- 期刊
中醫健保十大針灸疾病臨床運用之探討
The Study of Clinical Application for Top 10 Acupuncture Disease in National Health Insurance
摘要
目的：本研究目的指建構發生於中醫針灸科門診前十大疾病，並建立病患特性、醫療機構特性及中醫師基本特性之整合性資料檔。本研究方法是採用2003年至2007年健保抽樣歸入檔作資料分析，統計中醫針灸科門診發生疾病的頻次，並對中醫就醫情形，進行描述性分析統計。方法：自2003無1月起至2007年12月底，納入研究對象包括35,554個門診處方明細，共開出69,585筆門診處方醫令。依據國際疾病分類號碼(ICD-9 codes)主診斷為主，統計中醫針灸科及傷科有使用針灸處置費之門診處方醫令，最常發生的前十大重要疾病，分別為：1．腰肌痛；2．肌炎；3．肩胛肌肉痛（五十肩）；4．頸肌痛；5．背痛；6．坐骨神經痛；7．踝之扭傷及拉傷；8．頸椎痛；9．關節痛（下肢）；10．神經痛、神經炎及神經根。分析顯示針灸治療的醫事機構特約類別以基層院所為主，醫事人員性別以男性為主，醫事機構分局別以台北或中區分局別為主，病患方面以女性為主，發生關節痛（下肢）的病患年齡層較高（66~75歲）；發生踝之扭傷及拉傷的病患年齡層較低（16~25歲）。結論：由本研究統計出發生於中醫針灸科門診前十大疾病中，腰肌痛、肩胛肌肉痛（五十肩）、頸肌痛、坐骨神經痛、背痛皆是世界衛生組織(WHO)認可之43種針灸治療有效的病症之一，為針刺適應症項目之一。目前使用針灸治療的民眾愈來愈多，且有愈來愈多的文獻實證中醫和針灸治療各種疾病的效果。民衆常利用針灸來改變身體的功能，而改善身體狀況達到治療疾病，甚至保健強身之最高目的。
並列摘要
To explore the frequency of Chinese medicine acupuncture outpatient service, we have the study by analyzing the population-based Chinese medicine database, in Taiwan. The study was linked characteristic of patient demographics, medical situation and Chinese medicine doctors. The complete datasets of Chinese medicine outpatient reimbursement claims from 2003 to 2007 were supplied by the National Health Insurance Research Database, Taiwan, and the top ten of usage frequencies and characteristics of the Chinese medicine acupuncture users.From 2003 to 2007, there were 35,554 ambulatory care expenditures by visits and 69,585 details of ambulatory care orders. According to ICD-9 codes, we quantified prescriptions with the top ten disease frequencies of the Chinese medicine acupuncture users. The most common indications were Lumbago, Myalgia and Myositis, Frozen shoulder, Spains and strains of neck, Backache, Sciatica, Spains and strains of ankle, cervicalgia, pain in joint, Lower leg, and Neuralgia, Neuritis and Radiculitis. Analyses show that the special medical institutions for acupuncture therapy are basic hospitals; gender of medical personnel is mainly male; the branches of the medical institutions are distributed in Taipei or central Taiwan; the patients are mainly females; patients with arthralgia (lower limbs) are in higher age group (66~75 years old); and ankle sprain and strain appear on the ones in lower age group (16~25 years old).According to the statistics in this study, within the top ten illnesses in acupuncture outpatient services in traditional Chinese medicine, psoas muscle pain, shoulder muscle pain (frozen shoulder), neck muscle pain, sciatica, and backache are included in the 43 effective illnesses with acupuncture therapy approved by World Health Organization (WHO). Presently, there are more people receiving acupuncture therapy and more literatures have proved the treatments of traditional Chinese medicine and acupuncture therapy on various diseases. People are likely to utilize acupuncture for changing physical functions, improving physical conditions to treat illnesses, and achieving the ultimate purpose of health care.