| 摘要: | 退化性關節炎〈骨關節炎〉在中老年族群中較常見，女性較男性患病率高，是一種慢性、多發性及進展性的關節疾病。目前已知年紀、女性、肥胖、軟骨炎、關節受傷，以及長期反覆性增加關節的負擔等，都是造成退化性關節炎的重要因子。隨著現代醫療進步，老年人口比例逐年上升，根據衛生福利部統計，國人膝關節退化的盛行率約有15%。且隨著運動風氣盛行，很多人的膝蓋常會不當使用，有呈現年輕化的趨勢。西醫對於退化性關節炎的藥物治療，只能給予非類固醇類消炎藥來止痛，但常會有消化道方面的副作用。因此，有部份國人會選擇傳統中醫的治療。本研究希望藉用健保資料庫資料來分析中藥方劑用於退化性關節炎的使用性。因此收集2013年一整年經醫師診斷為退化性關節炎後，有接受中藥方劑治療〈ICD-9-CM:715.00、716.1、716.9〉的健保資料庫資料，進行卡方檢定及敘述性統計分析。經統計分析後發現，退化性關節炎患者接受中藥方劑的治療中，中醫師開給「獨活寄生湯」處方者有2427人次（43.7%），佔大多數。之後，在處方「獨活寄生湯」者中，發現以50歲～59歲年齡層居多（17%），而女性佔有64.9%，男性佔35.1%，女性與男性的比例約為1.84：1。由此分析結果可知，接受中醫藥方劑治療的退化性關節炎患者中，女性患病率高於男性，年齡層在50~59歲居多，與流行病學的調查吻合。而依「獨活寄生湯」的祛風濕、補肝腎、壯腰膝、補氣血，用於痺症，肝腎兩虛，氣血不足的藥理屬性及作用，在台灣的中醫師確實較常用「獨活寄生湯」來治療骨關節炎。
Degenerative arthritis (osteoarthritis) is a common disease among middle aged and old aged individuals. Females’ morbidity rate is higher than males’. Osteoarthritis is a chronic, multiple progressive articulation disease. The risk factors of osteoarthritis included age, female, fat, cartilage inflammation, joint injuries, as well as long-term repeated increase burden of the joint. Due to the improvements of modern medical care, the proportion of the aged population grows every year, resulting in the population ageing phenomenon. According to the statistics of the Ministry of Health and Welfare, the prevalence of knee degenerative arthritis in Taiwan is 15%. Furthermore, because of the current prevalent exercising movement, many people often injure their knees from exercising improperly. Consequently, the patients’ age has gradually declined. Western medicine for the treatment of osteoarthritis can only be prescription with non-steroidal anti-inflammatory drugs (NSAIDs), but NSAIDs often have side effects of the digestive tract. Therefore, most of the people will choose the traditional Chinese medicine (TCM). This study uses the longitudinal cohort of the year 2013, which is collected by the National Health Insurance Database. This thesis aims to compare the analysis of those whom have been diagnosed with osteoarthritis and received the treatment of TCM (ICD-9-CM: 715.00, 716.1, 716.9) by Chi-squared test. The statistical analysis shown that the majority (43.7%) of osteoarthritis patients receiving TCM is prescription with “Du-huo-ji-sheng Tang”. Foremove analysis of patients’ prescription with ““Du-huo-ji-sheng Tang”, we found that 50 to 59 years age group is the majority (17%). The prevalence of women was 64.9% and men accounted for 35.1%. The incidence ratio of women to men is about 1.84:1. From the analysis results, osteoarthritis treatment with TCM, are mostly consistent with the epidemiological investigation. And “Du-huo-ji-sheng Tang” is indeed the more common TCM to osteoarthritis treatment. |
