Giordano James, Boatwright Douglas, Stapleton Sarai, Huff Lew
Department of Pathology and Physical Medicine, Moody Health Center, Pasadena, TX 77505, USA.
J Altern Complement Med. 2002 Dec;8(6):897-906. doi: 10.1089/10755530260511892.
Complementary and alternative medicine (CAM) is growing in popularity among patients traditionally seen in an allopathic setting. A literature review and information search was conducted to determine the trend in demand for and the availability of CAM in the United States. The results of major surveys show that there is an increase in the use of CAM in the United States. The best predictor of CAM use is higher level of education. In addition, findings reveal that the field of CAM is poorly researched. Many studies in CAM therapies have flaws, such as insufficient statistical power, poor controls, inconsistent treatment, and lack of comparisons. The National Center for Complementary and Alternative Medicine of the National Institutes of Health, has declared their top strategic priority to be investing in research. Currently, more than 70 medical schools offer some type of training in alternative medicine, although there are few guidelines for curriculum and there is considerable heterogeneity in content, format, and requirements among CAM courses. As patients have greater access to information, their needs and values change. They become more involved in their overall health care and are taking a more natural and holistic approach to achieving well-being. Health care practitioners, both allopathic and alternative, must be well informed. There is an imperative to make CAM research a high priority. Valid and reliable empirical data must document the clinical efficacy and safety of CAM practices. In order to integrate CAM into the mainstream, there must be a coordinated effort among all the entities involved. Physicians need to be familiar with proven CAM therapies in order to advise patients about these modalities and the potential benefits and limitations. CAM practitioners should be licensed and regulated in scope of practice to provide a high standard of care, and be sufficiently educated in conventional medical science(s) in order to recognize how, where, and why their respective complementary practice is most effective for integration.
补充和替代医学（CAM）在传统接受对抗疗法的患者中越来越受欢迎。我们进行了文献综述和信息搜索，以确定美国对补充和替代医学的需求趋势以及其可获得性。主要调查结果显示，美国补充和替代医学的使用有所增加。使用补充和替代医学的最佳预测因素是较高的教育水平。此外，研究结果表明，补充和替代医学领域的研究较少。许多补充和替代医学疗法的研究存在缺陷，如统计效力不足、对照不佳、治疗不一致以及缺乏比较。美国国立卫生研究院的补充和替代医学国家中心已宣布其首要战略重点是投资于研究。目前，超过70所医学院校提供某种类型的替代医学培训，尽管针对课程设置的指导方针很少，而且补充和替代医学课程在内容、形式和要求方面存在很大差异。随着患者获取信息的机会增多，他们的需求和价值观也在发生变化。他们更加关注自己的整体医疗保健，并采取更自然和整体的方法来实现健康。无论是对抗疗法还是替代疗法的医疗从业者都必须充分了解情况。必须将补充和替代医学研究作为高度优先事项。有效和可靠的实证数据必须记录补充和替代医学实践的临床疗效和安全性。为了将补充和替代医学纳入主流，所有相关实体必须共同努力。医生需要熟悉经过验证的补充和替代医学疗法，以便就这些疗法及其潜在益处和局限性向患者提供建议。补充和替代医学从业者应获得执业许可并在执业范围内受到监管，以提供高标准的护理，并接受足够的传统医学科学教育，以便认识到他们各自的补充疗法在何处、如何以及为何最有效地进行整合。
