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研究生:鍾明軒
研究生(外文):Ming-Hsuan Chung
論文名稱:類風濕性關節炎及乾燥症病人合併中醫治療前後西藥用藥改變之分析
論文名稱(外文):Analysis of Changes in Western Medicines in Rheumatoid Arthritis and Sjögren’s Syndrome Patients with Traditional Chinese Medicine Treatment
指導教授:歐陽彥正歐陽彥正引用關係
口試委員:韓謝忱劉津秀
口試日期:2019-07-18
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:生醫電子與資訊學研究所
學門:工程學門
學類:生醫工程學類
論文種類:學術論文
論文出版年:2019
畢業學年度:107
語文別:中文
論文頁數:171
中文關鍵詞:中醫類風溼性關節炎乾燥症
DOI:10.6342/NTU201901706
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類風濕性關節炎(Rheumatoid arthritis)及乾燥症(Sjögren’s syndrome)是兩個常見的自體免疫疾病,病人常使用中醫(Traditional Chinese Medicine)作為補充和替代醫學。本研究使用台北慈濟醫院風濕免疫科與中醫部門的資料庫,將西藥部分常用的藥物分為八類,並換算等效劑量。藉由Kolmogorov–Smirnov test與Kuiper’s test得到有效的時間段後,分析有效的族群分布,並繪製中藥關聯圖與排序常用中藥。結果顯示,類風濕性關節炎中,相較於未合併中醫治療,steroid劑量在病程後期,女性減少0.06、40到60歲病人減少0.14;antihistamine劑量在病程後期,40到60歲病人減少2.04;painkiller劑量在病程後期,40到60歲、60歲以上病人趨勢下降;ultracet劑量在病程前期,40到60歲病人減少0.44;cevimeline劑量在病程前期,60歲以上病人趨勢下降;乾燥症中,相較於未合併中醫治療, steroid劑量在病程後期,60歲以上病人減少0.04;antihistamine劑量在病程後期,女性減少0.78、60歲以上病人減少0.45;painkiller劑量在病程後期,40到60歲病人減少0.17、女性增幅減少80%;actein劑量在病程前期,女性減少1.06、60歲以上病人減少0.47。
Rheumatoid arthritis (RA) and Sjögren’s syndrome (SjS) are common autoimmune diseases, and patients usually use Traditional Chinese Medicine (TCM) as a complementary and alternative therapy. To determine the effect of using TCM, this research analyzed the medical records of patients in the database of Taipei Tzu Chi Hospital Division of Rheumatology and Chinese medicine department. After classifying the drug by eight classes and calculating the equivalent dose, the drug-effective period of TCM treatment was evaluated by Kolmogorov–Smirnov test and Kuiper’s test. Then, by calculating the dosage of different demographic group, the drug-effective group, most commonly used TCM prescription, and the TCM drug association graph was obtained. The result shows that, with TCM treatment, the steroid dosage of RA female patients dropped 0.06 and 40 to 60 age group patients dropped 0.14 in the late disease process; the antihistamine dosage of RA 40 to 60 age group patients dropped 2.04 in the late disease process; the trend of painkiller dosage of RA 40 to 60 and above 60 age group patients declined in the late disease process; the dosage of ultracet of RA 40 to 60 age group patients dropped 0.44 in the early disease process; the trend of cevimeline dosage of RA above 60 age group patients declined in the early disease process; the steroid dosage of SjS above 60 age group patients dropped 0.04 in the late disease process; the antihistamine dosage of SjS feamle patients dropped 0.78 and above 60 age group patients dropped 0.45 in the late disease process; the painkiller dosage of SjS 40 to 60 age group patients droup 0.17 and the dosage increased proportion of SjS feamle patients declined 80% in the late disease process; the actein dosage of SjS female patients dropped 1.06 and above 60 age group patients dropped 0.47 in the early disease process.
口試委員會審定書 i
誌謝 ii
中文摘要 iii
英文摘要 iv
目錄 v
圖目錄 vii
表目錄 xiii
附表目錄 xx
第一章 前言 1
第二章 材料與方法 3
第一節 台北慈濟醫院風免科與中醫部門資料庫 3
(一) 資料取得 3
(二) 研究對象 4
(三) 變項定義 5
第二節 研究方法 8
(一) 人口學分布 8
(二) 有無使用中醫之病人西醫用藥劑量比較 8
(三) 不同區間的西藥劑量比較 8
(四) 中西醫用藥關聯圖繪製 10
第三章 結果 12
第一節 人口學分布 12
(一) 類風濕性關節炎 12
(二) 乾燥症 15
第二節 西藥關聯圖 18
(一) 類風濕性關節炎 18
(二) 乾燥症 19
第三節 中藥關聯圖 21
(一) 類風濕性關節炎 21
(二) 乾燥症 22
第四節 病人有無合併中醫治療之西醫用藥劑量比較 23
(一) 類風濕性關節炎 23
(二) 乾燥症 23
第五節 不同區間西醫用藥劑量變化 25
(一) 類風濕性關節炎 25
(二) 乾燥症 34
第六節 切割後人口學分布、中西醫用藥比較 44
(一) 類風濕性關節炎 44
(二) 乾燥症 84
第七節 差異區間內有效人口使用的中藥 116
(一) 類風濕性關節炎 116
(二) 乾燥症 124
第四章 討論 133
第五章 未來展望 138
參考文獻 139
附錄 154
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