台灣抗凝血西藥及及非類固醇止痛藥與科學中藥併用及交互作用之藥物流行病學研究

賴榮年
陽明大學
藥物併用與交互作用是醫藥安全衛生的重要課題，一直以來均受政府與醫界的高度重視與研究。隨著傳統醫學的療效逐漸受到肯定，民眾利用全民健康保險給付的中醫藥門診也更加的普遍，中西藥同時併用的狀況變的更為常見。抗凝血藥物如Warfarin以及aspirin等隨著心血管疾病的增加而被民眾長期服用；另外非類固醇止痛藥（包含Acetaminophen）等也是民眾平時常用的藥物；這類藥物長期使用下與中藥同時併用的機會也隨之增加，過去之前也有此類藥物與草藥的交互作用報告。因此本研究將對過去有關此類藥物跟中草藥的交互作用作文獻回顧；並利用健保資料庫針對此類藥物的中西藥併用狀況進行描述型統計與此類中西藥物交互作用是否造成重大副作用進行藥物流行病學的研究，提供中醫藥委員會對此類中西藥併用的概況以及此類中西藥交互作用是否會導致重大或致命副作用的實證資料，維護國人用藥安全。
關鍵字：抗凝血藥物；非類固醇止痛藥；中西藥併用交互作用；全民健保資料庫；藥物流行病學

Anticoagulant Drug- Herb Interaction and Non Steroid Antiinflammatory Drug-Herb Interaction in Taiwan

Jung-Nien Lai
National Yang-Ming university
Drug interaction is one of the most important issues in drug safety. When the traditional Chinese medicine(TCM) become more popular, these herbs are often co-administered with therapeutic drugs raising the potential of drug–herb interactions, which may have important clinical significance based on an increasing number of clinical reports of such interactions. The interaction between herbs and drugs with narrow therapeutic indices (e.g. warfarin and digoxin) is is a significant safety concern. Because the pharmacokinetics and/or pharmacodynamics of the drug may be altered by combination with herbal remedies, potentially severe and perhaps even life-threatening adverse reactions may occur. In the other way, the wide using drugs like acetaminophen are also co-administered TCM easily. But there is still lack the solid data of the drug-herb interaction of these drugs. Our research will provide the description study of the these kinds of drug herb co-administered in national health insurance system. We also try to find out the severe and perhaps even life-threatening adverse due to these drug- herb interactions in the national health insurance cohort 1996-2007. We hope this research can help our government to built a safe TCM environment.
關鍵字：Anticoagulant Drug；Non Steroid Antiinflammatory Drug；drug interaction；Pharmacoepidemiology