臺灣博碩士論文加值系統

雷諾氏現象為結締組織疾病常見之症候，而目前尚缺乏根治性療法。中醫古籍有「厥」、「寒入陽絡」等論述，與本症相當，傷寒論並提出當歸四逆湯為主治方劑，本項研究擬對其療效加以評估。 在風濕病特別門診篩選雷諾氏現象患者，對照組 7 人， 實驗組 14 人，服當歸四逆湯濃縮粉劑，每日 3 次，每次 3 公克，持續治療 8 週。 治療前後均以紅外線熱象儀及血流測量儀檢查手溫及血流量，選擇中指遠端指節之溫度與血流量，以 Wilcoxon signed-rankstest 統計分析，以評估療效。
研究結果顯示：實驗組經治療 8 週後， 基準點之手溫有明顯改善 ( 左手 p=0.009 右手 p=0.028)，平均手溫上升 1.8±2.1 ℃。冷水試驗後20 分鐘之手溫恢復力也有顯著上升（ p=0.022 ），且冷水試驗後 20 分鐘之平均手溫上升 3.3±2.5 ℃；對照組經治療後基準點之手溫並未改善( 左手 p ＝ 0.311 右手 p ＝ 0.735)， 冷水試驗後 20 分鐘之手溫恢復力也無顯著改善（左手 p=0.735 右手 p=1.000 ）。 在血流量方面，實驗組經治療 8 週後基準點血流量大幅增加（左手 p=0.075 右手p=0.012 ），而冷水試驗後 20 分鐘恢復力雖有上升卻未達統計上之顯著水準（左手 p=0.477 右手 p=0.48 ）； 對照組經治療後基準點血流量並無顯著增加（左手 p=0.176 右手 p=0.612 ），冷水試驗後 20 分鐘恢復力也無顯著變化（左手 p=0.499 右手 p=1.000 ）。 實驗組服用當歸四逆湯 4 週後，手溫明顯改善，而血流量並無改善。服藥 8 週後，手溫回升更加明顯，血流量也有增加現象，且有 12 例雷諾氏現象消失。 停藥 4 週後，手溫並無下降現象，而血流量下降。 副作用方面，有 4 例出現噁心，1 例出現腹瀉及噁心，但停藥後均消失。以上變化在對照組均未發現。
當歸四逆湯對雷諾氏現象患者肢端溫度回升的療效，比血流量的改善明顯，但本研究病例數尚少，療程僅達 8 週，應可繼續治療以確定療效。 且其副作用如何克服，值得進一步研究。

Raynaud's phenomenon is a common complication of connective tissue diseases that has no specific treatment. It corresponds to conditions in Chinese medicine for which Shang- Han-Lun proposed the formula of Dang-Quei-Shi-Ni-Tang(DQ-4). This study assesses the DQ-4 on Raynaud's phenomenon.
The study population including 14 males and 7 females with Raynaud's phenomenon screened in by an outpatient rheumatology clinic. They were prescribed DQ-4 powder in a dose of 3 grams, three times a day for period of two months. The hand temperature and blood flow volume were monitored before and after treatment with thermotracer and velocimetry by measuring the temperature and blood flow volume of the middle finger. Statistical analysis was made usingthe Wilcoxon signed-ranks test.
The results showed that after 8 weeks of treatment there was a markedimprove- ment in the cyanosis of their extremities. On average, the increase infinger temperature was 1.8+2.1 ℃ on basline and 3.3+2.5 ℃ 20 minutes aftercold test, the blood flow volume also higher than that before treatment. After7-8 weeks of treatment, 4 subjects experienced nausea, and 1 experienced both nausea and diarrhea. These side-effects completely disappeared afterdiscontinuation of treatment. DQ-4 had a marked and lasting effect in raising the temperature than theblood flow volume of the extremities in patients suffering from Raynaud'sphenomenon.
However, since the study is based on a limited number of subjects, further observation is necessary to confirm the effect. Moreover, furtherresearch must also be conducted to discover how to overcome the side-effects ofthe treatment.