Crawford Nigel W, Cincotta Domenic R, Lim Alissa, Powell Colin V E
Department of General Paediatrics, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK.
BMC Complement Altern Med. 2006 May 2;6:16. doi: 10.1186/1472-6882-6-16.
A high prevalence of CAM use has been documented worldwide in children and adolescents with chronic illnesses. Only a small number of studies, however, have been conducted in the United Kingdom. The primary aim of this study was to examine the use of CAM by children and adolescents with a wide spectrum of acute and chronic medical problems in a tertiary children's hospital in Wales.
Structured personal interviews of 100 inpatients and 400 outpatients were conducted over a 2-month period in 2004. The yearly and monthly prevalence of CAM use were assessed and divided into medicinal and non-medicinal therapies. This use was correlated with socio-demographic factors.
There were 580 patients approached to attain 500 completed questionnaires. The use of at least one type of CAM in the past year was 41% (95% CI 37-46%) and past month 26% (95% CI 23-30%). The yearly prevalence of medicinal CAM was 38% and non-medicinal 12%. The users were more likely to have parents that were tertiary educated (mother: OR = 2.3, 95%CI 1.6-3.3) and a higher family income (Pearson chi-square for trend = 14.3, p < 0.001). The most common medicinal types of CAM were non-prescribed vitamins and minerals (23%) and herbal therapies (10%). Aromatherapy (5%) and reflexology (3%) were the most prevalent non-medicinal CAMs. None of the inpatient medical records documented CAM use in the past month. Fifty-two percent of medicinal and 38% of non-medicinal CAM users felt their doctor did not need to know about CAM use. Sixty-six percent of CAM users did not disclose the fact to their doctor. Three percent of all participants were using herbs and prescription medicines concurrently.
There is a high prevalence of CAM use in our study population. Paediatricians need to ensure that they ask parents and older children about their CAM usage and advise caution with regard to potential interactions.CAM is a rapidly expanding industry that requires further evidence-based research to provide more information on the effectiveness and safety of many CAM therapies. Statutory or self-regulation of the different segments of the industry is important. Integration of CAM with allopathic western medicine through education and better communication is slowly progressing.
全球范围内，患有慢性疾病的儿童和青少年中补充替代医学（CAM）的使用率很高。然而，在英国开展的相关研究却为数不多。本研究的主要目的是调查威尔士一家三级儿童医院中患有各种急慢性疾病的儿童和青少年对补充替代医学的使用情况。
2004年，在两个月的时间里，对100名住院患者和400名门诊患者进行了结构化的个人访谈。评估了补充替代医学使用的年度和月度患病率，并将其分为药物疗法和非药物疗法。这种使用情况与社会人口统计学因素相关。
共接触了580名患者以获取500份完整问卷。过去一年中至少使用一种补充替代医学的比例为41%（95%置信区间37 - 46%），过去一个月为26%（95%置信区间23 - 30%）。药物补充替代医学的年度患病率为38%，非药物的为12%。使用者的父母更有可能接受过高等教育（母亲：比值比 = 2.3，95%置信区间1.6 - 3.3）且家庭收入较高（趋势的Pearson卡方检验 = 14.3，p < 0.001）。最常见的药物类补充替代医学是非处方维生素和矿物质（23%）以及草药疗法（10%）。芳香疗法（5%）和反射疗法（3%）是最常见的非药物补充替代医学。在过去一个月里，住院病历中均未记录补充替代医学的使用情况。52%的药物补充替代医学使用者和38%的非药物补充替代医学使用者认为他们的医生无需了解其补充替代医学的使用情况。66%的补充替代医学使用者未向医生透露这一情况。所有参与者中有3%同时使用草药和处方药。
在我们的研究人群中，补充替代医学的使用率很高。儿科医生需要确保询问家长和年龄较大的儿童关于他们补充替代医学的使用情况，并就潜在的相互作用给予谨慎建议。补充替代医学是一个迅速发展的行业，需要进一步开展基于证据的研究，以提供更多关于许多补充替代医学疗法有效性和安全性的信息。对该行业不同领域进行法定或自我监管很重要。通过教育和更好的沟通，将补充替代医学与西医结合的工作正在缓慢推进。
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