and age affect this pattern.

並列關鍵字

Chronic liver diseases ； Chinese herbal medicine ； pharmacoepidemiology ； National Health Insurance ； prescription pattern

參考文獻

Bellentani, S,Tiribelli, C,Saccoccio, G,Sodde, M,Fratti, N,De Martin, C(1994).Prevalence of chronic liver disease in the general population of northern Italy: the dionysos study.Hepatology.20,1442-1449.

Chen, CW,Sun, J,Li, YM,Shen, PA,Chen, YQ(2011).Action mechanisms of du-huo-ji-sheng-tang on cartilage degradation in a rabbit model of osteoarthritis.Evid. Based Complement. Alternat. Med..571479.

Chen, FP,Kung, YY,Chen, YC,Jong, MS,Chen, TJ,Chen, FJ,Hwang, SJ(2008).Frequency and pattern of Chinese herbal medicine prescriptions for chronic hepatitis in Taiwan.J. Ethnopharmacol..117,84-91.

Ferrucci, LM,Bell, BP,Dhotre, KB,Manos, MM,Terrault, NA,Zaman, A(2010).Complementary and alternative medicine use in chronic liver disease patients.J. Clin. Gastroenterol..44,e40-e45.

Hwang, SJ(2001).Hepatitis C virus infection: an overview.J. Microbiol. Immunol. Infect..34,227-234.