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台湾地区脑瘫患儿使用中医辅助治疗的全国性回顾性队列研究。

Complementary traditional Chinese medicine use in Children with cerebral palsy: a nationwide retrospective cohort study in Taiwan.

作者信息

Liao Hou-Hsun, Yen Hung-Rong, Muo Chih-Hsin, Lee Yu-Chen, Wu Mei-Yao, Chou Li-Wei, Sun Mao-Feng, Chang Tung-Ti

机构信息

Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.

Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, NO. 2, Min-Sheng Road. Dalin Town, Chiayi, Taiwan, Republic of China.

出版信息

BMC Complement Altern Med. 2017 Mar 14;17(1):155. doi: 10.1186/s12906-017-1668-5.

Abstract

BACKGROUND

Complementary traditional Chinese medicine (TCM) has been used to treat patients with cerebral palsy (CP). However, large-scale surveys examining its use in the treatment of CP and associated disorders are lacking.

METHODS

We enrolled 11,218 patients ≤ 18 years of age with CP in the Taiwanese National Health Insurance Research Database from 1995 to 2011. Patients were categorized as TCM users (n = 6,997; 62.37%) and non-TCM users (n = 4,221; 37.63%) based on the inclusion of TCM in their treatment plan.

RESULTS

Children with higher proportions of complementary TCM use were male, younger, and lived in urbanized areas. Most TCM users (n = 5332, 76.2%) visited TCM outpatient departments more than 20 times per year. In both groups, the three most common reasons for clinical visits were problems of the nervous system, respiratory system, and digestive system. Acupuncture was commonly used in problems of injury, musculoskeletal system and connective tissue, and nervous system. Chinese herbal medicine was used to improve the primary symptoms of CP in patients, as well as its associated disorders. The incidence rate ratios in allergic rhinitis, dyspepsia, menstrual disorders, and musculoskeletal system and connective tissue diseases among TCM users were significantly higher than non-TCM users. Although patients receiving complementary TCM therapies had higher medical expenditure for utilizing outpatient clinical consultations, their medical costs for visiting ER and hospitalization were significantly lower than that of non-TCM user within one year of the diagnosis of CP.

CONCLUSION

This study was a large-scale survey to characterize patterns of complementary TCM use among children with CP. The complementary use of TCM in children with CP was considerably high. Future clinical trials and basic researches can be developed based on the findings of this study.

摘要

背景

中医辅助疗法已被用于治疗脑瘫(CP)患者。然而,缺乏关于其在治疗CP及相关疾病中应用情况的大规模调查。

方法

我们从1995年至2011年的台湾国民健康保险研究数据库中纳入了11218名年龄≤18岁的CP患者。根据治疗方案中是否包含中医,将患者分为中医使用者(n = 6997;62.37%)和非中医使用者(n = 4221;37.63%)。

结果

中医辅助治疗使用比例较高的儿童为男性、年龄较小且居住在城市化地区。大多数中医使用者(n = 5332,76.2%)每年看中医门诊超过20次。在两组中,临床就诊的三个最常见原因是神经系统、呼吸系统和消化系统问题。针灸常用于损伤、肌肉骨骼系统和结缔组织以及神经系统问题。中药用于改善CP患者的主要症状及其相关疾病。中医使用者中过敏性鼻炎、消化不良、月经失调以及肌肉骨骼系统和结缔组织疾病的发病率比值显著高于非中医使用者。尽管接受中医辅助治疗的患者因门诊临床咨询的医疗支出较高,但在CP诊断后的一年内,他们急诊和住院的医疗费用显著低于非中医使用者。

结论

本研究是一项大规模调查,旨在描述CP儿童中医辅助治疗的使用模式。CP儿童中医辅助治疗的使用率相当高。未来可基于本研究结果开展临床试验和基础研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4db/5348761/6ef8115a2221/12906_2017_1668_Fig1_HTML.jpg

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