中醫針藥使用在過敏性鼻炎患者的特點──健保資料庫研究

Characteristics of Chinese Herbal Medicine and Acupuncture Users Among Allergic Rhinitis Patients: A Population-based Study

研究背景與動機：過敏性鼻炎為常見疾病，病患常尋求傳統中醫作為輔助治療。雖已有過敏性鼻炎患者的中藥治療分析，但對於接受針藥治療族群的分析，目前已知尚無相關資料。材料與方法：從2010年的百萬人承保抽樣歸人檔中，因過敏性鼻炎診斷（ICD-9-CM code: 477.9）接受針藥併用者的中藥處方，利用關聯法則探勘和社會網路分析，繪製過敏性鼻炎針藥使用者之「中藥治療圖譜」。結果：診斷過敏性鼻炎共有102,907人，曾使用中醫有47,282人（45.9%）。針藥併用11,360人對比單純使用中藥者30,986人年齡層偏大（針藥併用者：39.1±18.4歲，單純使用中藥者：30.8±19.9歲，p-value＜0.001），共病指標較高（針藥併用者：18.2%，中藥使用者：11.6%，p-value＜0.001）。以針藥併用者43,860張處方，繪製成過敏性鼻炎針藥使用者之「中藥治療圖譜」，得知小青龍湯、辛夷清肺湯與桔梗為核心藥物。小青龍湯與辛夷散為關係緊密的組合。結論：由此研究可得知過敏性鼻炎患者之針藥使用特色與常用之處方與組合，可作為臨床與後續基礎研究之重要參考。

Background and Purpose: Allergic rhinitis (AR) is a highly prevalent disease, and traditional Chinese medicine (TCM) is commonly used as a complementary therapy for AR. Previous studies have shown that both Chinese herbal medicine (CHM) and acupuncture may be effective in treating allergic rhinitis. However, the features of acupuncture with or without CHM users among AR patients remain unknown. Materials and Methods: All CHM prescriptions made for AR (ICD-9-CM code: 477.9) of CHM and acupuncture users were retrieved form the National Health Insurance Research Database in 2010. Association rule mining (ARM) and social network analysis (SNA) were used to explore and demonstrate CHM network. Results: A total of 102,907 people with the diagnosis of allergic rhinitis were included, and 47,282 people (45.9%) used TCM. Compared with CHM only users (30,986 people), CHM+ACU users (11,360 people) showed significant older age (CHM+ACU users versus CHM users: 39.1 ± 18.4 years old versus 30.8 ± 19.9 years old, p-value ＜ 0.001) and had higher Charlson Comorbidity Index score (CHM+ACU users versus CHM users: 18.2% versus 11.6%, p-value ＜ 0.001). We demonstrate CHM networks by 43,860 prescriptions that used CHM combined acupuncture. Xiao-Qing-Long-Tang, Xin-Yi-Qing-Fei-Tang and Platycodon grandiflorum are core CHMs for treating allergic rhinitis. Xiao-Qing-Long-Tang and Xin-Yi-San have strong connection in CHM networks. Conclusion: This research indicates characteristics of CHM prescriptions among CHM and acupuncture users with allergic rhinitis. These findings would be helpful for future clinical studies and research.