臺灣新竹縣橫山鄉風濕病之流行病學調查研究

The Epidemiologic Study of Rheumatic Diseases in Hen- San Village in Taiwan

風濕病是常見的疾病之一。目前我國尚無具體資料顯示中國人風濕病整體與個別風濕病之盛行率。去年我們在橫山鄉，利用設計好之問卷，以分層、系統及隨機抽樣，對該鄉2,998位20歲以上人口，進行調查。（包括風濕病盛行率、危險因素及醫療行為等）。研究結果顯示，2,998人口中，共有896人曾或現有風濕病，其中445人接受醫生臨床、抽血及X光檢查。類風濕關節炎之盛行率為0.4％，僵直性脊推炎0.4％，退化性關節炎9.3％，痛風0.2％，外傷關節炎0.27％，椎肩盤脫出1.1％，肌腱炎9％，紅斑性狼瘡，臨床上無典型病例發現。在本研究風濕病仍有近一半以上的人口尋訪中醫（或吃中藥），年長者及教育程度較低者，常較年輕者在發病後早看醫生及服藥，因病痛影響收入者僅6 ％，而影響工作者僅23％，女性、收入較低與教育程度較低者，得風濕病之機會較大。另外，吃魚較少、外傷、重度工作、喝酒較多者與家族中已有風濕病者，亦容易有風濕病。我們第二年將在新店地區，繼續此流行病學之調查研究，期望能利用第一年之經驗作更詳盡完整之調查，同時比較城市與鄉村地區之風濕病，有無不同之處。

Rheumatic disease is one of the common disease in Taiwan. Currently, we have no data to show the prevalence of the whole or individual rheumatic disease. We spent one year by using the modified questionnaire from Dr. Liang and random, systemic, as well as stratified sampling to investigate the prevalence and risk factors of rheumatic disease, and medical behavior of rheumatic patients. Totally, 2998 cases who resided in Hen-San county with age over 20 accomplished the questionnaire. The results disclosed 896 in total 2998 cases answered had or has rheumatic disease. Among them, 445 received interview and physical examination by rheumatologist. If indicated, serological and radiologic examinations were also done in some patients. The prevalence of rheumatoid arthritis was 0.4%, ankylosing spondylitis 0.4%, osteoarthritis 9.3%, gout 0.2% traumatic arthritis 0.27%, HIVD 1.1% tendinitis 9%, No typical case of systemic lupus erythematosus was found. In our study, nearly 1/2 of rheumatic patients still visited herb doctor or took herb medicines as their remedies. The low educated and aged people usually visited doctors early when they had rheumatic disease or pain. Only 6% of rheumatic patients complained of income loss and 23% of working inconvenience due to the pain. Rheumatic diseases are predominant in our female, people with low- wage, low-educated, heavy work, previous trauma, low-fish and high- alcohol diet, and other family members with rheumatic disease. We will continue the investigation in Sin-Dian district in the next year. We hope can get more detailed and perfect results and meantime, to see what is the difference in rheumatic diseases between city and country area.