| Summary: | 碩士 === 國立陽明大學 === 傳統醫藥研究所 === 106 === Depression is a significant medical condition that affects not only mood and behavior but also various physical functions. Many studies showed that it is associated with poorer quality of life, increased service utilization and risk of suicide. Antidepressants have many of the side effects and psychological treatments are limited. Thus, patients with depressive disorders have looked for other treatments, such as complementary and alternative medicine (CAM). In previous studies, traditional Chinese medicine (TCM) showed the benefits for treatment of depression. Thus, in this study we aimed to examine the utilization and core prescription patterns of Chinese herbal medicine (CHM) among patients with depressive disorders in Taiwan.
First, all patients diagnosed with major depressive disorder (ICD-9 234.2x or 234.3x) or minor depression (ICD-9 300.4) or dysthymia (ICD-9 311) were extracted from the three randomly sampled cohorts of 1,000,0s individuals, which were recruited from 26 million individuals in the NHI Research Database in 2000, 2005, and 2010. Second, in the depressive disorders cohort, patients who had at least one CHM outpatient clinical visit from 2002 to 2011 were defined as CHM users, whereas those with no CHM outpatient records were defined as non-CHM users. Finally, claims with only diagnosis code of depressive disorder without any other baseline diseases were defined as single diagnosis of depression. Only CHM users with single diagnosis of depressive disorders were included in this study. Data mining was conducted to explore the patterns of herbal products.
There were 197,146 patients with diagnosis of depressive disorders; of these, 1806 with single diagnosis of depression (0.9%) utilized CHM. Among the top 10 most commonly prescribed Chinese herbal medicine for the treatment of single diagnosis of depression, the most common formulas were Gan-Mai-Da-Zao-Tang (12.19%), Jia-Wei-Xiao-Yao-San (10.08%), and Chai-Hu-Jia-Long-Gu-Mu-Li-Tang (6.83%); Suan Zao Ren (3.99%), Da Huang(3.07%) and Yuan Zhi (2.89%) were found to be the most commonly prescribed single herbs. The core patterns of prescription was the combination of three formulas and three single herbs, Gan-Mai-Da-Zao-Tang, Jia-Wei-Xiao-Yao-San, Chai-Hu-Jia-Long-Gu-Mu-Li-Tang, He Huan Pi, Yuan Zhi and Shi Chang Pu.
This study showed the core prescription patterns of CHM for patients with single diagnosis of depressive disorders in Taiwan. Further studies on the efficacy of these formulas and single herbs in treating depressive disorders are needed.
Keywords: depressive disorders, National Health Insurance Research Database, Traditional Chinese medicine, Chinese herbal medicine.
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