[Facebook 粉絲專頁上線了] 張清貿醫師整合中西醫照護自體免疫性疾病-修格蘭氏症Sjögren Syndrome之中西醫實證探討，歡迎大家一起來討論最新的自體免疫疾病整合醫學新知！

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張清貿醫師整合中西醫照護自體免疫性疾病-修格蘭氏症Sjögren Syndrome之中西醫實證探討

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張清貿醫師一直致力於中西醫整合醫學照護修格蘭氏症、乾燥症、紅斑性狼瘡、類風濕關節炎等自體免疫性疾病。

歡迎大家一起來討論最新的自體免疫疾病整合醫學新知！

[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

J Altern Complement Med. 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 CW1,2, Chang MH3,4, Lin TH1, Hwang KL5, Fu TC6,7, Shih PH8,9, Chang CM (張清貿) 10,11,*, Yang CP12,13,*.

Author information

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

[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

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

開診地點：北榮傳醫部第5、6診

	14:00-17:00	指導醫師
1/17(五)	183中醫內科	張清貿醫師
1/31(五)	189中醫針灸科	張清貿醫師
2/14(五)	183中醫內科	張清貿醫師
2/21(五)	189中醫針灸科	張清貿醫師
3/12(四)	183中醫內科 (14:30開始)	張清貿醫師
3/26(四)	189中醫針灸科 (14:30開始)	張清貿醫師
4/17(五)	183中醫內科	張清貿醫師
4/24(五)	189中醫針灸科	張清貿醫師
5/15(五)	183中醫內科	張清貿醫師
5/29(五)	189中醫針灸科	張清貿醫師
6/12(五)	183中醫內科	張清貿醫師
6/19(五)	189中醫針灸科	張清貿醫師

***[教學門診] 張清貿醫師教學門診介紹***

(感謝「乾燥症—水噹噹之喬伊斯日常」-喬伊斯分享的心得)

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！

[榮譽獲獎] 201911 107-2 陽明大學醫學院網路教學評估優良教師獎

[榮譽獲獎]

201911 107-2 陽明大學醫學院網路教學評估優良教師獎

[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！⋯⋯

＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝＝

J Ethnopharmacol. 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

Chang CM1, Shih PH2, Chen TJ3, Ho WC4, Yang CP5.

Author information

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.

Copyright © 2019. Published by Elsevier B.V.

KEYWORDS:

Complementary and alternative medicine; Dermatomyositis; Herbal medicine; Integrated therapy; Polymyositis

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。