摘要
目的：本研究目的为探讨中医门诊申报失眠及非器质性睡眠障碍患者年龄层之分布、处方用药排行、单方及复方排行前20名、医疗费用结构、治疗方式及同一病者连续5年追踪占率等为主要目的。方法：本研究数据源以2005—2009年中央健康保险局台北分局特约中医院所申报全数据为数据库,以门诊申报失眠及非器质性睡眠障碍疾病资料为撷取条件,依中医院所申报ICD-9-CM主、次诊断为ICD-9-CM（780.5及307.40~307.50）之所有患者。结果：2005—2009年中医门诊主、次诊断申报失眠及非器质性睡眠障碍疾病总病人数为637742人;5年间平均就医次数为4.2次。总件数为2689455件。主、次诊断为失眠及非器质性睡眠障碍疾病患者各年龄层分布为20~59岁分布最多,男女的比率为0.45比1;单方药材排名前5名为酸枣仁（16.45%）、夜交藤（16.20%）、合欢皮（8.93%）、远志（8.09%）、茯神（8.03%）;复方前5名分别为加味逍遥散（23.68%）、酸枣仁汤（22.17%）、天王补心丹（15.66%）、柴胡加龙牡汤（12.18%）及甘麦大枣汤（8.88%）;每张处方的用药品项数单方以1~5个品项最多,复方品项数以1~3个品项最多,其中每张处方不分单复方的用药品项数以3~7个品项占最多。治疗的方式以纯内科服药治疗占最多;持续就医5年者追踪占率为26.62%。结论：本研究提供中医师临床治疗失眠及非器质性睡眠障碍疾病的用药频率及型态,从研究中我们无法了解失眠及非器质性睡眠障碍疾病的中医证型分类,但从用药频率分析得知,中医临床治疗失眠及非器质性睡眠障碍疾病的中药方剂是以能疏肝解郁、清热除烦、补心安神、益气和中、行气化痰、调和胆胃、泻肝利湿、行气止痛、滋补肾阴、清虚火为主。对于中医师临床处方用药应有很好的参考价值。至于相关的方剂及药物的作用机转仍有待日后进一步加以阐明。
Objective ： This study intended to investigate the age distribution, medication rank, top twenty of herbal medicines and prescriptions, medical expense structure, the treatment way and identical patient five year tracing occupying rate in Chinese medicine outpatient service reported that insomnia and distribution. Methods ： This research data were come from the data base of Central Committee Health Insurance Bureau Taipei Sub-bureau Special Chinese medicine hospital reported that the outpatient service reported that losing sleep and the non-organic sleep disorder disease during 2005-2009 year. The ICD- 9-CM is belonging to ICD-9-CM （ 780.5 and 307.40-307.50 ）. Results ： During 2005-2009, the total patients＇ diagnosis insomnia and the non-organic sleep disorder disease were 637742 people. The average times which the patients treated by a doctor were 4.2 times. The total number of articles is 2689455. The average age distribution of insomnia and the non-organic sleep disorder disease patient is 20-59 year old. The men＇s and women＇s ratio is 0.45 ： 1. The top of five Folk remedy raw material for medicine were Spina Date Seed （ 16.45% ）, Tuber Fleeceflower Stem （ 16.20% ）, Silktree Albizzia Bark （ 8.93% ）, Polygalae Radix （ 8.09% ）, Indian bread with hostwood （ 8.03% ）; The top of five prescriptions were Jiawei Xiaoyao San （ 23.68% ）, SuanzaorenTang （ 22.17% ）, Tianwang Buxin Dan （ 15.66% ）, the hupleurum chinensis add Long Mutang （ 12.18% ）and gan mai da zao tang （8.88%）. The average items of Each prescription contained 1-5 herbal medicines, 1-3 formula and 3-7 items. The pure internal medicine was the most treatment way. The ratio of five year tracing was 26.62%. Conclusion ： This study provides frequency and patterns of clinic application of Chinese Medicine Prescription for insomnia and the sleep disorders of nonorganic origin for Traditional physicians. We could not understand the classification of TCM symptoms in this study. From medication frequency analysis, Chinese medicine clinical care insomnia and the non-organic sleep disorder disease＇s formula used by Traditional physicians were belonged to sparseliver xie yu, raises the blood to calm the nerves, the refrigeration to eliminate bothersome, to make up feels at ease, the profit to be mad with, dispels symptoms such as bloating the phlegm reduction, the well distributed gallbladder stomach, flows swiftly the liver advantage to be wet, clearing heat and detoxication, dispels symptoms such as bloating the pain-relieving and incites invigorates the kidney cloudy, the clear deficiency-fire primarily. This study has the very good reference value regarding the traditional Chinese doctor clinical prescription medication. The action of mechanisms of the formula and herbal medicines will need to be elucidated in the future.
出处
《辽宁中医药大学学报》
CAS
2011年第10期144-149,共6页
Journal of Liaoning University of Traditional Chinese Medicine
关键词
失眠
非器质性睡眠障碍疾病
传统中药
中药用药频率与型态
insomnia
sleep disorders of nonorganic origin
herbal medicines
frequency and patterns of Chinese medicine
