腦性麻痹中醫治療之現況探討

CURRENT PRACTICE OF TRADITIONAL CHINESE MEDICINE USED IN CEREBRAL PALSY

腦性麻痺是兒童失能的最重要原因，由於其無法治愈，在台灣有部份患者會尋求傳統中醫的治療。本病在傳統中醫學相當於「五遲」、「五軟」、「五硬」等範疇。為了探討中醫藥治療腦性麻痹的現況，我們選取2005 年全民健康保險資料庫20 萬人次歸人檔，進行資料挖掘的工作，結果發現：腦性麻痹患者共221 人，當中曾接受中醫治療者有106 人。全部中醫處方共241筆，治療型態以中藥治療最多（n=218）、針灸次之（n=26），最後是推拿整復（n=5）。藥物統計分析發現複方以黃耆五物湯最多，而單味藥以雞血藤使用最多。本研究結果顯示：台灣腦性麻痹病人使用中醫治療者約佔48%，且所使用之方藥以溫經活血祛風行氣除痹為主。Cerebral palsy (CP) is the most important cause of disability in children. In Taiwan, some CP patients would seek the therapy of traditional Chinese medicine (TCM). Descriptions of “five retardations”, “five flaccidity”, and “five stiffnesses” had been recorded in the ancient Chinese medical literatures and are likely related with CP. In order to discuss the current status of CP treatment with TCM, we conducted a retrospective cross-sectional study by using a database of 200,000 patients based on the 2005 version of National Health Insurance Database. We found 221 CP patients and 106 of them received TCM. In the total 241 prescriptions, TCM herbal formula was used most frequently (n=218). Acupuncture was the second (n=26), and massage was the least (n=5). Analysis of the TCM formula prescribed for CP showed huang-qi-wu-wu-tang was the most common one. The most common single TCM herb prescribed for CP was Milettia reticulata Benth (Ji-xue-teng). This study revealed the fact that 48% of CP patients in Taiwan receiving TCM. The treatment of CP included warming meridians and activating blood, eliminating wind, promoting qi, and removing paralysis.