臺灣博碩士論文加值系統

多囊性卵巢症候群是全球性的婦女疾患，盛行率約百分之五到十。其包含生殖系統、代謝問題、心理健康問題等，症狀多變繁雜，醫學界已清楚得知，多囊性卵巢症候群女性患有胰島素抵抗比例較高，且預期未來罹患第二型糖尿病風險上升，目前西醫以症狀治療為主。此研究想瞭解在臨床上，多囊性卵巢症候群女性使用中醫比例、處方內容與就醫模式。使用中醫女性是否在能達成健康促進、預防未來疾病。
在台灣，中醫藥的使用相當普遍，自民國八十六年後，中醫納入全民健保，全民健保資料庫紀錄民眾就醫模式與處置內容等資訊。因此選用全民健保資料庫進行數據分析，隨機抽取百萬人口，以多囊性卵巢症候群女性的中醫利用狀況為獨立變項，分析其年齡、都市化程度、就醫醫院等級、常見共病、處方內容等資訊。另外，分析中藥組與無服用中藥組，採1:1條件配對後追蹤兩組第二型糖尿病發生率。
結果:89.22%多囊性卵巢症候群女性曾求診中醫，最常使用的單味藥為香附、複方藥為加味逍遙散。使用中藥女性未來罹患第二型糖尿病風險較無使用中藥顯著降低（HR = 0.31,95％CI = 0.15-0.64，P = 0.0014）。因次我們認為，中醫在多囊性卵巢症候群發揮預防疾病功能，針對能夠促進健康的中藥品項在未來期待能進行更大規模臨床研究與藥理分析。

Polycystic ovary syndrome (PCOS) is a common condition in human beings, affecting 5-10% of women of reproductive age worldwide. It might lead to a variety of syndrome such as reproductive, metabolic and mood disorders. The symptoms of PCOS are complex. The academic circles had made it clear that women with polycystic ovary syndrome have a higher proportion of insulin resistance and are expected to have an increased risk of developing type 2 diabetes in the future. This study aimed to understand the clinical use of Chinese medicine in women with PCOS, prescription content and whether the intervention of Traditional Chinese Medicine(TCM) in women with PCOS could reduce the risk of type 2 diabetes mellitus.
It’s common in Taiwan to receive Chinese medicine therapy. Since 1997, Chinese medicine has been reimbursed under Taiwanese National Health Insurance (NHI) system. These databases included information of characteristics and prescription of Chinese Medicine. Therefore, we selected the National Health Insurance Database as data source, randomly selected 1 million enrollees. The usage of Chinese medicine in women with polycystic ovary syndrome as independent variables to analyze age, urbanization, hospital level, comorbidities and prescription contents. In addition, the incidence of type 2 diabetes mellitus in the two groups was tracked after 1:1 matched.
RESULTS: 89.22% of women with polycystic ovary syndrome had sought Chinese medicine therapy. Jia-Wei- Xiao-Yao- San was the most commonly used formula, while Xiang-Fu (Rhizoma Cyperi) was the most commonly used single herb in our database. Women using Chinese medicine have a significantly lower risk of type 2 diabetes mellitus than those without Chinese medicine (HR = 0.31, 95% CI = 0.15-0.64, P = 0.0014). Our study suggests that Chinese medicine may play a role in the prevention of subsequent complication of diabetes in patients with PCOS. It is expected that in the future, further clinical research and pharmacological analysis based on these findings.

第一章 前言 1
第二章 文獻探討 3
2.1 多囊性卵巢症候群西醫論述 3
2.2 多囊性卵巢症候群西醫治療現況 5
2.3 多囊性卵巢症候群中醫論述 7
2.4 多囊性卵巢症候群中醫治療研究進展 8
2.4.1 針灸治療 8
2.4.2 中藥複方治療 10
2.4.3 中藥單方治療 11
第三章 材料與方法 13
3.1 資料來源 13
3.2 研究族群及變項 13
3.2.1 多囊性卵巢症候群中藥使用全國人口研究 13
3.2.2 多囊性卵巢症候群中藥介入後與第二型糖尿病發生
關聯研究 13
3.3 統計分析 15
第四章 結果 16
4.1多囊性卵巢症候群中藥使用全國人口研究 16
4.1.1 中醫組與非中醫組的人口特徵比較 16
4.1.2 中醫組就診中醫次數及治療方式比較 16
4.1.3 最常用來治療多囊性卵巢症候群的中藥 18
4.1.4 中醫組與非中醫組就診原因及頻率分布 19
4.2 多囊性卵巢症候群中藥介入後與第二型糖尿病發生關聯 21
4.2.1 中醫組與非中醫組配對後共病與使用藥物比較 21
4.2.2 中藥介入後第二型糖尿病發生關聯之分析 23
4.2.3 每年使用中醫時間與第二型糖尿病發生關聯之比較 23
4.2.4 最常用來治療多囊性卵巢症候群的中藥 26
4.2.5 最常用中藥與第二型糖尿病發生之關聯性 26
第五章 討論 32
5.1 多囊性卵巢症候群研究 32
5.1.1 中醫組與非中醫組人口特性分析 32
5.1.2 常用藥物可能的藥理機轉 32
5.2 中藥介入後與第二型糖尿病發生關聯研究 34
5.2.1 中藥介入與第二型糖尿病發生之關聯探討 34
5.2.2 降低第二型糖尿病發生率之中藥分析 35
5.3 研究的優點與限制 36
5.4 未來研究方向 36
第六章 結論 37
參考文獻 38

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