西醫住院中醫會診患者中醫療效及生活品質評估之研究：以缺氧性腦病變、腦外傷和腦中風為對象

謝慶良
中國醫藥大學附設醫院
健保至今尚未開放中醫住院給付，主要的因素之一是因中醫住院所帶來的實際效益尚未有客觀的評估。講求實證醫學的時代，唯有透過詳實的探討和比較，才能確立中醫藥的臨床療效，進一步提升中醫藥在臨床上的角色；另外，過去的中醫藥研究均未針對住院病人使用中醫藥有關之療效、生活品質改善的滿意度，及中藥所帶來的不良反應做客觀的評估，因此本研究的目的在於評估西醫住院中醫會診之中醫療效和生活品質之改善程度，其結果提供相關單位及醫療機構，作為辦理中醫住院或中西醫結合等相關議題或政策的參考。對象是中國醫藥大學附設醫院西醫住院中醫會診中醫神經科的病患，預計兩年，總共完成160例（每年各80例）缺氧性腦病變、腦外傷，和腦中風患者西醫住院中醫會診後中醫療效和生活品質改善情形。中醫療效和生活品質改善的評估是比較至少服用連續兩週中醫方藥前後（1）生活品質量表, IQOLA SF-36 Taiwan Standard Version 1.0；（2）生活功能獨立量表（Function Independence Measure，FIM）；（3）Modified Rankin Scale；（4）美國國家衛生研究研究院中風評量表（NIHSS）；（5）中風病辨證診斷表；（6）巴式量表（Barthel Index）；（7）Glasgow Coma Scale（GCS）的變化情形，這些數值的變化經過統計分析後，確定其代表之意義。我們預期本研究的結果可以客觀評估西醫住院中醫會診之中醫療效和生活品質改善之滿意度，將來可作為政府制訂政策的參考。
關鍵字：西醫住院中醫會診；缺氧性腦病變；腦外傷；腦中風；療效評估

The study on the assessment of Chinese Medicine therapeutic effect and life quality in hospital in-patient with Chinese Medicine co-management: hypoxic encephalopathy, head injury and stroke patients

Ching-Liang Hsieh
China Medical University Hospital
Up till now, Taiwans National Health Insurance Scheme (NHIS) has not allowed for direct admission of in-patients by Chinese Medicine (CM) physicians in the hospital system. One contributing factor for this is that to date, there is no objective evaluation on the likely therapeutic and economic benefits for such policies. In the era of evidence-based medicine (EBM), the efficacy and cost-effectiveness of CM can only be validated through a comprehensive and accurate evaluation process, hence elevating the role of CM in clinical management of patients. In addition, previous research efforts seldom focused on measures of efficacy in CM modalities, patients perceived changes in quality of life (QOL), and objective evaluation on adverse reactions attributable to CM therapeutics, among hospital in-patients who received CM co-management. Hence we propose the current research project in order to assess the likely therapeutic benefits and QOL changes in hospital in-patients who also receive concurrent CM management. The findings will be made available for relevant medical and political institutions that are considering introducing policy models of direct CM admission of in-patients, or integrative patient care by Western medicine and CM. Our intended research candidates are the medical neurology in-patients who will also receive CM co-management at the China Medical University Hospital (CMUH), Taichung.
關鍵字：Hospital in-patients with Chinese Medicine co-management；Hypoxic encephalopathy；Traumatic brain injury；Stroke；Therapeutic effect assessment