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更年期婦女骨關節病變與獨活寄生湯之探討

Study on Du Huo Ji Sheng Tang for Menopausal Women with Osteodystrophy

摘要


全世界目前估計有10億婦女正在經歷更年期(menopause),而這群女性深受更年期症候群困擾,包括熱潮紅、盜汗、冒冷汗和心悸,失眠、情緒低落、疲勞,以及泌尿生殖系統症狀,如陰道乾燥,性慾下降,並且還有關節痛等骨性疾病。更年期婦女最常見骨性病變(osteodystrophy)包含了退化性關節炎(Osteoarthritis)與原發性停經型骨質疏鬆(primary postmenopausal osteoporosis)。而骨性病變更是困擾年長女性之重大問題,包含關節疼痛影響行為能力、骨質疏鬆所造成易發性骨折,然而西醫治療更年期骨性病變有其侷限性,藉由尋找適合治療更年期女性骨性病變之中醫用藥,期望除了提供有效治療,也減少病人副作用與醫療經費的耗用。從分析健保資料庫發現獨活寄生湯為處理骨性病變常用首要的中醫方劑,而透過文獻研究,認為獨活寄生湯能有效處理更年期婦女骨性病變。本研究擬透過歸納臨床試驗之實證、文獻典籍的回顧,整理本方對於骨性問題之改善,並透過基礎實驗探討其運作機轉,進一步了解獨活寄生湯如何協助改善更年期婦女之骨性病變。以此模式推廣更多中醫藥安全、便利,具有臨床效用的方劑,以造福民眾。

並列摘要


An estimated 1 billion women worldwide are currently experiencing menopause, and this group of women is suffering from menopausal symptoms, including hot flashes, night sweats, cold sweats, and palpitations, insomnia, depressed mood, fatigue, and urogenital symptoms such as vaginal desiccation, decreased libido, and bone diseases such as joint pain. Osteodystrophy is the most common bone lesions in menopausal women include degenerative arthritis and primary menopausal osteoporosis. Osteodystrophy is a major problem that plagues older women, including joint pain affecting behavioral capacity and susceptible fractures caused by osteoporosis. However, western medicine has limitations in treating menopausal osteopathy. It is expected that in addition to providing effective treatment, medical drugs in the disease will also reduce the consumption of side effects and medical expenses. From the analysis of the health insurance database, it was found that Du Huo Ji Sheng Tang (DHJST) is the most common prescription for treating bone lesions in Traditional Chinese Medicine (TCM). According to literature research, DHJST can effectively treat bone lesions of menopausal women. This study intends to summarize the improvement of bone problems by summarizing the evidence of clinical trials and literature classics, and to explore its operational mechanism through basic experiments to further understand how DHJST can help to improve the bone lesions of menopausal women. Hoping to promote more safe, convenient, and clinically effective TCM prescriptions in this mode to benefit the people.

參考文獻


Hoga, L, Rodolpho J,Gonçalves B,Quirino B: Women's experience of menopause: a systematic review of qualitative evidence. JBI Database System Rev Implement Rep, 2015; 13(8): 250-337.
Takahashi, T.A., K.M. Johnson: Menopause. Med Clin North Am, 2015; 99(3): 521-534.
Nelson, H.D.: Menopause. Lancet, 2008; 371(9614): 760-770.
Santoro, N., C.N. Epperson, and S.B. Mathews: Menopausal Symptoms and Their Management. Endocrinol Metab Clin North Am, 2015; 44(3): 497-515.
Thornton, K., J. Chervenak, G. Neal-Perry: Menopause and Sexuality. Endocrinol Metab Clin North Am, 2015; 44(3): 649-661.

被引用紀錄


陳品璇、曾育慧、許中華(2022)。中醫居家醫療之現況與展望台灣公共衛生雜誌41(1),16-35。https://doi.org/10.6288/TJPH.202202_41(1).110130

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