2015年12月24日星期四

[修格蘭氏症患者來信Q&A] Sjögren's syndrome 修格蘭氏症/乾燥症......等自體免疫性疾病患者，懷孕時需不需要服用奎寧 Hydroxychloroquine？ - 張清貿醫師

[修格蘭氏症患者來信Q&A]

Sjögren's syndrome 修格蘭氏症/乾燥症......等自體免疫性疾病患者，懷孕時需不需要服用奎寧 Hydroxychloroquine？

張醫師您好！

我原本就有服用奎寧 Hydroxychloroquine，但最近懷孕後，風濕免疫科醫師及婦產科醫師建議我停用奎寧 Hydroxychloroquine，但我停藥幾週後，Sjögren's syndrome 修格蘭氏症/乾燥症開始出現，想請問中醫是否可以幫忙這一部份？

可以請您給我一些建議嗎？感恩！

＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝

張清貿醫師回覆：

Sjögren's syndrome 修格蘭氏症/乾燥症患者您好：

由於必賴克瘻 (奎寧 Hydroxychloroquine)可以調節免疫，Sjögren's syndrome 修格蘭氏症/乾燥症患者、Systemic lupus erythematosus 紅斑性狼瘡、Rheumatoid Arthritis 類風濕性關節炎或是硬皮症 Systemic Sclerosis......等自體免疫性患者，常常需要服用奎寧 Hydroxychloroquine。

加上自體免疫疾病好發於女性居多，有一部分青中年女性患者會遇到懷孕的問題，這時候就會猶豫需不需要繼續服用奎寧，根據FDA制定懷孕五等級用藥安全分級說明，奎寧 Hydroxychloroquine屬於C級用藥，就是說這個藥物在動物實驗顯示對胎兒有害但，缺乏控制良好的孕婦實驗；或缺乏動物實驗或孕婦實驗數據。詳如下圖亞東醫院藥劑部衛教單張所述。

2015年12月1日星期二

[相片] 20151201 台大傳醫社課演講照片-中醫病因病機學

2015年11月25日星期三

[論文發表] Prescription Patterns of Traditional Chinese Medicine for Peptic Ulcer Disease in Taiwan: A NationwidePopulation-based Study，胃潰瘍疾病之中醫藥處方研究

2015 Nov 5. pii: S0378-8741(15)30205-1. doi: 10.1016/j.jep.2015.11.002. [Epub ahead of print]

Prescription Patterns of Traditional Chinese Medicine for Peptic Ulcer Disease in Taiwan: A NationwidePopulation-based Study.

胃潰瘍疾病之中醫藥處方研究

Huang CY1, Lai WY2, Sun MF3, Lin CC4, Chen BC5, Lin HJ6, Chang CM7, Yang CH6, Huang KC8, Yen HR9.

Author information

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE:

Peptic ulcer disease is a common digestive disease. There is a lack of large-scale survey on the use of traditional Chinese medicine (TCM) for the treatment of peptic ulcer disease. This study aimed to investigate the utilization of TCM for the treatment of peptic ulcer disease in Taiwan.

MATERIALS AND METHODS:

We analyzed a random sample comprised of one million individuals with newly diagnosed peptic ulcer diseasebetween 2001 to 2010 from the National Health Insurance Research Database in Taiwan. Demographic characteristics and TCM usage, includingChinese herbal formulas and the single herbs prescribed for patients with peptic ulcer disease, were analyzed.

RESULTS:

A total of 96,624 newly diagnosed subjects with peptic ulcer disease were included. 14,983 (15.5%) patients were TCM users. People residing in highly urbanized areas, younger people and female (compared with male) were more likely to use TCM. With regard to the comorbidities, TCM users had a lower prevalence of coronary artery disease, chronic obstructive lung disease, diabetes mellitus and liver cirrhosis and stroke. The average time between onset of peptic ulcer disease and the first visit to a TCM clinic was 4.7 months. Majority of the patients (n=14,449; 96.4%) received only Chinese herbal remedies. The most frequently prescribed Chinese herbal formula and single herb was Ban-Xia-Xie-Xin-Tang (Pinelliae Decoction to Drain the Epigastrium) and Hai-Piao-Xiao (Os Sepiae), respectivley. The core pattern analysis showed that combination of Ban-Xia-Xie-Xin-Tang, Hai-Piao-Xiao (Os Sepiae), Yan-Hu-Suo (Rhizoma Corydalis), Bei-Mu (Bulbus Fritillariae Thunbergii) and Chuan-Lian-Zi (Fructus Toosendan) was most frequently used for peptic ulcer disease.

CONCLUSIONS:

Our study identified the core prescription patterns of TCM for patients with peptic ulcer disease in Taiwan. Further basic and clinical studies are necessary to elucidate the efficacy and mechanisms.

KEYWORDS:

Ban-Xia-Xie-Xin-Tang; Complementary and alternative medicine; National health insurance research database; Os Sepiae; Peptic ulcer disease;Traditional Chinese medicine

2015年11月17日星期二

[榮譽獲獎] 張清貿醫師榮獲104年度退輔會臺北榮民總醫院「臨床教學績優醫師獎」

[榮譽獲獎]

臺北榮民總醫院傳統醫學部張清貿醫師

榮獲104年度退輔會臺北榮民總醫院「臨床教學績優醫師獎」

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2015年11月16日星期一

[論文發表] Characteristics of Traditional Chinese Medicine Use in Patients with Rheumatoid Arthritis in Taiwan: A Nationwide Population-Based Study，類風濕關節炎之特性與中醫藥處方研究

2015 Oct 16. pii: S0378-8741(15)30182-3. doi: 10.1016/j.jep.2015.10.024. [Epub ahead of print]

Characteristics of Traditional Chinese Medicine Use in Patients with Rheumatoid Arthritis in Taiwan: A Nationwide Population-Based Study.

類風濕關節炎之特性與中醫藥處方研究

Huang MC1, Pai FT2, Lin CC3, Chang CM4, Chang HH5, Lee YC6, Sun MF7, Yen HR8.