The Fundamental Research for Establishing Taiwan Pen Tsao- The Ethnopharmaceutical Study on the Blood Sugar Reducing Prescription in Taiwan

[[abstract]]糖尿病是全球十大死因之一，對全球健康及經濟造成相當大的影響。根據統計，全球約有5.37億成年人患有DM，預計到 2045年將增加到 7.83億人。目前臺灣成年人的DM患病率略低於全球平均值，但根據每年 DM人口增長趨勢，DM及其併發症對國人健康的影響不容小覷。雖然現今西醫藥已經普及，但在臺灣每戶家庭醫療支出中，中藥的使用仍佔很大一部分，而中藥可做為治療 DM的輔助療法。糖尿病是一種糖、蛋白質和脂肪代謝性障礙疾病，其原因很多，但主要是胰島素分泌或生成異常，糖尿病可分為胰島素依賴性糖尿病(Insulin Dependent Diabetes Mellitus,IDDM,又稱第1型)及非胰島素依賴性糖尿病(Noninsulin Dependent Diabetes Mellitus, NIDDM,又稱第2型)。臨床表現以吃多、喝多、尿多、疲倦與體重減輕。中醫屬“消渴”範疇，表現以可飲多、尿多、能食為主。在中草藥盛行的年代，本研究是調查台灣各地中藥房使用降血糖方藥，歸納其核心藥材並分析其特性，增加民間用草本植物降血糖的瞭解。分析藥物資訊，定義相對引用次數（relative frequency of citation,RFC）大於0.3之藥材為常用藥材，調查臺灣各縣市中藥行具降血糖作用的方劑，並確定各方劑所使用的藥材基原。統整分析臺灣常用於降血糖的藥材品項，並依Spearmans相關性分析，找出臺灣降血糖核心方劑。購買91帖降血糖方經拆解後得到111味中藥材，其中以豆科（8%）和菊科（6%）為主要基原，RFC大於0.3的常用藥材有7味，按其中藥特性分析，有60％屬溫性，50％屬甘味，中醫傳統功效，歸經方面歸胃經佔70％、歸腎經佔60％，藥效分類以補益類最多，佔60％。按中醫消渴病分類大多以下消為主要方藥，佔30％。降血糖方由多種中藥組成。藥材有地黃、山藥和黃耆等，方劑以六味地黃丸為台灣民間使用降血糖方核心組成。雖然這些方藥因顧客疾病需求，由台灣中藥房未經醫師診斷直接販賣於糖尿病患者服用多年，其臨床確效，防治具有學術意義，但其降血糖機轉研究尚待進一步研究釐清。[[abstract]]Ethnopharmacological relevance:Diabetes is one of the top ten causes of death in the world and has a considerable impact on global health and the economy. According to statistics, about 537 million adults worldwide suffer from DM, which is expected to increase to 783 million by 2045. At present, the prevalence of DM in Taiwanese adults is slightly lower than the global average, but according to the annual DM population growth trend, the impact of DM and its complications on the health of Chinese people should not be underestimated. Although Western medicine has become popular today, the use of traditional Chinese medicine still accounts for a large part of the medical expenditure of each household in Taiwan. In addition, traditional Chinese medicine can be used as an adjuvant therapy for the treatment of DM. Diabetes is a disorder of sugar, protein and fat metabolism, mainly caused by abnormal secretion or production of insulin. Diabetes can be divided into Insulin Dependent Diabetes Mellitus, IDDM and Noninsulin Dependent Diabetes Mellitus, NIDDM. Clinical manifestations include excessive eating, drinking, urination, fatigue and weight loss. Traditional Chinese Medicine called "Xiao Ke", which is mainly manifested by drinking, urinating, and being able to eat.In the age of Chinese herbal medicine, this study investigates the use of hypoglycemic prescriptions in Chinese pharmacies across Taiwan, summarizes its core medicinal materials and analyzes their properties, so as to increase the understanding of folk herbs for lowering blood sugar. Analyze drug information and define relative frequency of citation (RFC). Medicinal materials greater than 0.3 are commonly used medicinal materials. Investigate the prescriptions with hypoglycemic effect of traditional Chinese medicine in Taiwan's counties and cities, and determine the origin of the medicinal materials used in each formulation. A comprehensive analysis of the medicinal materials commonly used for hypoglycemic in Taiwan and the Spearman s correlation analysis were carried out to find out the core hypoglycemic prescriptions in Taiwan.After purchasing 91 blood sugar-lowering prescriptions, 111 Chinese medicinal materials were obtained after dismantling, among which Leguminosae (8%) and Compositae (6%) were the main bases. There are 7 commonly used medicinal materials with RFC greater than 0.3. According to the analysis of the characteristics of traditional Chinese medicine, 60% are warm, 50% are sweet.In traditional Chinese medicine, the stomach meridian accounts for 70%, and the kidney meridian accounts for 60%. According to the classification of diabetes mellitus in traditional Chinese medicine, most of the prescriptions are "Xia Xiao ", accounting for 30%.The blood sugar lowering formula consists of a variety of traditional Chinese medicines. The medicinal materials include Ti huang ,Shanand Huang ch'ietc., and the prescription is composed of Liuwei Dihuang Pills. Liuwei Dihuang Pills is the core composition of Taiwanese folk hypoglycemic prescriptions. Due todiabetic patients’ requests, Taiwanese traditional Chinese pharmacies directly sold the pills to Patients for many years. The treatment has clinical efficacy and prevention has academic significance. However, the research on their hypoglycemic mechanism needs to be further studied and clarified