2015年5月6日 星期三

[研究發表摘錄介紹] 獨活寄生湯、骨碎補、續斷三種方藥組合為退化性關節炎(osteoarthritis, OA)之主要中醫藥組合

[研究發表摘錄介紹] 

「獨活寄生湯」、「骨碎補」加「續斷」為退化性關節炎(osteoarthritis, OA)之主要中醫藥組合






在台灣,年紀大於50歲平均有37%罹患退化性關節炎(osteoarthritis, OA),由於現今西醫常規治療下存在許多副作用,因此許多患者尋求替代療法治療患病關節之不適,臺北榮民總醫院傳統醫學部從2002年健保資料庫中分析全人口檔(22,520,776)之中醫處方分析,結果顯示20,059位患者在中醫門診治療過OA,並總共服用32,050項中醫處方,其中40-49歲患者佔最多數,女性比男性為1.891,處方分析中最常被使用的單方為「杜仲」,其他依次為「續斷」、「牛膝」、「木瓜」、「丹參」,最常被使用之複方為「獨活寄生湯」,其他依次為「疏經活血湯」、「當歸拈痛湯」、「六味地黃丸」、「濟生腎氣丸」。最常開立之兩種藥物組合為「獨活寄生湯」加「身痛逐瘀湯」,最常開立三種藥物組合為「獨活寄生湯」、「骨碎補」加「續斷」
本研究探討2002年全人口退化性關節炎之中醫藥物流行病學調查,相關成果並於20143月發表於BMC Complementary and Alternative Medicine。本研究極具參考價值,可提供台灣中醫師與退化性關節炎患者參考。

This study is the first nationwide population based survey of the CHM use for OA patients in Taiwan. Females used CHM for OA higher than males (1.89:1), and the female aged 50-69 years had the highest prevalence of CHM use for OA. Menopause, higher percentage of obesity and osteoporosis in female may be the factors accounting for this phenomenon [38-40].

The most commonly combination of three CHMs is “Du-huo-ji-sheng-tang, Gu-sui-pu plus Xu-duan”, followed by “Du-huo-ji-sheng-tang, Yan-hu-suo plus Nui-xi” and “Du-huo-ji-sheng-tang, Shu-jing-huo-zue-tang plus Yan-hu-suo.” “Gu-sui-pu” could inhibit the osteoclast activity in the OA mouse model [54] and prevent osteoporosis [55]. And “Yan-hu-suo” had anti-inflammatory effect with decreasing vascular permeability and restraining the development of adjuvant-induced edema in arthritic mice and rat models [56]. It also could alleviate pain with analgesic effect in a rat model [57].

TCM doctors in Taiwan frequently prescribe a combination of Chinese herbal formulae and Chinese single herb with the concepts of “pattern identification as the basis for determining treatment” and “sovereign, minister, assistant, and courier” [33,35,37]. Mostly, there were six items of CHM in a prescription for OA. Since female OA patients usually combined with menopausal syndrome and osteoporosis, the TCM doctors might combine use these CHM formulae more frequently in order to treat these two diseases.

BMC Complementary and Alternative Medicine摘錄Discussion部份內容:
Fang-Pey Chen, Ching-Mao Chang, Shinn-Jang Hwang*, Yu-Chun Chen and Fun-Jou Chen: Chinese herbal prescriptions for osteoarthritis in Taiwan: analysis of national health insurance dataset. BMC Complementary and Alternative Medicine. 2014 (SCI, 2013 IF=1.877)