合中醫治療失智患者的臨床效用
 
曾元卜¹　謝承運¹　龔彥穎^1,2　陳方佩^1,2結

 
隨著台灣邁入高齡化社會，失智患者人數逐年攀升，全人整合照護扮演重要角色。中醫藥是台灣正統醫療體系之一，具有簡便安全且低副作用、治療過程和緩及成本效益高等優勢，據統計，在台灣43.3%的失智症患者會尋求傳統中醫治療。本文介紹中醫對失智症治療的目標與角色，對不同病程制定合適的治療策略，譬如對輕度認知障礙與輕度失智的目標是維持患者的認知功能，對中度失智的目標是減少患者的精神與行為症狀，對重度失智的目標則是維持生活功能，避免插管。同時，中醫亦可對失智症照護者提供協助，減輕身心壓力。冀望透過中醫醫療院所結合西醫基層醫師及長照機構，提供中西醫整合照護，連結醫療、家庭及社會資源，為失智症患者提供更周全的醫療服務。
（台灣家醫誌2020; 30: 55-67）DOI: 10.3966/168232812020063002001
 
關鍵詞： 失智、中醫、基層醫師、整合照護
 

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¹臺北榮民總醫院傳統醫學部、²國立陽明大學傳統醫藥研究所
受理日期：109年2月5日　　修改日期：109年3月10日　　同意刊登：109年4月8日
通訊作者：陳方佩　　　　 通訊地址：11217臺北市北投區石牌路二段201號
 

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Integrating Traditional Chinese Medicine into Dementia Treatment
 
Yuan-Pu Tseng¹, Cheng-Yun Hsieh¹, Yen-Ying Kung^1,2 and Fang-Pey Chen^1,2

As the population in Taiwan continues aging, the number of patients with dementia is rising, and holistic health care becomes more and more important. Traditional Chinese medicine (TCM) has been an integral part of Taiwan’s medical system and well recognized for its advantages of safety, low side effect, high cost-effectiveness, and gentle treatment process. According to related statistics, 43.3% of patients with dementia in Taiwan have been treated with TCM therapies.
The article introduces the goals of TCM therapy for dementia treatment and proposes appropriate treatment strategies for different stages of dementia. The goals are respectively maintaining patients’ cognitive function for mild cognitive impairment and mild dementia, mitigating the behavioral and psychological symptoms of dementia for moderate dementia, and prolonging patients’ life function and avoiding intubation for severe dementia. Meanwhile, TCM therapy can also provide assistance to caregivers to reduce their physical and mental stress. It is hoped that TCM clinics can join forces with long-term care institutions and primary care physicians trained in Western medicine to develop effective integrated care and orchestrate multiple resources to offer patients with dementia better medical treatment and care.
(Taiwan J Fam Med 2020; 30: 55-67) DOI: 10.3966/168232812020063002001
 
Key words: dementia, integrated care, primary care physician,traditional Chinese medicine (TCM)
 

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¹Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.; ²Institute of Traditional
Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
Received: February 5, 2020; Revised: March 10, 2020; Accepted: April 8, 2020.