傳統中藥方劑加味逍遙散用於停經症候群之探討

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標題:	傳統中藥方劑加味逍遙散用於停經症候群之探討 Survey the effectiveness of Jia-Wey-Shiau-Yau-San, a traditional Chinese herbal prescription on menopausal symptoms
作者:	林忠勳
貢獻者:	藥學系劉淑芬
關鍵字:	中藥方劑加味逍遙散停經症候群全民健康保險研究資料庫 Chinese herbal prescriptions Jia-Wey-Shiau-Yau-San (JWSYS) menopausal symptoms National Health Insurance Research Database
日期:	2016
上傳時間:	2016-12-21 15:35:18 (UTC+8)
摘要:	賀爾蒙療法 (Hormone replacement therapy, HRT) 是治療許多停經症候群症狀的一個重要方法，但長期使用有增加乳癌發生的風險，因此許多婦女望之卻步。然而，已有一些報告指出，替代療法已被證實能成功地減少許多更年期症狀。這些替代療法包括天然激素、中藥方劑、維生素和礦物質等順勢療法。加味逍遙散，中國傳統中草藥方劑之一，是用於各種停經症候群相關症狀治療著名的中藥方劑。此外，由於加味逍遙散具有良好的順從性和安全性，且無雌激素作用和改變代謝的作用，顯示加味逍遙散或許可能成為停經症候群婦女在不能或不願意接受賀爾蒙療法治療時用來緩解症狀的替代性選擇。本研究主要是藉由台灣全民健康保險研究資料庫（NHIRD）來評估中藥方劑應用於停經症候群症狀的使用概況。研究數據是收集2013年一整年中有使用加味逍遙散治療停經症候群的用藥記錄分析。資料分析是採用SPSS 12.0 Ver.統計學軟體來進行數據分析。分析國際疾病分類（ICD-9）的婦科疾病中，停經症候群比例高達94.1％。經過描述性統計分析，其中又以50-55歲的女性患者有使用加味逍遙散來治療停經症候群佔多數，比例高達40.2%。此外，我們發現加味逍遙散的給藥天數為8-14天最多，佔44.1％。最後由6,590個有使用中藥方劑來治療停經症候群症狀的個案分析中，我們發現患者使用加味逍遙散的比例最高佔了91.0％ (勝算比=3.815)，歸脾湯佔4.7％，當歸芍藥散佔2.7％，而半夏厚朴湯佔1.5％。總而言之，統計調查結果顯示，在治療更年期停經症候群症狀中最常見的中藥方劑為加味逍遙散。雖然這些數據是由台灣全民健康保險研究資料庫統計出來的結果，但是這項調查研究對於加味逍遙散用於更年期停經症候群症狀的確切療效和臨床作用尚未證明，需要進一步的研究來驗證其療效。 The hormone replacement therapy (HRT) is a key tool in treating many postmenopausal symptoms. However, some reports have found that alternative therapies have been proved successful in reducing menopausal symptoms. These include natural hormones, herbal preparations, vitamins, minerals and homeopathic remedies. Jia-Wey-Shiau-Yau-San (JWSYS), one of the traditional Chinese herbal prescriptions, is a famous herbal remedy used for the management of various menopausal-related symptoms. Moreover, JWSYS showed a good compliance and safety without estrogenic effects and metabolic alterations, suggesting that JWSYS might be an alternative choice for relief of climacteric symptoms in postmenopausal women, who are unable or do not want to receive HRT.The present study was to evaluate the drug utilization patterns of Chinese herbal prescription for menopausal symptoms in Taiwan by National Health Insurance Research Database (NHIRD).The study analysis data was collected in 2013 and we also analyzed medical records of NHIRD, which treatment menopausal symptoms for women by JWSYS. Data were analyzed using SPSS/12.0 statistical software.Analysis of International Classification of Diseases-9 (ICD-9) gynecological diseases, menopausal symptoms have the highest proportion of 94.1%. By descriptive analysis, the majority of female patients with menopausal symptoms in the age of JWSYS at 50-55, accounting for 40.2%.In addition, we found that JWSYS treatment dosing day is 8-14 days, accounting for 44.1%. The records of 6,590 individuals who were administered with the Chinese herbal prescriptions to treat symptoms of the menopause were reviewed. With the analysis of usage of Chinese herbal prescriptions, we found that the patients with JWSYS accounted with 91.0% (OR=3.815), Gui-Pi-Tang accounted with4.7%, Dang-Gui-Shao-Yao-San accounted with2.7%, and Ban-Xia-Hou-Po-Tang accounted with 1.5%, respectively.In conclusion, the survey revealed that the most common Chinese herbal prescription in the treatment of menopausal symptoms was JWSYS. Although the data were generated in Taiwan, however, the exact efficacy and clinical roles of JWSYS have not been convincingly demonstrated in this study. Further studies are warranted to validate the efficacy of JWSYS deserves.
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