兒童過敏性鼻炎中醫照護計畫和呼吸道及精神疾病的關聯

Association of a Traditional Chinese Medicine Pilot Program with Respiratory and Psychiatric Disorders in Children with Allergic Rhinitis

背景：兒童過敏性鼻炎使用中醫治療的比例日益增加，但中醫兒童過敏性鼻炎照護試辦計畫的療效證據仍然有限。本研究旨在利用全國健康保險研究資料庫的數據，探討此計畫是否能降低過敏性鼻炎兒童呼吸道和精神疾病的風險。方法：從全民健康保險研究數據庫中隨機抽樣，納入2017至2021年參與中醫兒童過敏性鼻炎照護試辦計畫的11,782名兒童，確定了1793名試辦計畫使用者，並根據年齡、性別、共病和指標年份進行匹配，隨機選擇1793名兒童為對照組。使用Cox比例風險回歸模型計算兩組之呼吸道和精神疾病的風險比。結果：計畫組的呼吸道疾病風險高於非計畫組，調整後的風險比為1.38（95% CI: 1.26-1.51）。相反地，計畫組的精神疾病風險略高於非計畫組，但差異無統計學意義（調整後風險比= 1.11，95% CI = 0.86-1.45）。結論：研究結果顯示參與中醫兒童過敏性鼻炎照護試辦計畫與特定結果有關，但並未證實因果關係。此發現可提供兒童過敏性鼻炎照護試辦計畫未來制定中醫指導原則和標準適用性的量化評估方法的參考。

Background: The use of traditional Chinese medicine (TCM) for treating allergic rhinitis (AR) in children is on the rise, but evidence of TCM Children's Allergic Rhinitis Care Pilot Program (CARP) benefit remains limited. This study aimed to determine whether CARP treatment reduces the risk of respiratory and psychiatric disorders in children with AR, using data from the National Health Insurance Research Database (NHIRD). Method: We identified 11,782 children diagnosed with AR from the TCM CARP using a random sample of 2 million NHIRD beneficiaries between 2017 and 2021. Among these, 1793 TCM CARP users (who received TCM for over 30 days) and 1793 non-CARP users were randomly selected using 1:1 propensity score matched with age, sex, comorbidity, and index year. We used Cox proportional hazards regression to calculate hazard ratios (HRs) for respiratory and psychiatric disorders between the two groups. Results: The CARP cohort exhibited a higher risk of respiratory disorders compared to the non-CARP cohort with an adjusted HR of 1.38 (95% CI: 1.26-1.51). Conversely, the risk of psychiatric disorders was slightly higher in the CARP cohort than in the non-CARP cohort, but the difference was not statistically significant (adjusted HR = 1.11, 95% CI = 0.86-1.45). Conclusion: The study indicated a link between CARP involvement and specific outcomes, though it did not confirm a cause-and-effect relationship. This insight could serve as a basis for developing quantitative evaluation methods to assess the applicability of Chinese medicine guidelines and standards in future CARP initiatives.