- 學位論文
探討台灣慢性攝護腺炎/慢性骨盆腔疼痛患者使用傳統中醫療法之相關因素
Study of Traditional Chinese Medicine Usage and Associated Factors among Chronic Prostatitis/ Chronic Pelvic Pain Syndrome Patients in Taiwan
摘要
背景與目的: 慢性攝護腺炎/慢性骨盆腔疼痛對於小於50歲的男性病患是最常見的泌尿科診斷，對於大於50歲男性病患也是僅次於良性攝護腺增生以及攝護腺癌的第三常見診斷，盛行率約9%。由於此類疾病盛行率高加上致病機轉不明確，臨床表徵又呈現多樣化，目前西醫缺乏實證療效，因此目前治療方面也呈現多樣化，包括除正統的西醫療法之外，另有逐漸興起的替代療法，亦稱為輔助及另類療法。傳統中醫在臺灣是最普遍的輔助及另類療法，也是台灣醫療體系的重要一環，因此探討慢性攝護腺炎/慢性骨盆腔疼痛病患之中醫使用狀況是一個重要的研究議題。 方法: 本研究以台灣全民健保資料庫次級資料進行回溯性研究分析，擷取2007至2010年主次診斷碼為慢性攝護腺炎的中、西醫門診就醫資料，探討其健保下中醫使用盛行率及影響使用之相關因素。 結果: 台灣慢性攝護腺炎/慢性骨盆腔疼痛疾病之盛行率約為 0.9%。病患大多是40歲以上之中、老年人為主(平均54.5歲)；診斷前曾經有就診中醫經驗者居多；病患就醫區域大多居住於醫療資源較豐富的高度都市化區域，北台灣占一半以上；就醫時以無罹患慢性疾病居多。病患於就醫後一年內曾經使用傳統中醫療法之盛行率約2.5%，影響其使用的相關因素包括年齡、是否於疾病診斷前曾經就診中醫、投保就醫區域以及病患居住都市化程度等。傳統中醫療法以使用中醫處方為主，標本兼治，主要處方以清熱、利水、止洩、止痛及抗發炎的中藥治標以及補腎之中藥固本。 結論: 目前台灣於全民健保下慢性攝護腺炎/慢性骨盆腔疼痛患者選擇使用傳統中醫療法之盛行率約2.5%，使用型態以中醫處方為主，影響其使用的相關因素包括年齡、是否於疾病診斷前曾經就診中醫、投保就醫區域以及病患居住都市化程度等。
並列摘要
Background and objectives: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is the most common urologic diagnosis in men younger than 50 years and the third most common urologic diagnosis in men older than 50 years, with an estimated prevalence in the community of about 9%. The etiology of CP/CPPS can be multifactorial and can present with a variety of symptoms. Given the lack of proven efficacy of conventional western medicines such as antibiotics, alpha blockers, many patients have turned to complementary and alternative therapies. Traditional Chinese Medicine (TCM) is the most important types of Complrmentary and Alternative Medicine (CAM) in Taiwan. Survey of TCM usage is important issue for CP/CPPS patients in Taiwan. Yet little information exists particularly by a large-scale surveillance about CAM use among CP/CPPS patients in Taiwan. This study aimed to explore a survey to analyze the prevalence and factors associated with TCM using entire CP/CPPS population in Taiwan. Method: A retrospective study using National Health Insurance Research Database (NHIRD) was conducted. Claims of outpatient services of CP/CPPS patients from 2007 to 2010 were retrieved to explore the prevalence of TCM use and associated factors. Results: The prevalence of TCM use was 3.1%, 2.2%, 2.1%, and 2.5% in each cross- sectional year during 2007–2010, respectively. Overall, 182 patients (2.5%) had used TCM in one year follow up period after index date. The most common used pattern of TCM was Chinese herbal remedy (100%), followed by acupuncture. Most patients received TCM at private clinics (45.5%). The TCM useage associated factors among CP/CPPS patients are age, have ever used TCM before the CP/CPPS diagnosis, insured region and urbanization of patient’s residence. Conclusions: A certain portion of patients with CP/CPPS used TCM with NHI coverage in Taiwan (2.5%). The most common used pattern is Chinese herbal remedy, characteristic by “to address both the symptoms and root cause”. The associated factors and determinants between TCM users and TCM non-users are age, have ever used TCM before the CP/CPPS diagnosis, insured region and urbanization of patient’s residence. Further studies are needed to investigate TCM efficacy among CP/CPPS patients in Taiwan.