Kuo Yi-Ting, Chang Tung-Ti, Muo Chih-Hsin, Wu Mei-Yao, Sun Mao-Feng, Yeh Chia-Chou, Yen Hung-Rong
1 Graduate Institue of Chinese Medicine, School of Chinese Medicine, China Medical University, Taichung, Taiwan.
2 Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.
Integr Cancer Ther. 2018 Jun;17(2):531-541. doi: 10.1177/1534735417716302. Epub 2017 Jun 30.
Many patients with cancer seek complementary and alternative medicine treatments. We investigated the use of traditional Chinese medicine (TCM) by adult cancer patients in Taiwan.
We reviewed the Registry for Catastrophic Illness Patients Database of Taiwan, and included all adult patients diagnosed cancer, based on the International Classification of Diseases (ninth revision), from 2001 to 2009 and followed until 2011. This database allowed categorization of patients as TCM users (n = 74 620) or non-TCM users (n = 508 179). All demographic and clinical claims data were analyzed.
Compared with non-TCM users, TCM users were younger and more likely to be female, white-collar workers, and reside in highly urbanized areas. The average interval between cancer diagnosis and TCM consultation was 15.3 months. The most common cancer type was breast cancer in TCM users (19.4%), and intrahepatic bile duct cancer in non-TCM users (13.6%). The major condition for which TCM users visited clinics were endocrine, nutritional and metabolic diseases, and immunity disorders (23.2%). A total of 33.1% of TCM users visited TCM clinics more than 9 times per year and their time from diagnosis to first TCM consultation was 5.14 months. The most common TCM treatment was Chinese herbal medicine. The common diseases for which cancer patients sought TCM treatment were insomnia, malaise and fatigue, dizziness and headache, gastrointestinal disorders, myalgia and fasciitis, anxiety, and depression. Overall, TCM users had a lower adjusted hazard ratio (aHR) for mortality (aHR = 0.69, 95% CI = 0.68-0.70) after adjustment for age, sex, urbanization of residence, occupation, annual medical center visits, and annual non-medical center visits.
This study provides an overview of TCM usage among adult cancer patients in Taiwan. TCM use varied among patients with different types of cancer. Physicians caring for cancer patients should pay more attention to their patients' use of complementary TCM.
许多癌症患者寻求补充和替代医学治疗。我们调查了台湾成年癌症患者对中医的使用情况。
我们查阅了台湾重大伤病患者数据库登记处的数据，纳入了所有根据国际疾病分类（第九版）在2001年至2009年期间被诊断为癌症且随访至2011年的成年患者。该数据库可将患者分为中医使用者（n = 74620）和非中医使用者（n = 508179）。对所有人口统计学和临床索赔数据进行了分析。
与非中医使用者相比，中医使用者更年轻，更可能为女性、白领，且居住在高度城市化地区。癌症诊断与中医咨询之间的平均间隔为15.3个月。中医使用者中最常见的癌症类型是乳腺癌（19.4%），非中医使用者中最常见的是肝内胆管癌（13.6%）。中医使用者就诊的主要疾病是内分泌、营养和代谢疾病以及免疫紊乱（23.2%）。共有33.1%的中医使用者每年看中医诊所超过9次，从诊断到首次中医咨询的时间为5.14个月。最常见的中医治疗方法是中药。癌症患者寻求中医治疗的常见疾病有失眠、不适和疲劳、头晕和头痛、胃肠道疾病、肌痛和筋膜炎、焦虑和抑郁。总体而言，在对年龄、性别、居住城市化程度、职业、每年去医疗中心就诊次数和每年非医疗中心就诊次数进行调整后，中医使用者的调整后死亡风险比（aHR）较低（aHR = 0.69，95%CI = 0.68 - 0.70）。
本研究概述了台湾成年癌症患者对中医的使用情况。不同类型癌症患者对中医的使用情况有所不同。照顾癌症患者的医生应更加关注患者对补充性中医的使用。
