台灣尿路結石患者服用中醫藥之臨床分析
柳瑞明、林柏宏1、林舜穀2
衛生福利部桃園醫院 泌尿科；1林口長庚紀念醫院 泌尿科; 2國立陽明大學 傳醫所
The use and the prescription pattern of traditional Chinese medicine among urolithiasis patients in Taiwan: a population-based study
Jui-Ming Liu, Po-Hung Lin1, Shun-Ku Lin 2
Division of Urology , Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; 1.Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan 2Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei City, Taiwan
Purpose:
Few studies have been published concerning the use of traditional Chinese medicine (TCM) for urolithiasis patients and the factors that are related to the use of TCM are not clear. This study investigates the pattern of TCM usage for urolithiasis patients in Taiwan and determines the most common Chinese herbal products used for urolithiasis. The results of this descriptive study pave the way for clinical trials, to evaluate the efficacy and safety of this strategy.
Materials and Methods:
This study is a population-based study that analyzes one million samples, randomly selected from 22 million patients in the Taiwanese National Health Insurance Research Database between 1997 and 2008. To determine the key independent variables for the use of TCM for patients with urolithiasis, a series of demographic factors are used, including age, gender, region, the charge and the medical conditions: comorbidity, calculi location and medication. Multiple logistic regressions were conducted to evaluate the factors that correlated with CHP usage.
Results:
A total of 82,551 newly diagnosed urolithiasis patients in the 12 years of data are used, 51,685 (62.6%) of whom use TCM and 30,866 (37.4%) of whom do not use TCM. A younger age, female gender, polypharmacy, multiple comorbidities and stone in the lower urinary tract results in a greater tendency to use TCM, after adjusting for demographic factors. Jia-Wei-Xiao-Yao-San and Ji-Sheng-Shen-Qi-Wan are the most frequently prescribed Chinese medicine formulae.
Conclusions:
This is the first study to examine the use of and the prescription pattern for Traditional Chinese Medicine for urolithiasis patients, using a random, national, population-based sample. More than 62% of urolithiasis patients use TCM, and patients with polypharmacy, multiple comorbidities and stone in the ureter are more likely to use TCM. Highly frequently prescribed Chinese medicine formulae including Wu-Ling-San and Zhu-Ling-Tang were reported to prevent crystallization formation or relieve urolithiasis related symptoms.