Department of Sport and Health Management, Da-Yeh University, Changhua 51591, Taiwan.
Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan.
Int J Environ Res Public Health. 2019 Oct 24;16(21):4086. doi: 10.3390/ijerph16214086.
Carpal tunnel syndrome (CTS) is a common musculoskeletal disorder and an occupational disease caused by repeated exercise or overuse of the hand. We investigated the characteristics of traditional Chinese medicine (TCM) use by practitioners in CTS patients, including demographic variables, socioeconomic status, previous medical conditions, health care use, and hospital characteristics for TCM health care. This cross-sectional study identified 25,965 patients newly diagnosed with CTS based on the first medical diagnosis recorded between 1999 and 2013 in the nationwide representative insurance database of Taiwan. The date of initial CTS diagnosis in outpatient data was defined as the index date, and four patients were excluded because of missing gender-related information. Patients who used TCM care as the first option at their diagnosis were classified as TCM users ( = 677; 2.61%), and all others were TCM non-users ( = 25,288; 97.4%). In the all variables-adjusted model, female patients had an adjusted odds ratio (OR; 95% CI) of TCM use of 1.35 (1.11-1.66). National Health Insurance (NHI) registration was associated with higher odds ratios of TCM use in central, southern, and eastern Taiwan than in northern Taiwan (ORs = 1.43, 1.86, and 1.82, respectively). NHI registration was associated with higher odds ratios of TCM use in rural cities than in urban cities (OR (95% CI) = 1.33 (1.02-1.72)). The TCM group had a 20% less likelihood of exhibiting symptoms, signs, and ill-defined conditions and injury and poisoning. The TCM group had a 56% lower likelihood of having diseases of the musculoskeletal system and connective tissue. Multi-level model outcomes were similar to the results of the all variables-adjusted model, except for the NHI registration outcome in rural and urban cities (OR [95% CI] = 1.33 [0.98-1.81]). Significant associations between the number of TCM visits and TCM use were observed in all logistic regression models. The study presented key demographic characteristics, health care use, and medical conditions associated with TCM use for CTS. Previous experience of TCM use may affect the use of TCM for CTS treatment. This information provides a reference for the allocations of relevant medical resources and health care providers.
腕管综合征（CTS）是一种常见的肌肉骨骼疾病和职业病，由手部重复运动或过度使用引起。我们调查了从业者在 CTS 患者中使用中医（TCM）的特点，包括人口统计学变量、社会经济状况、既往病史、医疗保健利用和 TCM 保健的医院特征。这项横断面研究根据台湾全国代表性保险数据库中 1999 年至 2013 年记录的首次医疗诊断，确定了 25965 名新诊断为 CTS 的患者。门诊数据中 CTS 首次诊断的日期被定义为索引日期，由于缺少与性别相关的信息，有 4 名患者被排除在外。将将 TCM 护理作为首次治疗选择的患者分类为 TCM 用户（=677；2.61%），其余所有患者均为 TCM 非用户（=25288；97.4%）。在所有变量调整模型中，女性患者使用 TCM 的调整优势比（OR；95%CI）为 1.35（1.11-1.66）。与北部地区相比，中部、南部和东部地区的全民健康保险（NHI）登记与 TCM 使用的更高优势比相关（ORs=1.43、1.86 和 1.82）。与城市相比，农村城市的 NHI 登记与 TCM 使用的更高优势比相关（OR（95%CI）=1.33（1.02-1.72））。TCM 组出现症状、体征和定义不明确的疾病和损伤中毒的可能性降低 20%。TCM 组患有肌肉骨骼系统和结缔组织疾病的可能性降低 56%。多水平模型的结果与所有变量调整模型的结果相似，除了农村和城市的 NHI 登记结果（OR[95%CI]=1.33[0.98-1.81]）。在所有逻辑回归模型中，TCM 就诊次数与 TCM 使用之间均存在显著关联。该研究介绍了与 TCM 使用相关的 CTS 的关键人口统计学特征、医疗保健利用和医疗状况。以前使用 TCM 的经验可能会影响 TCM 治疗 CTS 的使用。这些信息为相关医疗资源和医疗保健提供者的分配提供了参考。
