2019年12月29日 星期日

[論文發表] Laser Acupuncture for Carpal Tunnel Syndrome: A Single-Blinded Controlled Study,雷射針灸治療腕隧道症候群-一個單盲對照臨床試驗-張清貿醫師


 2019 Oct;25(10):1035-1043. doi: 10.1089/acm.2019.0169. Epub 2019 Sep 9.

Laser Acupuncture for Carpal Tunnel Syndrome: A Single-Blinded Controlled Study.

雷射針灸治療腕隧道症候群-一個單盲對照臨床試驗

Juan CW1,2Chang MH3,4Lin TH1Hwang KL5Fu TC6,7Shih PH8,9Chang CM (張清貿) 10,11,*Yang CP12,13,*.

Abstract

Objectives: This study aimed to compare the efficacy of laser acupuncture (LA) treatment with that of placebo LA treatment in patients with idiopathic, mild-to-moderate carpal tunnel syndrome (CTS), as measured by subjective symptom assessments and objective changes in nerve conduction studies (NCSs). Design: A randomized, single-blinded, controlled study. Settings: A Teaching Hospital in the Taichung, Taiwan between March 2013 and November 2013. Subjects: 84 consecutive treatment-naive patients with CTS. Interventions: Participants were randomly divided into two treatment arms: (1) LA, administered at traditional Chinese acu-points on the affected side, once a day, 5 times a week, for 4 weeks (N = 43); and (2) placebo LA, administered using the same device and protocol, with the LA device switched off (N = 41). Outcome measures: Patients completed the Global symptom score (GSS) at baseline and two and four weeks later. The primary outcome was changes in GSS. NCSs were performed at baseline and repeated at the end of the study as a secondary outcome. Results: There was a significantly greater reduction in GSS in the LA group than in the placebo group at week 2 (-9.30 ± 4.94 vs. -2.29 ± 4.27, respectively, P < 0.01) and at week 4 (-10.67 ± 5.98 vs. -2.90 ± 5.61, respectively, P < 0.01). However, NCSs did not show significant difference between the two groups. Conclusions: LA may be more effective than placebo LA in the treatment of mild-to-moderate idiopathic CTS in terms of subjective measurement. For patients who fear needle-based treatment, such as acupuncture or local injections, or those who do not opt for early surgical decompression, LA treatment can be considered as an effective and alternative form of acu-points stimulation therapy.

KEYWORDS:

carpal tunnel syndrome; laser acupuncture; low-level laser





2019年12月10日 星期二

[教學門診] 2020年01-06月臺北榮民總醫院傳統醫學部-張清貿主治醫師教學門診



202001-06
臺北榮民總醫院傳統醫學部
張清貿主治醫師教學門診

開診地點:北榮傳醫部第56


14:00-17:00
指導醫師
1/17()
183中醫內科
張清貿醫師
1/31()
189中醫針灸科

張清貿醫師
2/14()
183中醫內科
張清貿醫師
2/21()
189中醫針灸科
張清貿醫師
3/12()
183中醫內科
(14:30開始)
張清貿醫師
3/26()
189中醫針灸科
(14:30開始)
張清貿醫師
4/17()
183中醫內科
張清貿醫師
4/24()
189中醫針灸科
張清貿醫師
5/15()
183中醫內科
張清貿醫師
5/29()
189中醫針灸科
張清貿醫師
6/12()
183中醫內科
張清貿醫師
6/19()
189中醫針灸科
張清貿醫師

本教學門診限定看診人數3人以下,將優先提供給以下疾病之初診患者掛號:

1.          Sjögren syndrome/Sicca Syndrome (Dry Eye, Dry month):修格蘭氏症 /乾燥症 (口乾、眼乾)

2.          Systemic Lupus Erythematosus:紅斑性狼瘡
3.          Systemic Sclerosis:硬皮症
4.          Rheumatoid arthritis:類風濕性關節炎
5.          Autoimmune Rheumatic Diseases:自體免疫風濕疾病
6.          Dry Eye Syndrome/Keratoconjunctivitis:乾眼症


上述初診患者有需求可以提前或當天至本部掛號櫃台掛號,或是利用02-2875-7453 #9電話掛號

****由於傳醫部將在2020/03/07開始整修,會換到2門診五樓看診,五月多整修完成在回來,這段期間電話請打二門診五樓電話分機02-2871-2121 #批價櫃檯服務台4889或4890

若以前都未於北榮就診之外院患者,希望可以在就診教學門診時攜帶外院報告前來,這將有助於更全面了解您的病情!

2019年11月5日 星期二

[榮譽獲獎] 2019年中華民國中醫師公會全聯會「中醫藥特殊傑出論文獎」- 多發性肌炎及皮肌炎(PM/DM,Polymyositis and Dermatomyositis)



[榮譽獲獎] 
108年度中華民國中醫師公會全國聯合會
中醫藥特殊傑出論文獎


感謝 楊鈞百 醫師、何文照教授、陳曾基主任、 施柏瑄 醫師

研究團隊的幫忙!⋯⋯
==========================
 2019 Feb 25. pii: S0378-8741(18)34634-8. doi: 10.1016/j.jep.2019.02.042. [Epub ahead of print]

Integrated Therapy Decreases the Mortality of Patients with Polymyositis and Dermatomyositis: A Taiwan-wide Population-Based Retrospective Study.


整合中西醫醫療可減少多發性肌炎與皮肌炎患者之死亡率:臺灣族群回顧性研究


Abstract

ETHNOPHARMACOLOGICAL RELEVANCE:

The issue of whether integrated treatment with conventional medicine (CM) and herbal medicine (HM) can reduce mortality in patients with polymyositis/dermatomyositis (PM/DM) had not been addressed.

AIM OF THE STUDY:

In this study, we investigated the effect of integrated therapy on mortality in a retrospective PM/DM cohort in the Taiwan National Health Insurance Research Database (NHIRD).

MATERIALS AND METHODS:

Patients with PM/DM were retrospectively enrolled from the PM/DM Registry of Catastrophic Illnesses cohort in the Taiwan NHIRD between 1997 and 2011. The patients were divided into an integrated medicine (IM) group that received CM and HM and a non-IM group that received CM alone. The Cox proportional hazards regression model and Kaplan-Meier method were used to evaluate the hazard ratio (HR) for mortality.

RESULTS:

Three hundred and eighty-five of 2595 patients with newly diagnosed PM/DM had received IM and 99 had received non-IM. The adjusted HR for mortality was lower in the IM group than in the non-IM group (0.42, 95% confidence interval 0.26-0.68, p<0.001). The adjusted HR for mortality was also lower in the IM group that had received CM plus HM than in the group that received CM alone (0.48, 95% confidence interval 0.28-0.84, p<0.05). The core pattern of HM prescriptions integrated with methylprednisolone, methotrexate, azathioprine, or cyclophosphamide to decrease mortality included "San-Qi" (Panax notoginseng), "Bai-Ji" (Bletilla striata), "Chen-Pi" (Citrus reticulata), "Hou-Po" (Magnolia officinalis), and "Dan-Shan" (Salvia miltiorrhiza).

CONCLUSION:

Integrated therapy has reduced mortality in patients with PM/DM in Taiwan. Further investigation of the clinical effects and pharmaceutical mechanism involved is needed.

KEYWORDS:

Complementary and alternative medicine; Dermatomyositis; Herbal medicine; Integrated therapyPolymyositis

本研究利用臺灣健保資料庫探討1997至2011年間,臺灣多發性肌炎及皮肌炎(PM/DM,Polymyositis and Dermatomyositis)之中西醫整合照護情形,研究顯示在總數2595位PM/DM患者中,有385位接受中西醫整合治療,僅99位接受純西醫治療。而接受中西醫整合之患者,可顯著降低死亡風險達0.42 (p<0.001),且細部分析中西整合照護與純西醫照護相比,也可顯著降低死亡風險達0.48 (p<0.05)。前五大常使用中醫複方為銀翹散、加味逍遙散、血府逐瘀湯、參苓白朮散及龜鹿二仙膠,前五大常見使用中醫單方為三七、丹參、木瓜、炙甘草及蟬蛻,治療中醫核心處方為三七、白芨、陳皮、厚朴及丹參本文也整理中醫藥治療PM/DM核心處方之機轉,並整理成相關表格及機轉圖,也提出中醫藥核心處方可以降低死亡率,可作為提供中西醫師治療PM/DM之實證醫學之證據。



2019年10月12日 星期六

[恭賀] 修格蘭氏症 Sjögren Syndrome 懷孕順產



[恭賀] 修格蘭氏症 Sjögren Syndrome 懷孕順產

我有一位修格蘭氏症 Sjögren Syndrome患者,每個月從竹北上來看診,來看診之前懷孕常常在20週左右會中止,到我們診我看完跟他說應該是免疫引起的,可能是抗磷脂質抗體症候群 (Antiphospholipid syndrome, APS),造成血栓,影響懷孕過程。

經過中西醫整合治療,加上後期建議他好好安胎,好幾次都覺得快撐不下去,今天早上收到簡訊說順利生產了,母子均安

自體免疫性疾病患者,有的人怎麼樣都無法懷孕,甚至是就算懷孕了也無法順產,懷孕生產過程還會經歷生離死別,

還好順利了,我也放下心中的大石頭。

接下來就好好休息做完月子,再啟動下一段新的歷程。

2019年10月2日 星期三

[演講] 20191022 新南向傳統聯合論壇-傳統醫藥資源及轉譯應用-整合中西醫療法治療紅斑性狼瘡:從真實世界的大數據資料庫研究到臨床報告 ,北榮傳醫部張清貿醫師







2019 新南向傳統聯合論壇-傳統醫藥資源及轉譯應用 

2019 Joint Forum for Traditional Medicine under the New Southbound Policy- The 
Application and Translation of Traditional Medicine Resources   

時間  Date:108 年 10 月 22 日  上午 9:00 -  下午 5:00 
地點  Venue:張榮發基金會國際會議中心 802 會議室 

演講時間:16:35-17:00 
演講主題 :整合中西醫療法治療紅斑性狼瘡:從真實世界的大數據資料庫研究到臨床報告 
Integrative  Therapy  for  Systemic  Lupus Erythematosus: from real-world big data to clinical reports 

演講人:臺北榮民總醫院傳統醫學部 張清貿主治醫師/助理教授 
Ching-Mao Chang, Attending physician, Center for Traditional Medicine, Taipei Veterans General Hospital

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感謝國家中醫藥研究所 沈郁強 組長 邀請,
讓我有機會到2019 新南向傳統聯合論壇分享

整合中西醫療法治療紅斑性狼瘡:從真實世界的大數據資料庫研究到臨床報告
Integrative Therapy for Systemic Lupus Erythematosus: from real-world big data to clinical reports

[研究發表][臨床病例報告] 中西醫整合治療紅斑性狼瘡腎炎病例報告Integrated Therapy Improve Urinary Total Protein in Patients with Lupus Nephritis: A Case Report


[持續追蹤] 蛋白尿指數回覆正常範圍了:中西醫整合治療紅斑性狼瘡腎炎之持續追蹤病例報告 20190104


希望未來還能有機會繼續向大家報告!