門診糖尿病藥物治療型態之研究–以某醫學中心為例

A Study of the Transition Patterns of Prescription for Type II Diabetes Outpatients in a Medical Center in Taiwan

胡繡華(Hsiu-Hua Hu)

指導教授 ： 詹前隆

元智大學/資訊學院/資訊管理學系/碩士(2005年)

摘要

本研究以糖尿病患者的門診就醫紀錄，應用馬可夫鏈預測糖尿病患用藥的移轉機率及藥物停留時間，分析糖化血色素與病患年齡及性別間之關係。
在研究中發現，在門診處方中使用一種口服藥停留時間為3.372年，二種口服藥停留時間為3.188年。三或四種口服藥停留時間為4.845年。總計使用口服用藥11.405年後才需轉為胰島素注射。
服用降血糖藥物的病患中，男性患者四年糖化血色素檢驗平均值控制比女性患者好。未服用降血糖藥物的病患中，糖化血色素的控制，不同性別在第一年糖化血色素檢驗平均值都較高，糖化血色素檢驗平均值在第二年下降，第三、四年則緩慢上升。除了第一年女性略高於男性外，第二、三、四年女性都比男性好。在年齡層方面，65歲以上年齡層糖化血色素檢驗平均值比65歲以下年齡層控制的好。
本研究發現在血糖控制的藥物治療模式上，以採用一類降血糖之病患佔多數，亦發現有部分糖尿病患者，是未使用藥物治療，但糖化血色素卻也控制良好，說明透過運動、飲食及衛教以達到良好的血糖控制。

關鍵字

糖尿病、糖化血色素、門診處方

並列摘要

This research was based on the medication records of diabetes outpatients in a hospital. We calculated the transitional probabilities of the states of their medicines, and used Markov-chain to predict the time required to transfer from one state to another. We also explored the relationship between HbA1c and diabetes patients’ age and gender.
The results revealed that the patients’ staying periods of one oral medicine were 3.372 years; two oral medicines were 3.188 years; three or four oral medicines were 4.845 years. After taking oral medicines for 11.405 years, patients changed to require insulin injection.
For the patients taking oral hypoglycemic agents, the average HbA1c level of male patients was better than that of female patients in four years of the study. For the patients not taking oral hypoglycemic agents, the average HbA1c levels in the first year for both genders were high. The HbA1c level decreased in the second year, then increased slowly in the third and the fourth year. The HbA1c level of women was higher than that of men in the first year, but lower than that of men in the second, the third, and the fourth year. The HbA1c of patients over 65 years old was better than that of the patients below 65 years old.
This research also found that most diabetes patients used only one oral hypoglycemic agent to control their blood sugar. However, some diabetes patients without medicines had better control of sugar through excise, diet, and education.

並列關鍵字

Diabetes、HbA1c、Medicines