| Summary: | 碩士 === 臺北醫學大學 === 醫學資訊研究所 === 102 === Background: In 1995, Taiwan launched National Health Insurance (NHI), and traditional Chinese medicine was covered by NHI at 1996. People taking Chinese and western medicine at the same period increased, it is reasonable to propose that the adverse effects resulted from herb-drug interactions may increase too. It is imperative to build up the database of herb-drug interaction for monitoring the adverse effects from Traditional Chinese medicine compound formula with western medicine.
Objective: The aim of this study is to (1): Establish the database for recorded drug interaction between traditional Chinese medicine compound formula and western medicine. (2): Analysis the interaction between traditional Chinese medicine and western drug status by using National Health Insurance Database.
Method: The study is designed as 2 phases. Phase 1 is to establish the database of the interactions between traditional Chinese compound formula and western medicine. Phase 2 is divided into 2 parts; part 1 initiate the retrospective study, recruited the data from National Health Insurance Research Database in 1998 to 2011; to analyze the potential interaction between traditional Chinese medicine and western medicine, and investigated the incidence, demographic information and prescription hospital by this study. Part 2 is to set up auto alert system based on the traditional Chinese medicine and western medicine interaction database in a teaching hospital in the north of Taiwan. We analyse the incidence in this hospital and the doctors’ prescription pattern after them receiving the alerts.
Result: Based on the above method to find traditional Chinese medicine which ingredients are mostly like western medicine: Ephedrae Herba (its extracts contain ephedrine ingredients) and there are 15 compound formula, Angelicae Sinensis Radix, Angelicae Dahuricae Radix (its extracts contain coumarin ingredients) and there are 9 compound formula. There were 586,318 potential herb-drug interactions documented in the traditional Chinese compound formula and western medicine interaction database. In period of 1998 to 2011, the prevalence of herb-drug interaction related to Ephedrae Herba was 0.18‰. The most common traditional Chinese compound formula were MA SHING GAN SHYR TANG(23.1%), SHEAU CHING LONG TANG(15.5%), DINQ CHUAN TANG(13.2%). The prevalence of herb-drug interaction related to Angelicae Sinensis Radix, Angelicae Dahuricae Radix was 4.59%. The most common traditional Chinese compound formula were TSANG EEL SAAN(32%), HUOH SHIANG JENQ CHIH SAAN(31.4%), SHY WUH TANG(10.7%).
There were 480 potential herb-drug interactions documented in the teaching hospital alert system. Approximately 16.7% of doctors changed prescription medicine after receiving the alarm information.
Conclusion: After implementation of National Health Insurance in Taiwan, the convenience of the clinic-visit makes the utilization of health care increased for both Chinese and western medicine. Different clinics prescription maybe cause drug interaction, the potential risks cannot be ignored. This herb-drug interaction database provides clinical physicians to determine when prescribing to avoid serious adverse drug reactions.
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