臺灣乳癌婦女1998～2008年間的中藥使用率及模式分析

PREVALENCE, PATTERN, AND COSTS OF CHINESE MEDICINE USE AMONG BREAST CANCER WOMEN IN TAIWAN DURING 1998-2008

目的：本研究目標在於探索台灣乳癌婦女中藥療法之使用情形。方法：本研究的設計是利用健保資料檔，採用回溯性的研究法分析全國1998~2008年，2,742 新罹患乳癌病人使用中醫醫療資源利用、就醫行為及中藥處方用藥，進行描述性統計分析。主要發現：研究期間共有2,742 位乳癌新發生個案，其中2,236（81.5%）婦女至少尋求中醫藥療法一次，就診機構以私立中醫診所最高（69.0%），超過95%使用中醫藥治療的乳癌婦女，持續使用西醫乳癌療法，乳癌治療以手術+化療+荷爾蒙治療為主要的治療模式佔西醫療法的39.3%，中醫以科學中藥為主要的治療模式，中西醫門診最大的費用支出皆為藥費，婦女於罹患乳癌後不同於其他的病種，蒲公英、丹參為中醫師最常開立的單味中藥，複方則為加味逍遙散、天王補心丹。結論及建議：乳癌婦女有高頻率使用中藥療法的需求，除了乳癌的治療外，未來應多關注乳癌婦女尋求中醫藥照護的療效及安全性議題。aim: To analyze the prevalence, pattern, and costs of Chinese medicine (CM) among women with breast cancer in Taiwan. Methods: We recruited women with breast cancer from a random-sampled cohort of 1,000,000 National Health Insurance Research Database (NHIRD) from 1998 to 2008, estimated the prevalence, pattern, and costs for using Chinese medicine. The usage, frequency of services, and primary indications for Chinese herbal products (CHP) were evaluated. results: There were 2,742 women with breast cancer in our study. Among them, 2,236 (81.5%) women utilized Chinese medicine at least once, and more at hospital. The majority of CM users also used western medicine simultaneously. The most common type of treatment modalities for breast cancer was surgery plus chemotherapy and hormone therapy (39.3%). The most type of treatment modalities of traditional Chinese medicine was CHP. Jia-wei-xiao-yao-san, Tian-wang-bu-xin-dan and Taraxaci Herba, Salviae Miltiorrhizae Radix were the two most frequent prescribed formula and single herb, respectively. conclusion: The prevalence of CHP usage was high among women with breast cancer. The majority of CM users also received western medicine the same time. CM appeared to play a complementary rather than an alternative role. Studies on safety issues and drug–herb interactions are warranted for future research.