西醫辨病與中醫辨證的臨床整合：以更年期調查研究為例

Applied Epidemiological Study Results of Menopausal Women to Integrative Western and Chinese Medicine in the Clinic Application

吳炫璋(Hsien-Chang Wu)

《北台灣中醫醫學雜誌》 3卷1期 (2011/12) Pp. 27-40

https://doi.org/10.30127/BTWZYYXZZ.201112.0003

摘要

更年期婦女長期使用西藥荷爾蒙治療近年來一直有爭議，因此許多婦女轉而尋求中醫藥治療。本研究主要目的為探討台灣更年期婦女更年期症狀之盛行率與生活品質之相關性，提供未來中西醫師在照護更年期婦女所應注意與治療之重點。本研究採量性橫斷性的調查於大台北地區兩家教學醫院隨機抽取就診中醫門診或是健檢之更年期婦女共614位，依婦女主述之停經狀態，分成停經中期（peri-menopause）與停經後期（post-menopause），每位婦女均填寫生活品質問卷台灣簡明版（WHOQOL-BREF）與更年期身心症狀問卷（MRS）。統計方法主要採用描述性統計分析描述基本資料，並以獨立樣本 t檢定或卡方檢定分析停經中期與停經後期之更年期症狀盛行率與平均值。結果：停經中期婦女生理與環境生活品質分數明顯較停經後期婦女差；停經中期疲倦的發生率顯著較停經後期高，而停經後期以陰道乾澀的發生率較停經中期明顯。整體而言，關節肌肉酸痛與睡眠障礙等主述是更年期婦女最常見症狀。由本研究成果建議，臨床上中醫師在照護更年期婦女時，應進一步參酌現代更年期婦女停經分期與常見症狀，將現代辨病診斷分類模式融入中醫傳統的辨證中，採取辨證結合辨病的方式治療更年期症候群，將有助於提升更年期婦女實證照護的品質。

關鍵字

更年期症候群 ； 中西醫整合 ； 流行病學研究

並列摘要

It is still a controversial issue of the hormone replacement therapy among menopausal women for a long term use, thus many climacteric women transfer to seek for the traditional Chinese Medicine help. The primary aims of this study were to evaluate the prevalence of the menopausal symptoms and relationship of the quality of life to provide the important diagnostic and therapeutic points of view for the clinic doctors. This cross-sectional survey was conducted among women who, as a result of climacteric or menopausal-related symptoms at Buddhist Tzu Chi General Hospital, Taipei branch and Taipei City Hospital. A total of 614 menopausal women were classified into periand postmenopausal status. Each subject was asked to fill out a Menopausal Rating Scale (MRS) and World Health Organization Quality of life (QOL) questionnaire. Descriptive method was employed to illustrate the basic demographic and MRS and QOL outcome variables. The independent t test and χ2 test were used, as appropriate, to ascertain the significance of the differences between the mean values and each two continuous variables. We found that the physical and environmental QOL domain score of the perimenopausal women was significantly poor than the postmenopausal women. The prevalence of fatigue was significantly in the perimenopausal women and vaginal dryness in the postmenopausal women. Overall, the joint and muscle complaints with sleep disorder were the chief complaints amongst menopausal women in north Taiwan. Our research suggests that the common menopausal symptoms and menopausal status of the present should be taken into consideration of the diagnosis in the traditional Chinese pattern identification. Integrative of the Western and Chinese Medicine to treat the menopausal symptoms will help to promote the evidence and quality to care the health of the climacteric women.

並列關鍵字

Menopausal symptoms ； Integrative medicine ； Epidemiological study