[交換學生] 馬來西亞醫學大學國際交換學生至臺北榮總傳統醫學部張清貿醫師門診學習

馬來西亞醫學大學國際交換學生至臺北榮總傳統醫學部張清貿醫師門診學習

[論文發表] Adjunctive Chinese Herbal Medicine therapy improves survival of patients with chronic myeloid leukemia: a nationwide population-based cohort study，中醫藥改善慢性骨髓性白血病患者存活率之研究

Full Text 全文下載

Cancer Med. 2016 Jan 15. doi: 10.1002/cam4.627. [Epub ahead of print]

Adjunctive Chinese Herbal Medicine therapy improves survival of patients with chronic myeloid leukemia: a nationwide population-based cohort study.

中醫藥改善慢性骨髓性白血病患者存活率之研究

Fleischer T1, Chang TT2,3,4, Chiang JH5,6,7, Chang CM8,9, Hsieh CY10, Yen HR2,3,7,11.

Author information

Abstract

Despite good clinical results of current drugs, a good reason still exists to search for additional therapies for the management of Chronic Myeloid Leukemia (CML). Chinese Herbal Medicine (CHM) has thus far been overlooked by researchers and no data exists on the subject. We studied the impact of adjunctive CHM on the disease course of CML, using mortality as the major outcome measurement. We used the Taiwanese National Health Insurance Research Database to perform a nationwide population-based cohort study. Our study included CML patients diagnosed between 2000 and 2010. We matched groups according to age, sex, Charlson Comorbidity Index (CCI) score and use of imatinib, and compared the Hazard Ratios (HR) of CHM group and non-CHM users, as well as characterized trends of prescriptions used for treating CML. 1371 patients were diagnosed with CML in the years examined, of which 466 were included in to this study. We found that the HR of CHM group was significantly lower compared to non-CHM groups (0.32, 95% CI 0.22-0.48, P < 0.0001). We also established that this association between reduced HR was dose-dependent, and the longer CHM users received prescriptions, the lower the HR (P < 0.01). We also analyzed the most commonly used herbal products as well as the HR associated to their use, thus providing future research candidates. Our results supply a strong reason to assume that when administered by properly trained physicians, CHM may have a substantial positive impact on the management of CML.

© 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

KEYWORDS:

CML ; NHIRD ; Chinese herbal medicine; Taiwan; leukemia

陽光廚坊 - 今天晚餐吃紅麴五花肉和泰式椰香雞

陽光廚坊 - 今天晚餐吃紅麴五花肉和泰式椰香雞

[學會感謝狀] 20160110 台灣中醫臨床醫學會第七屆張清貿副秘書長感謝狀

[學會感謝狀] 

台灣中醫臨床醫學會第七屆

張清貿副秘書長感謝狀

[論文發表] 針刺緩解粒線體疾病病童疑似肌陣攣發作之病例報告

Full Text 全文下載

針刺緩解粒線體疾病病童疑似肌陣攣發作之病例報告

A Case Report of Acupuncture Alleviate Suspected Myoclonic Seizure on Child with Mitochondrial Disease

蔡承宏(Cheng-Hung Tsai) ； 張清貿(Ching-Mao Chang) ； 龔彥穎(Yen-Ying Kung) ； 陳方佩(Fang-Pey Chen) ； 吳大鵬(Ta-Peng Wu)

中醫藥研究論叢 ； 18卷2期 (2015 / 09 / 30) ， P117 - 127

繁體中文 DOI： 10.6516/TJTCM.2015.18(2)117 

針刺 ； 粒線體疾病 ； 肌陣攣發作 ； Acupuncture ； Mitochondrial Disease ； Myoclonic Seizure

中文摘要

一名滿六足歲的病童患有粒線體疾病、難治性發作（refractory seizure）與智能遲滯（mental Retardation）之病史。病童自出生4 個月大時開始反覆發作，發作型態不定，主要表現腿部肌肉抽動伴隨眼雙眼上吊，或四肢肌肉抽動伴隨鐘擺式眼球震顫（pendular nystagmus），持續時間亦不固定。該病童於103年7月14日開始於臺北榮民總醫院傳統醫學部門診進行針刺治療，經過中醫四診診斷後，辨證為腎精虧損、腦髓失養、脾失健運、肝風內動，而整理釐清其治則為醒腦開竅、補脾益腎、補虛熄風。自10月28日出院至隔年的1月2日，在針刺治療的同時，未曾再有大發作被觀察到，並成功減少Phenobarbital的用量。本病例報告顯示針刺有可能緩解粒線體肌病（mitochondrial myopathy）造成的發作，提供另一種中西醫整合療法的思維與方法。

Abstract

This six-year-old patient has the history of mitochondrial disease, refractory seizure and mental retardation. Seizure attack since four-month-old he has suffered from. The pattern of his seizure is variable and unstable. It could be muscle twitch of both side of legs accompanying upward gaze, or muscle twitch of limbs with pendular nystagmus. The duration of seizure attack is also unstable. This patient has received acupuncture therapy at Center for Traditional Medicine of Taipei Veterans General Hospital since July 14, 2014. After the induction of four diagnostic methods from Traditional Chinese Medicine (TCM), syndrome differentiation was kidney-essence deficiency, brain dystrophy, dysfunction of spleen in transportation, and endogenous liver wind. Therapeutic principle was ＂activating spirit to resuscitate brain therapeusis＂ (Xingnao Kaiqiao), reinforcing spleen and kidney and supplementing vacuity to extinguish wind. Since 10/28 discharged to 1/2 of the following year, there wasn't any generalized seizure been observed with acupuncture therapies, and the dosage of Phenobarbital was reducd successfully. This case demonstrates that acupuncture has the potential to alleviate the seizure attack of mitochondrial disease, and provides us another thinking and method of integrated therapy including both TCM and Western Medicine.

[門診調動] 2016年開始週三上午、週四下午，支援北榮關渡醫院中醫科門診

2016年開始週三上午、週四下午，
支援北榮關渡醫院中醫科門診

[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。

[相片] 20151201 台大傳醫社課演講照片-中醫病因病機學

[相片] 20151201 台大傳醫社課演講照片-中醫病因病機學

[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

J Ethnopharmacol. 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.

Copyright © 2015. Published by Elsevier Ireland Ltd.

KEYWORDS:

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

[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」

]]」

[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

J Ethnopharmacol. 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.

Author information

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE:

Large-scale study of traditional Chinese medicine (TCM) usage among patients with rheumatoidarthritis (RA) is lacking. The aim of this study is to evaluate the TCM usage among RA patients in Taiwan.

MATERIALS AND METHODS:

We examined the "registry for catastrophic illness patient dataset" of the National Health Insurance Research Database (NHIRD; n=23 million people) in Taiwan. Patients (n=25,263) newly diagnosed as RA in 2001-2009 were included and then followed-up until the end of 2011. Based on the medical utilization, they were further categorized into TCM users (n=6,891; 27.3%) and non-TCM users (n=18,372; 72.7%). The demographic data and core prescription patterns of the TCM users were analyzed.

RESULTS:

Compared to non-TCM user, TCM users were younger (mean age: 49.6 versus 54.0 years), had a higher female/male ratio (82.7%/17.3% versus 74.1%/25.9%), resided in more urbanized area. Herbal remedies were the most commonly used therapeutic approach (76.4%), followed by combining acupuncture (21.1%). The frequency of outpatient visits in TCM users was higher across all disease categories except circulatory system. The most commonly prescribed formula and herb was Shang-Jong-Shiah-Tong-Yong-Tong-Feng-Wan and Rhizoma Corydalis, respectively. The analysis of core pattern revealed that Dang-Gui-Nian-Tong-Tang, Shu-Jing-Huo-Xie-Tang, Gui-Zhi-Shao-Yao-Zhi-Mu-Tang, Myrrha and Olibanum, were among the most frequently used combinations. RA patients who had anxiety and depression, allergic rhinitis, osteoporosis, menstrual disorder, and menopausal syndrome were prone to have more TCM visits compared to non-TCM users.

CONCLUSIONS:

Our population-based study revealed the high prevalence and specific usage patterns of TCM in the RA patients in Taiwan. The information could be used for further pharmacological investigation and clinical trials.

Copyright © 2015. Published by Elsevier Ireland Ltd.

KEYWORDS:

Rhizoma Corydalis; Shang-Jong-Shiah-Tong-Yong-Tong-Feng-Wan; complementary and alternative medicine; national health insurance research database; rheumatoid arthritis; traditional Chinese medicine

[心得] 肚子餓就會買很多東西來吃，結果高估自己戰力

[心得] 肚子餓就會買很多東西來吃，結果高估自己戰力

剛剛從宜蘭支援回來，本來要去買滷味當晚餐，

結果經過新開的雞排店，味道好香就決定改吃雞排，所以我點了：

厚切雞排*1+轟炸大魷魚*1+豆乾*1+米血*1+炸湯圓*1，總共205元，再買一杯烏龍茶手搖杯來喝。

然後雞排真的滿好吃的，只是他的胡椒粉帶一點甜，

吃完後........我剩下就吃不下了

轟炸大魷魚還好好的躺在那邊

每次都高估自己戰力

[會議] 代表臺北榮總傳統醫學部，至北市聯合醫院昆明院區進行中醫負責醫師訓練計畫期末報告

[會議] 代表臺北榮總傳統醫學部，

至北市聯合醫院昆明院區進行中醫負責醫師訓練計畫期末報告

[祝賀] 恭賀天選中醫診所洪嘉言院長，開幕誌慶，華佗妙手！ - 張清貿醫師施柏瑄醫師敬賀

恭賀  天選中醫診所  洪嘉言院長

開幕誌慶，華佗妙手！


臺北榮民總醫院傳統醫學部 張清貿醫師
臺北振興醫院中醫科 施柏瑄醫師 敬賀

[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，會不會併發癌症？

[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 

會不會併發癌症？

張醫師您好！

因為我自從得了Sjögren's syndrome 修格蘭氏症/乾燥症，很多人都說風濕免疫疾病一輩子都不會好，連重大傷病卡都是永久，加上需要吃很多藥物，我很擔心我會不會最後得到癌症？

我需要去做檢查嗎？我需要特別注意什麼嗎？

再麻煩您給我建議！謝謝

[會議] 北榮傳醫部，邀請北護江慧珠老師演講「身體經驗與行為」

[研究新知介紹] 修格蘭氏症(Sjögren's syndrome) 與癌症(Cancer)的發生風險

[研究新知介紹]

修格蘭氏症(Sjögren's syndrome) 與癌症(Cancer)的發生風險

中醫藥實證醫學之探討

修格蘭氏症/乾燥症之中醫研究

張清貿醫師

<張清貿醫師導讀>

成大風濕免疫科2012年在風濕科第一名期刊Annals of the Rheumatic Diseases發表一篇文章，探討「修格蘭氏症(Sjögren's syndrome) 與癌症(Cancer)的發生風險」。研究團隊利用台灣健保資料庫，統計2002年到2008年間7852位修格蘭氏症(Sjögren's syndrome)重大傷病之患者共277人併發癌症。

[親子] 胎教音樂 - 夜夜夜夜與塵緣

[親子] 胎教音樂 - 夜夜夜夜與塵緣

每個小孩我都會錄一首歌當胎教音樂

第一胎是齊秦的夜夜夜夜
http://www.tlkg.com.cn/ugcp/info.kg?enid=0158d32941ffc937a1ce5ff38cda6558

今天是給第二胎是羅文的塵緣
http://www.tlkg.com.cn/ugcp/info.kg?enid=736a9e3dc91b71bea1ce5ff38cda6558

兩胎聽到音樂都會開始胎動，
胖辜廷緯出生以後在哭哭時，夜夜夜夜這首歌會停下來聽一下。

[教育訓練] 中醫耳鼻喉科專科醫師訓練

中醫耳鼻喉科專科醫師訓練

[會議] 中醫、食品與營養 - 與指導教授張恒鴻院長到台大食科所

[會議］

中醫、食品與營養

與指導教授張恒鴻院長到台大食科所

好久沒來吃員工餐廳，今天是檸檬魚，第一次吃到

韓劇《我人生的春天》觀後感

韓劇《我人生的春天》觀後感

一開始題材很吸引人，弟弟的女朋友因為心臟病換心，結果換到哥哥老婆的心臟，然後哥哥就跟弟弟女朋友相愛。

現在韓劇都喜歡拍這種的，但整部戲看下來就發現他們一直都在談戀愛，都不需要上班下班，就算上班也像下班，這種戀愛怎麼可能在現實中存在，

這就是臨床上常說的，有統計差異卻沒臨床意義！！

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

http://baike.baidu.com/view/13764731.htm

韓劇《我人生的春天》

講述時日不多的身患心臟病的女人，在接受心臟移植後，遇到心臟捐獻者的老公，開始特別戀情的感性愛情故事。

畜牧業品牌企業的代表姜東河（甘宇成飾）因為一次事故失去了妻子，獨自撫養兒子，但在遇到接受妻子捐贈的心臟過上新生活的女子李春天（崔秀英飾）之後開始命運般的愛情。

-----------------------

姜東禾

45歲。雖說是韓國代表性畜牧企業Hanuraon的CEO，卻異常的落魄。過度的節儉樸素，顯得非常窮酸。妻子在世時還有人照顧著刮鬍子洗臉，所以還算乾淨。妻子去世後，立即回歸原型。在藍色的海洋中失去了比誰都愛小藍與小海的妻子。就這樣在東禾的最初也是最後的愛情結束後，每日都生活在回憶她的後悔自責的冬日中。所以感到非常寒冷。無論身心、妻子的忌日。陽光溫暖刺眼的一天，在失去妻子的海岸邊，遇到了春天。並且，熱情如火的春天漸漸融化掉了冰封的東禾。不是因酒，不是因工作，而是因他人，東禾感受到了溫暖與擔心。這也是理所當然的吧。不僅是年輕的小女孩，還是弟弟的愛人。但是，為何視線總是為她所吸引，內心總是朝向她。決不可發生的事情正漸漸發生著。

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李春天

27歲。海吉醫院的臨床營養師。因為爸爸是院長，媽媽是理事長，所以明明可以隨便對付工作，卻為了給患者們提供更便宜更好吃更有營養的食物，不惜每天凌晨就去早市。在過分熱情工作的另一面則是她的罪惡感。因擴張型心肌病等死的她，在接受了心臟移植手術之後，迎來了新的人生。正因為是代替著某人活在這世上，不，因為某人代替我離開了這人世，所以要數倍努力活下去的執念深深支配著她。別人戀愛時，病著，病愈後連日專注於工作，所以戀愛經驗可謂白紙一張。在受到主治醫生東旭的鼓勵與支持下恢復的日子裡，相當的依賴著他，並深信這就是愛情。於是雖然與其定下了婚約，卻總是工作優先。手術五年後，僅僅知道捐給自己的心臟來自牛島的春天，為了表示感謝，第一次來到濟洲島遇到東禾的家人，並漸漸被他所吸引。本以為，因為他們是東旭的家人，可她的心臟卻告訴她並非如此，告訴她這才是愛情。

[演講照片] 20150919 中區風濕病月會演講：修格蘭氏症的中醫核心處方分析 - 張清貿醫師

很感謝中區風濕病月會給我這個機會演講

修格蘭氏症的中醫核心處方分析

張清貿醫師