Levy Susan E, Hyman Susan L
Children's Seashore House, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, 1914, USA.
Ment Retard Dev Disabil Res Rev. 2005;11(2):131-42. doi: 10.1002/mrdd.20062.
In no area of developmental pediatric practice is there more controversy regarding the choice of treatment than related to children with autistic spectrum disorders (ASD). Complementary and alternative medical therapies (CAM) are often elected because they are perceived as treating the cause of symptoms rather than the symptoms themselves. CAM used for autism can be divided by proposed mechanism: immune modulation, gastrointestinal, supplements that affect neurotransmitter function, and nonbiologic intervention. Secretin as a therapy for autism is discussed as an example of how a clinical observation rapidly grew to a widespread treatment before well-designed studies demonstrated absence of effect. The plausibility for behavioral effect was not substantiated by clinical studies. CAM used for treatment of autism is examined in terms of rationale, evidence of efficacy, side effects, and additional commentary. Families and clinicians need access to well-designed clinical evidence to assist them in choice of therapies.
在发育儿科实践的任何领域，与自闭症谱系障碍（ASD）儿童相关的治疗选择都没有比这更具争议性的了。补充和替代医学疗法（CAM）常常被选用，因为它们被认为是在治疗症状的根源而非症状本身。用于自闭症的CAM可根据其提出的机制进行划分：免疫调节、胃肠道、影响神经递质功能的补充剂以及非生物干预。作为自闭症治疗方法的促胰液素，被作为一个例子来讨论，即临床观察如何在精心设计的研究证明其无效之前迅速发展成为一种广泛使用的治疗方法。临床研究并未证实其对行为产生影响的合理性。本文从理论依据、疗效证据、副作用以及其他评论等方面对用于治疗自闭症的CAM进行了审视。家庭和临床医生需要获取精心设计的临床证据，以帮助他们选择治疗方法。
