卵巢早衰之中醫用藥分析──從健保資料庫分析

The prescription patterns of traditional Chinese medicine for women with Premature ovarian failure in Taiwan: A nationwide population-based study

卵巢早衰（Premature ovarian failure, POF）是指四十歲前的育齡女性出現雌激素缺乏、月經紊亂、閉經及不孕等卵巢功能衰退的症狀。原發性卵巢早衰大多仍無明確病因，目前西醫以賀爾蒙療法為主，長期使用恐有癌症風險，故台灣許多患者會尋求中醫治療。此研究回顧台灣健保資料庫數據，分析卵巢早衰患者的病歷資料，統計出中醫治療卵巢早衰最常使用之方藥，以期作為臨床使用處方之參考及未來臨床研究之方向。本研究自台灣全民健康保險資料庫中擷取1999年至2013年間數據，篩選出1,818名西醫診斷卵巢早衰的患者，再統計分析這些「卵巢早衰」患者中醫就診情形，其中958名有因月經或不孕症相關疾患就診中醫，最常用的方劑與中藥：方劑前三名依序為加味逍遙散（10.62%）、溫經湯（5.33%）及桂枝茯苓丸（4.21%）；單味藥前三名為益母草（4.46%）、菟絲子（3.64%）、香附（3.53%）。由統計結果之用藥傾向可推論，台灣中醫師治療卵巢早衰的治療原則為疏肝解鬱、補腎滋陰、養血活血祛瘀。

Premature ovarian failure (POF) refers to the decline of ovarian function such as estrogen deficiency, menstrual disorders, amenorrhea, and infertility in women of reproductive age. Western medicine treatments are mostly hormone therapy, which increases cancer risk. So in Taiwan, many patients with premature ovarian failure would take Chinese medicine. This study reviewed the data from Taiwan's health insurance database, analyzed the medical records of patients with premature ovarian failure, and calculated the most used prescriptions of traditional Chinese medicine for treating premature ovarian failure. In this study, we extracted data from 1999 to 2013 from the National Health Insurance Database of Taiwan. We identified 1,818 patients with premature ovarian failure and analyzed their medical records afterward, 958 of whom had taken traditional Chinese medicine for the situation. The prescribed Chinese medicine formulas and herbs were ranked separately according to the prescription frequency. The most frequently used formula include Jia-Wei-Xiao-Yao Powder, Wen- Jing Decoction, and Gui-Zhi-Fu-ling Pills; the most used herbs are Leonurus cardiaca, Cuscutae Semen, and Cyperi Rhizoma. The main treatment principles include soothing the liver and nourishing blood, nourishing the yin and kidney, promoting blood circulation, and removing blood stasis.