[教育訓練] 台大生醫電子所莊曜宇教授演講

[支援分院] 張清貿醫師於2016年1月開始支援「臺北榮總關渡醫院」中醫科門診：週三上午08:30-12:00及週四下午13:30-17:00

張清貿醫師於2016年1月開始支援「臺北榮總關渡醫院」中醫科門診

地點：112台北市北投區知行路225巷12號 臺北榮總關渡醫院11F 中醫科

時間：週三上午08:30-12:00
            週四下午13:30-17:00

診療方式：中醫內科及針灸

診療專長：風濕免疫疾病、修格蘭氏症、紅斑性狼瘡、類風濕關節炎、硬皮症、過敏性鼻炎、異位性皮膚炎、癌症體質調理、針灸

[親子] 宇叡也被剃光頭了，跟去年廷緯哥哥來對比

[親子] 宇叡也被剃光頭了，跟去年廷緯哥哥來對比

[榮譽獲獎] 臺北榮總傳統醫學部張清貿醫師，榮獲台北市中醫師公會頒發2016年國醫節大會「中醫藥優良學術著作獎」

[獎狀] 臺北榮總傳統醫學部張清貿醫師，

榮獲台北市中醫師公會頒發2016年國醫節大會「中醫藥優良學術著作獎」

[親子] 廷緯宇叡兩兄弟對比

[親子] 廷緯宇叡兩兄弟對比

[書籍] 朱學亭老師的國際專書著作：Cancer Gene Profiling - Methods and Protocols

今天收到 朱學亭老師送我的國際專書著作，

"Cancer Gene Profiling - Methods and Protocols"

[教學] 北榮傳醫部張清貿醫師核心課程教學：傷寒論導讀 - 李心機讓傷寒論自己解釋自己

傷寒論疑難解讀(第2版)（簡體書）

ISBN13：9787117108508 出版社： 人民衛生出版社 作者：李心機 裝訂／頁數：／413頁 版次：2 規格(高/寬)：19*13cm 出版日：2009/01/01 李心機教授從事《傷寒論》的研究和教學20余年，宗成《傷寒論疑難解讀》一書。本書對《傷寒論》研究史上的“誤讀傳統”做了深入的剖析，對《傷寒論》中的具體方證進行了理論上的還原分析。他獨辟蹊徑，提出并運用“讓《傷寒論》自己詮解自己”的原則和方法，以尋繹仲景的理論思路，對后世的若干“誤讀現象”進行了駁正，并作出了全新的、合理的、自然的解釋。本書針對《傷寒論》中的句讀和義理，進行了疏證，糾正了《傷寒論》研究史上，多遵漢唐義疏之例“注不破經，疏不破注”的隨文敷飾之弊，提出了許多難能可貴的見解。

[教學] 北榮傳醫部張清貿醫師核心課程教學：傷寒論導讀 - 李心機讓傷寒論自己解釋自己

[健康] 可以量血壓心率的手環

[心得] 軟的可麗餅

今天去買可麗餅，前面一位小姐一直在盧老闆說，他要吃「軟的可麗餅」，
由於前一陣子在板橋大遠百吃過軟的法式可麗餅，超級貴，吃完還是覺得台式比較好吃，所以知道那個小姐在說什麼意思。

[演講] 2016年03月13日，2016年第8屆台北國際中醫藥學術論壇 Sjögren's syndrome 修格蘭氏症/乾燥症 張清貿醫師演講 - 2002年至2011年間台灣全民健康保險研究資料庫之中醫藥治療乾燥症核心處方分析

2016年第8屆台北國際中醫藥學術論壇

2002年至2011年間台灣全民健康保險研究資料庫之中醫藥治療乾燥症核心處方分析

大會時間：2016年3月13日（星期日） 下午14：10-14：30

大會地點：台北市徐州路2號／台大醫院國際會議中心

演講主題：2002年至2011年間台灣全民健康保險研究資料庫之中醫藥治療乾燥症核心處方分析

演講者：張清貿醫師

                臺北榮民總醫院傳統醫學部醫師

                長庚大學臨床醫學研究所博士候選人

[親子] 大兒子廷緯與二兒子宇叡，相差一歲半，長的還真像

[親子] 大兒子廷緯與二兒子宇叡，相差一歲半，長的還真像

[論文發表] Modulation of Endothelial Injury Biomarkers by Traditional Chinese Medicine LC in Systemic Lupus Erythematosus Patients Receiving Standard Treatments，中藥複方LC調控紅斑性狼瘡患者血管內皮損傷因子臨床研究

[論文發表] Modulation of Endothelial Injury Biomarkers by Traditional Chinese Medicine LC in Systemic Lupus Erythematosus Patients Receiving Standard Treatments

Full Text 下載

Sci Rep. 2016 Feb 5;6:19622. doi: 10.1038/srep19622.

Modulation of Endothelial Injury Biomarkers by Traditional Chinese Medicine LC in Systemic LupusErythematosus Patients Receiving Standard Treatments.

中藥複方LC調控紅斑性狼瘡患者血管內皮損傷因子臨床研究

Chang HH1,2, Luo SF3, Hsue YT4, Chang CM5, Lee TY6, Huang YC7,2, Hsu ML8, Chen YJ9.

Author information

Abstract

LC is an herbal remedy effectively reduced therapeutic dosage of glucocorticoid for systemic lupus erythematosus (SLE) patients in clinical trial (ISRCTN81818883). This translational research examined the impact of LC on biomarkers of endothelial injury in the enrolled subjects. Fifty sevenpatients with SLE were randomized to receive standard treatment without or with LC supplements. Blood samples were taken serially for quantification of endothelial progenitor cells (EPCs), circulating endothelial cells (CECs) and serological factors. The proportion of EPCs in the placebo group continued to increase during trial and was further elevated after withdrawal of standard treatment. The EPC ratio of LC group remained stationary during the entire observation period. The CEC ratio in placebo group exhibited an increasing trend whereas that in LC group declined. The ratio of apoptotic CECs had an increasing trend in both groups, to a lesser extent in LC group. After treatment, the levels of VEGF and IL-18 have a trend declined to a level lower in the LC group than the placebo group. No significant alteration was noted in serum levels of IFN-α, IL-1β and IL-6. The reduction of the steroid dosage by adding LC might be correlated with less extensive endothelial injury in SLE patients.

[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」