2016年1月20日 星期三

[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


 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 T1Chang TT2,3,4Chiang JH5,6,7Chang CM8,9Hsieh CY10Yen HR2,3,7,11.

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

2016年1月8日 星期五

[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




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.