類風濕性關節炎及乾燥症病人合併中醫治療前後西藥用藥改變之分析

Abstract

類風濕性關節炎（Rheumatoid arthritis）及乾燥症（Sjögren’s syndrome）是兩個常見的自體免疫疾病，病人常使用中醫（Traditional Chinese Medicine）作為補充和替代醫學。本研究使用台北慈濟醫院風濕免疫科與中醫部門的資料庫，將西藥部分常用的藥物分為八類，並換算等效劑量。藉由Kolmogorov–Smirnov test與Kuiper’s test得到有效的時間段後，分析有效的族群分布，並繪製中藥關聯圖與排序常用中藥。結果顯示，類風濕性關節炎中，相較於未合併中醫治療，steroid劑量在病程後期，女性減少0.06、40到60歲病人減少0.14；antihistamine劑量在病程後期，40到60歲病人減少2.04；painkiller劑量在病程後期，40到60歲、60歲以上病人趨勢下降；ultracet劑量在病程前期，40到60歲病人減少0.44；cevimeline劑量在病程前期，60歲以上病人趨勢下降；乾燥症中，相較於未合併中醫治療， steroid劑量在病程後期，60歲以上病人減少0.04；antihistamine劑量在病程後期，女性減少0.78、60歲以上病人減少0.45；painkiller劑量在病程後期，40到60歲病人減少0.17、女性增幅減少80%；actein劑量在病程前期，女性減少1.06、60歲以上病人減少0.47。

Rheumatoid arthritis (RA) and Sjögren’s syndrome (SjS) are common autoimmune diseases, and patients usually use Traditional Chinese Medicine (TCM) as a complementary and alternative therapy. To determine the effect of using TCM, this research analyzed the medical records of patients in the database of Taipei Tzu Chi Hospital Division of Rheumatology and Chinese medicine department. After classifying the drug by eight classes and calculating the equivalent dose, the drug-effective period of TCM treatment was evaluated by Kolmogorov–Smirnov test and Kuiper’s test. Then, by calculating the dosage of different demographic group, the drug-effective group, most commonly used TCM prescription, and the TCM drug association graph was obtained. The result shows that, with TCM treatment, the steroid dosage of RA female patients dropped 0.06 and 40 to 60 age group patients dropped 0.14 in the late disease process; the antihistamine dosage of RA 40 to 60 age group patients dropped 2.04 in the late disease process; the trend of painkiller dosage of RA 40 to 60 and above 60 age group patients declined in the late disease process; the dosage of ultracet of RA 40 to 60 age group patients dropped 0.44 in the early disease process; the trend of cevimeline dosage of RA above 60 age group patients declined in the early disease process; the steroid dosage of SjS above 60 age group patients dropped 0.04 in the late disease process; the antihistamine dosage of SjS feamle patients dropped 0.78 and above 60 age group patients dropped 0.45 in the late disease process; the painkiller dosage of SjS 40 to 60 age group patients droup 0.17 and the dosage increased proportion of SjS feamle patients declined 80% in the late disease process; the actein dosage of SjS female patients dropped 1.06 and above 60 age group patients dropped 0.47 in the early disease process.