探討台灣健保資料庫門診乾癬病人之中藥處方分析

Investigation of Chinese herbal productsprescribed to patients with psoriasis of outpatientservice from the National Health InsuranceResearch Database in Taiwan

本研究分析了台灣健保門診資料庫乾癬病人之中藥濃縮製劑的處方模式及其臨床運用探討。這項基於乾癬族群的世代研究是使用2003年至2013年間，從台灣全民健康保險研究資料庫中選出的100萬名患者進行隨機抽樣。評估了中藥濃縮製劑產品中治療乾癬十大最常用複方和單一中藥，包括平均配方劑量和處方頻率。分析了人口統計學特徵，包括性別和年齡。還討論了中藥濃縮製劑處方的施治原則和相關的機制。我們確定了1,055名（8.5％）乾癬患者，他們在這段期間曾使用過中藥濃縮製劑。年齡在19歲至45歲間的患者佔治療人數的最多（54.6％）。男性患者使用中藥濃縮製劑的頻率高於女性患者（男性：女性= 1.4：1）。溫清飲和牡丹皮分別是治療乾癬最常用的複方和單味藥。最常用的治療乾癬的雙中藥複方組合是溫清飲加血府逐瘀湯，而最常用的複方和單味藥的組合是消風散加土茯苓。後續仍需要進一步的研究來充分闡明這些中藥的功效和安全性。

This study analyzed the prescription patterns of Chinese herbal products (CHPs) in patients with psoriasis based on outpatient service data of National Health Insurance Research in Taiwan and investigated their clinical application. This population-based cohort study was conducted using a randomly sampled cohort of one million patients between 2003 and 2013 selected from the National Health Insurance Research Database in Taiwan. The use of CHPs and the top ten most frequently prescribed formulae and single herbs for treating psoriasis were assessed, including average formula doses and frequency of prescriptions. Demographic characteristics including sex and age were examined. The therapeutic principles and possible mechanisms of CHPs prescriptions are discussed. We identified 1,055 (8.5%) patients with psoriasis who used CHPs during the study period. Patients between 19 and 45 years of age comprised the largest number of those treated (54.6%). Male patients used CHPs forpsoriasis more frequently than did female patients (male:female = 1.4:1). The most frequently prescribed herbal formula and single herb for the treatment of psoriasis were Wen-Qing-Yin and Mu Dan Pi, respectively. According to the association rule, the most commonly prescribed twoformula CHP combination for treating psoriasis was Wen-Qing-Yin plus Xue-Fu-Zhu- Yu -Tang, while the most commonly prescribed combination of formula CHP and single herb was Xiao-Feng-San plus Tu Fu Ling. Further research is required to fully elucidate the efficacy and safety of these CHPs.