急診病患非病毒性肝炎與中草藥相關性之病例對照研究

Abstract

幾個世紀以來，中國人使用傳統中草藥治病，早已成為生活中的一部份。鑑於我國民眾經常使用傳統中草藥，本研究將檢視急診病患中初步診斷為非病毒性肝炎，且曾經使中藥草之頻率。我們將藉由研究設計及統計學方法探討肝炎與使用中草藥的關聯性。據我所知，本實驗是首次在病患抵達急診處時即探討非病毒性肝炎與使用中草藥是否相關之研究。我們希望證實草藥與疾病相關，並造成病患必須到急診就診。本研究為前瞻性病例對照研究之設計，其中收入非病毒性肝炎病患。在密集取樣後，我們收集資料並以邏輯廻歸來分析。本研究收集的70個案及140對照組。經統計分析之後，兩組在單一變數分析後，喝酒，使用過草藥，發病前使用著草藥，及使用西藥對發病在統計上有意義。在多變數分析後，使用草藥在發病前3個月內，及同時使用西藥是跟疾病由相關。雖然個案數目並不多，可是本研究顯示使用草藥及西藥是與非病毒性肝炎有相關。至於草藥與非病毒性肝炎的因果關係，是需要更進一步研究才能得到結論。

The use of Chinese herbal medicine to maintain health among the Chinese ethnic group is deeply rooted in the Chinese way of living for centuries. Since there is a high prevalence in the usage in Taiwan, our study aims to study the relationship of herbal use and visits to the emergency department under the diagnosis of acute non-viral hepatitis. This study is a prospective, density sampling case control study in which patients with non-viral hepatitis was questioned for herbal use. An univariate analysis and conditional logistic regression analysis using the PHPREG procedure in SAS 9.0 (SAS Institute Inc.) was preformed with a discreet logistic model stratified by matching variables. Seventy cases were matched to 140 controls. In the univariate model, long term use of drugs, history of western drugs used, history of herb use, alcohol consumption, recent use of herbs gave an increase in the risk of developing acute non viral hepatitis. After multiplicative conditional logistic regression, we find that the use of herbs within a 3-month period and the concurrent use of western drug pose the greatest threat of acute non-viral hepatitis. We concluded that herbs and drugs used prior to developing acute non viral hepatitis is associated with the development of the disease. Due to the small sample size of this study, there is a need for further study to correctly identifying the cause-effect relationship of herbs and hepatitis, so that further inferences can be made.