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台湾地区全民健康保险项下过敏性鼻炎的中药、西药及中西医结合用药处方

Prescriptions of traditional Chinese medicine, western medicine, and integrated Chinese-Western medicine for allergic rhinitis under the National Health Insurance in Taiwan.

作者信息

Huang Sheng-Kang, Ho Yu-Ling, Chang Yuan-Shiun

机构信息

Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, China Medical University, No. 91, Hsueh-Shih Road, Taichung City 40402, Taiwan; Chang-Hua Hospital, Ministry of Health and Welfare. No. 80 Chung Cheng Road. Changhua County 51341, Taiwan.

Department of Nursing, Hung Kuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, Taichung City 43302, Taiwan.

出版信息

J Ethnopharmacol. 2015 Sep 15;173:212-6. doi: 10.1016/j.jep.2015.06.051. Epub 2015 Jul 11.

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

Allergic rhinitis has long been a worldwide health problem with a global growth trend. The use of traditional Chinese medicines alone or integrated Chinese-Western medicines for its treatment is quite common in Taiwan. Respiratory diseases account for the majority of outpatient traditional Chinese medicine treatment, while allergic rhinitis accounts for the majority of respiratory diseases. We hereby conduct a comparative analysis between traditional Chinese medicine treatments and western medicine treatments for allergic rhinitis in Taiwan. The results of the analysis on the prescription difference of traditional Chinese medicine and western medicine treatments would be helpful to clinical guide and health policy decision making of ethnopharmacological therapy.

MATERIALS AND METHODS

Patients diagnosed as allergic rhinitis with diagnostic code 470-478 (ICD-9-CM) were selected as subjects from 2009-2010 National Health Insurance Research Database based on the claim data from the nationwide National Health Insurance in Taiwan. This retrospective study used Chi-Square test to test the effects of gender and age on visit of traditional Chinese medicine, western medicine, and integrated Chinese-Western medicine treatments.

RESULTS

A total of 45,804 patients diagnosed as allergic rhinitis with ICD-9-CM 470-478 were identified from 2009-2010 NHIRD. There were 36,874 subjects for western medicine treatment alone, 5829 subjects for traditional Chinese medicine treatment alone, and 3101 subjects for integrated Chinese-Western medicine treatment. Female patients were more than male in three treatments. 0-9 years children had the highest visit frequency in western medicine and integrated Chinese-Western medicine groups, while 10-19 years young-age rank the highest in traditional Chinese medicine group. The Chi-square test of independence showed that the effects of gender and age on visit of three treatments were significant.

CONCLUSIONS

The prescription drugs of western medicine treatment alone were almost for relieving the symptoms of allergic rhinitis. That leads to the little difference between 2009 and 2010. The same phenomenon occurs in integrated Chinese-Western medicine. However, the prescription drugs of traditional Chinese medicine treatment vary considerably. Multiple-composition medicine been replaced by single-composition medicine implied that syndrome differentiation and treatment were used and the synergistic effects of multiple-composition medicine were no longer suitable for the most patients of 2010.

摘要

民族药理学相关性

变应性鼻炎长期以来一直是一个全球性的健康问题,且呈全球增长趋势。在台湾,单独使用中药或中西医结合治疗变应性鼻炎颇为常见。呼吸系统疾病占中医门诊治疗的大多数,而变应性鼻炎又占呼吸系统疾病的大多数。我们在此对台湾变应性鼻炎的中医治疗和西医治疗进行比较分析。对中医和西医治疗处方差异的分析结果将有助于民族药理学治疗的临床指导和卫生政策决策。

材料与方法

根据台湾全国健康保险的理赔数据,从2009 - 2010年全国健康保险研究数据库中选取诊断代码为470 - 478(ICD - 9 - CM)的变应性鼻炎患者作为研究对象。这项回顾性研究采用卡方检验来检验性别和年龄对中医、西医及中西医结合治疗就诊情况的影响。

结果

从2009 - 2010年NHIRD中确定了45804例诊断为ICD - 9 - CM 470 - 478的变应性鼻炎患者。其中,仅接受西医治疗的有36874例,仅接受中医治疗的有5829例,接受中西医结合治疗的有3101例。三种治疗方式中女性患者均多于男性。0 - 9岁儿童在西医和中西医结合治疗组中的就诊频率最高,而10 - 19岁青少年在中医治疗组中就诊频率最高。独立性卡方检验表明,性别和年龄对三种治疗就诊情况的影响具有显著性。

结论

仅西医治疗的处方药几乎都是用于缓解变应性鼻炎症状的,这导致2009年和2010年之间差异不大。中西医结合治疗也出现同样现象。然而,中医治疗的处方药差异相当大。多成分药物被单成分药物取代意味着采用了辨证论治,且多成分药物的协同作用不再适用于2010年的大多数患者。

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