Markowitz Jonathan E, Mamula Petar, delRosario J Fernando, Baldassano Robert N, Lewis James D, Jawad Abbas F, Culton Keri, Strom Brian L
Division of Gastroenterology & Nutrition, The Children's Hospital of Philadelphia, Pennsylvania, USA.
Inflamm Bowel Dis. 2004 Sep;10(5):599-605. doi: 10.1097/00054725-200409000-00015.
Complementary and alternative medicine use is prominent in the United States. The use of complementary and alternative therapies appears to be common in patients with inflammatory bowel disease, but few studies have been completed in children. We sought to examine the extent that children with inflammatory bowel disease in the Greater Philadelphia area (Philadelphia County and the surrounding counties in Delaware, New Jersey, and Pennsylvania) use alternative therapies. We paid particular attention to the specific types of therapies used and whether certain demographic and disease associated factors influence the degree of usage. In this study, we questioned the families of all children diagnosed with inflammatory bowel disease, aged 6 to 16 years and living within Philadelphia and its surrounding counties, who were followed at 1 of the 2 academic pediatric gastroenterology programs that served the area. More than 80% of surveys were returned. Fifty-one percent (95% C.I. 45% to 56%) of patients surveyed reported some form of alternative medicine use within the previous year. Univariate analysis revealed increased use among patients who had Crohn disease, who used the Internet for research on their disease, who reported poor quality of life and had increased school absences in the past year. Therapies associated with alternative medicine use included biological and immunomodulatory therapy. Regression analysis revealed positive associations between use of alternative therapies and expenditure on nonprescription treatments, poor quality of life, Internet research, and the need for calorie supplementation, whereas there was a negative association with history of prior surgery for inflammatory bowel disease.
补充和替代医学在美国颇为盛行。在炎症性肠病患者中,补充和替代疗法的使用似乎很常见,但针对儿童的相关研究却为数不多。我们试图探究大费城地区(费城县以及特拉华州、新泽西州和宾夕法尼亚州周边各县)的炎症性肠病患儿使用替代疗法的程度。我们特别关注所使用疗法的具体类型,以及某些人口统计学和疾病相关因素是否会影响使用程度。在本研究中,我们询问了所有年龄在6至16岁、居住在费城及其周边各县、并在该地区两个学术性儿科胃肠病学项目之一接受随访的炎症性肠病患儿的家庭。超过80%的调查问卷被收回。接受调查的患者中有51%(95%置信区间为45%至56%)报告在上一年使用过某种形式的替代医学。单因素分析显示,患有克罗恩病、通过互联网研究自身疾病、报告生活质量差且过去一年缺课次数增加的患者使用替代医学的比例更高。与使用替代医学相关的疗法包括生物和免疫调节疗法。回归分析显示,替代疗法的使用与非处方治疗费用、生活质量差、互联网研究以及热量补充需求呈正相关,而与炎症性肠病既往手术史呈负相关。