全民健康保險中醫提升孕產照護品質計畫之觀察型研究

Observational study on National Health Insurance Project for Improving Infertility and the Quality of Maternal Care with Traditional Chinese Medicine

不孕症和低出生率是台灣重大公共衛生的問題。「全民健康保險中醫提升孕產照護品質計畫」自2015 年開始實施，針對原發性或特定病理因素所致之繼發性不孕、或有先兆流產傾向及有流產病史者，由中醫給予適當照護，並評估婦女的受孕率及保胎率。我們觀察2016 年中醫助孕健保專案治療計畫助孕成功率達23.27%，保胎成功率更達80.45%。就診病患的年齡以30 ～ 34 歲共2,063 人數最多（36.57%），其次是35 ～ 39 歲有2,012 人數（35.67%）。就診診斷病名以「女性不孕症」31,377 件（85.97%）為最多，其次為「女性不孕症源於其他原因」1,754件（4.81%）。台灣女性不孕症常使用的方劑為當歸芍藥散、溫經湯、加味逍遙散、左歸丸、右歸丸等補腎、疏肝和活血調經藥物。本研究結果顯示不孕症患者接受 中醫藥的治療，有助於受孕率和保胎率的提升。

 

Infertility and low birth rate are significant public health issues on Taiwan. “National Health Insurance Project for Improving Infertility and the Quality of Maternal Care with Traditional Chinese Medicine” has been implemented since 2015. Chinese medicine physician would treat those patients who had infertility caused by primary or secondary pathological factors, or past history of abortion. The pregnancy rate and miscarriageprevention rate were evaluated. We found the pregnancy rate of the project was 23.27% and the miscarriage-prevention rate was 80.45%. The number of patients aged 30-34 was 2,063 (36.57%), followed by 35 to 39 years was 2,012 (35.67%). The number of patients diagnosed as "female infertility" was 31,377(85.97%), followed by 1,754 cases(4.81%) of "female infertility originated from other causes".The most common Chinese herbal formulas to female infertility patients were Dang-Gui-Shao-Yao-San, Wen-Jing-Tang, Jia-Wei-Xiao-Yao-San, Zou-Gui-Wan, and You-Gui-Wan. They could nourish kidney, disperse liver, and promot blood flow to regulate menstruation. The conclusion of this study is that patients with infertility receiving Chinese medicine could improve the rate of pregnancy and miscarriage-prevention.