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研究生:莊昭華
研究生(外文):Chao-Hua Chuang
論文名稱:孕期暴露中草藥與兒童健康之探討
論文名稱(外文):Pregnant Women Exposed to Chinese Herbal Medicines and Children''s Health
指導教授:陳保中陳保中引用關係
學位類別:博士
校院名稱:國立臺灣大學
系所名稱:職業醫學與工業衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文出版年:2006
畢業學年度:94
語文別:中文
論文頁數:113
中文關鍵詞:孕婦中草藥兒童健康
外文關鍵詞:Pregnant womenHerbal medicine
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中醫對外國人而言是所謂的另類醫療或補充醫學,但對台灣人而言卻是我們的傳統醫學,而台灣孕婦使用中草藥更是普遍存在的現象。雖然孕期中使用草藥可能對胎兒或母親的健康有潛在性的危害,此行為在西方國家亦有逐漸普遍之趨勢。
在懷孕過程中使用任何藥物,都可能對胎兒或母親的健康產生潛在的危險性,因此孕婦使用草藥之情形也相對的引起關注。孕中使用草藥對母親及胎兒之影響,因使用之種類及目的不同,而有不同之研究結果。但有幾篇動物實驗發現,動物於懷孕時使用某些草藥,對動物胎兒出現潛在之不良影響。沒有太多的人類流行病學方面的研究資料,加上外國孕婦使用草藥的習慣及種類,和我國孕婦使用中草藥之情形差異相當大,如外國孕婦常用單一草藥,例如紫錐花、覆盆子等,但國內不只使用單方如黃連,更有使用複方之習慣,例如安胎飲、四物湯等,因此如何建立本土孕婦使用中草藥之安全與效用資料,相對顯得重要。
台灣孕婦使用中草藥已是行之有年,但是卻缺乏整體的研究証據及其健康之影響。因此我們希望藉著由1980年代中期,所建立之台灣台北出生世代研究追蹤的資料,來探討台灣孕婦使用中草藥之盛行率、危險因子及其對兒童健康之影響。
經由此一台灣本土出生世代資料,我們已先著手分析了1980年代中期,台灣孕婦使用中草藥之盛行率及危險因子;孕婦使用黃連對胎兒出生體重之影響;探討孕婦使用中草藥與胎兒畸型之關係;及孕婦使用中草藥與兒童癌症之關聯,未來將會陸續針對孕婦使用中草藥對下一代之健康影響做探討與分析,以期解開台灣孕婦使用中草藥習慣安全性之謎。
Chinese herbal medicine is an alternative therapy or a complemented therapy for foreigners, but it is the traditional medicine in Taiwan. Use of herbal medicine by pregnant women is common in Taiwan, and is gaining popularity worldwide, despite the concern regarding adverse effects produced during pregnancy.
Because of the potential harmful impact of any kind of medicine during pregnancy, such practice has raised concerns among public health practitioners and consumers regarding benefit and risk. There were inconclusive results in human depending on different herbs for different purposes in pregnancy, but several animal studies showed potential adverse fetal effects of specific herbal medicines.
There was a general lack of evidence about the use of herbal medicines during pregnancy. In addition, the habit and category of using herbs is so different between foreigners and Taiwanese that it is urgent to establish the data about the safety and efficacy of herbs used by pregnant women in Taiwan.
It is traditional and popular for Taiwan pregnant women using herbal medicines, but there is lack of whole picture of them using herbal medicines in Taiwan. Hence, we used the followed data from the Taiwan Taipei birth cohort study established in mid-1980’s to explore the relationship between pregnant women used herbs and health of children they gave birth to.
Using this database, we have analyzed the prevalence and risk factors of pregnant women using herbs; the relationship between pregnant women using Huanglian and birthweight; herbs used during pregnancy and the congenital malformation and childhood brain tumors. We will keep going to explore the safety and efficacy of herbs used by pregnant women and the health of children’s they gave birth to in future.
中文摘要 iii
Abstract iv
章節目錄 vi
圖表目錄 viii
第一章 前言 1
第二章 文獻探討 2
第一節 出生世代研究 2
第二節 孕婦使用草藥之盛行率及危險因子 3
第三節 使用草藥對孕婦及胎兒之健康影響 4
第四節 先天畸型 4
第五節 兒童腦癌 5
第三章 材料與方法 6
第四章 結果 7
第五章 討論 8
第六章 結論 10
參考文獻 11
附錄 I-1 28
附錄 I-2 42
附錄 I-3 51
附錄 I-4 84
附錄 II 111
附錄I 主論文投稿文章
I-1 Chuang CH, Lai JN, Wang JD, Chang PJ, Chen PC. Prevalence and Related Factors of Chinese Herbal Medicine Use in Pregnant Women of Taipei, 1985-1987. Taiwan J Public Health 2005;24 (4):355-347. (TSSCI)
I-2 Chuang CH, Lai JN, Wang JD, Chang PJ, Chen PC. Use of Coptidis Rhizoma and foetal growth - A follow-up study of 9,895 pregnancies. Pharmacoepidemiology and Drug Safety 2006; 15: 185-192. (SCI)
I-3 Chuang CH, Doyle P, Wang JD, Chang PJ, Lai JN, Chen PC. Herbal medicines used during the first trimester and major congenital malformations - An analysis of data from a pregnancy cohort study. Drug Saf, In Press. (SCI)
I-4 Chuang CH, Doyle P, Wang JD, Chang PJ, Chen PC. Increased risk of childhood brain tumors in the offspring and use of Coptidis Rhizoma during pregnancy (In Preparing).

附錄II其它相關研究著作摘要
II-1 Chuang CH, Hsieh WS, Guo YL, Tsai YJ, Chang PJ, Chen PC, Shio-Jean Lin. Chinese herbal medicines used in pregnancy: A population-based survey in Taiwan. (Pharmacoepidemiol Drug Saf, In Revision)

II-2 Chuang CH, Chang PJ, Hsieh WS, Guo YL, Lin SH, Chen PC, Shio-Jean Lin. An combined effect between employment status and trans-cultural marriage on breast feeding: a population-based survey in Taiwan (Paediatric Perinatal Epidemiol, In Revision)

圖表目錄
圖1. 1984-1987年資料收集流程圖 18
表1 全國性出生世代研究 19
表2 地區性出生世代研究 22
表3各國孕婦使用草藥之盛行率及危害因子 25
表4孕婦使用中草藥之安全性 27
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