探討中草藥之使用與健康及慢性疾病之關聯性

The Association of Chinese Herbal Medicine Use with Health and Chronic Disease Conditions in the Elderly in Taiwan

廖恩宜(Liao En-I)

指導教授 ： 蔡仲弘

亞洲大學/健康學院/長期照護研究所/碩士(2009年)

摘要

背景—中草藥之使用相當普遍。使用中草藥所引起的副作用或非預期反應常有所聞，但對健康或慢性疾病的長期影響則研究不多。
目的--本研究的目是以追蹤研究的方式，分析台灣中老年人中草藥之使用率，影響中草藥使用的因素及中草藥的使用對慢性疾病之影響。
方法--本研究採用具族群代表性的「台灣地區中老年身心社會狀況長期追蹤調查系列」 (Survey of Health and Living Status of the Elderly in Taiwan, SHLSET) 研究之1999年及2003年調查資料。以SPSS / Window 12.0中文版統計套裝軟體進行資料分析。橫斷研究以卡方檢定 (Chi-Square test) 分析中草藥與社會人口學變項、健康行為指標、自評健康或營養狀況及自述"經醫師診斷"罹患各種慢性疾病之關聯性。並以邏輯迴歸 (Logistic regression analysis) 分析社會人口學變項、健康行為指標、自評健康或營養狀況及自述"經醫師診斷"罹患慢性疾病對使用中草藥之影響及中草藥之使用對自述"經醫師診斷"罹患各種慢性疾病的影響。以邏輯迴歸縱貫分析個案於基準年 (1999年)自報中草藥之使用對2003年罹患慢性疾病盛行率之影響。
結果—本研究結果顯示約16%的台灣中老年人自報使用中草藥。低教育年數者使用之可能性高於高教育年數者 (p<0.05)。閩南人高於非閩南人 (p<0.05)。自評健康或營養狀況不佳者使用之可能性高於良好者 (p<0.05)。但中草藥之使用與年齡、抽菸、喝酒、嚼檳榔或運動習慣無關。而於基準年，女性中草藥使用之可能性高於男性及中部居民使用之可能性高於其他地區 (p<0.05)。個案於基準年自述"經醫師診斷"患有心臟病、腎臟病及痛風者使用之可能性皆高於未罹病者 (p<0.05)，四年後患有白內障及腎臟病使用之可能性高於未罹病者 (p<0.05)。以邏輯迴歸分析發現族群、居住地、自評健康或營養及腎臟病為使用中草藥之預測因子 (p<0.05)。經串聯兩次調查資料，以邏輯迴歸縱貫分析中草藥對四年後疾病盛行率的預測力，其結果發現使用中草藥增加43%罹患腎臟病之風險。
結論--本研究發現約16%的台灣中老年人使用中草藥。族群、居住地、自評健康或營養及腎臟病為影響中草藥之使用預測因子。本研究亦發現中草藥之使用增加罹患腎臟病之風險，但無法確定與何種中草藥有關。本研究之結果有助於衛生單位決策者瞭解中草藥之使用風險及研擬規劃預防措施以減少與腎臟病相關之醫療支出。

關鍵字

中草藥 ； 慢性腎臟病 ； 非預期效應 ； 健康風險

並列摘要

Background: The use of Chinese Herbal Medicine (CHM) is common among Taiwanese. There are reports of side effects or unintended reactions associated CHM use. However, the long term effects on the occurrence of chronic diseases have not been well investigated.
Objective: The objectives of this study are to investigate the prevalence of CHM use, the factors that impact the use, and the potential effects of CHM use on the occurrence of chronic diseases in older adult Taiwanese.
Methods: The study analyzed 1999 and 2003 cross-sectional and longitudinal data of the "Survey of Health and Living Status of the Elderly in Taiwan, SHLSET" conducted by the Bureau of Health Promotion of Taiwan. SPSS 12.0 Software Package was used to conduct the statistical analyses. Chi-square Test was used to test the significance of differences between those who used and did not use CHM stratified by sociodemographic and lifestyle variables, self-viewed health status, and the occurrence of chronic diseases. Binary logistic regression analysis was applied to determine the significance of the impact of sociodemographic and lifestyle variables, self-viewed health status, and the occurrence of chronic diseases on CHM use, and to determine the impact of CHM use on follow-up incidences of chronic diseases.
Results: Results show that approximately 16% of older Taiwanese self-reported use of CHM in 1999. Greater proportions of elderly who were less formally educated, ethnic Southern Fukienese, central Taiwan residents, self-viewed poorer health or nutritional status, or had heart disease or chronic kidney disease (CKD) used CHM. Age and lifestyle factors such smoking, drinking, betel-nut chewing and physical activity did not have significant effect. Binary regression analysis revealed a significant increase in follow-up incidence (43%) in CKD among CHM users compared to non-users.
Conclusion: Results show that CHM use is common among older Taiwanese (approximately 16%). CHM use is associated with increased CKD risk. CHM use is also associated with an increase in follow-up CKD. Results suggest that CHM use is not necessarily riskless. Greater efforts are needed to further explore the long-term health risk of CHM. More aggressive health promotion and better management and control of CHM use might be the key to reduce the potential risks.

並列關鍵字

Chinese herbal medicine ； Chronic kidney disease ； Unintended effects ； Health risk

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