补充和替代医学使用情况及其后续住院治疗的前瞻性调查。
Prospective investigation of complementary and alternative medicine use and subsequent hospitalizations.
作者信息
Smith Tyler C, Smith Besa, Ryan Margaret A K
机构信息
Department of Defense Center for Deployment Health Research, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA.
出版信息
BMC Complement Altern Med. 2008 May 8;8:19. doi: 10.1186/1472-6882-8-19.
BACKGROUND
The prevalence of complementary and alternative medicine (CAM) use has been estimated to be as high as 65% in some populations. However, there has been little objective research into the possible risks or benefits of unmanaged CAM therapies.
METHODS
In this prospective study of active duty US Navy and Marine Corps personnel, the association between self-reported practitioner-assisted or self-administered CAM use and future hospitalization was investigated. Cox regression models were used to examine risk of hospitalization due to any cause over the follow-up period from date of questionnaire submission, until hospitalization, separation from the military, or end of observation period (June 30, 2004), whichever occurred first.
RESULTS
After adjusting for baseline health, baseline trust and satisfaction with conventional medicine, and demographic characteristics, those who reported self-administering two or more CAM therapies were significantly less likely to be hospitalized for any cause when compared with those who did not self-administer CAM (HR = 0.38; 95% CI = 0.17, 0.86). Use of multiple practitioner-assisted CAM was not associated with a significant decrease or increase of risk for future hospitalization (HR = 1.86; 95 percent confidence interval = 0.96-3.63).
CONCLUSION
While there were limitations to these analyses, this investigation utilized an objective measure of health to investigate the potential health effects of CAM therapies and found a modest reduction in the overall risk of hospitalization associated with self-administration of two or more CAM therapies. In contrast, use of practitioner-assisted CAM was not associated with a protective effect.
背景
据估计,某些人群中使用补充和替代医学(CAM)的比例高达65%。然而,对于未经管理的CAM疗法可能存在的风险或益处,客观研究甚少。
方法
在这项针对美国现役海军和海军陆战队人员的前瞻性研究中,调查了自我报告的由从业者辅助或自行使用CAM与未来住院之间的关联。使用Cox回归模型来检查从问卷提交日期到住院、脱离军队或观察期结束(2004年6月30日)(以先发生者为准)的随访期间因任何原因住院的风险。
结果
在对基线健康状况、对传统医学的基线信任和满意度以及人口统计学特征进行调整后,与未自行使用CAM的人相比,报告自行使用两种或更多CAM疗法的人因任何原因住院的可能性显著降低(风险比[HR]=0.38;95%置信区间[CI]=0.17,0.86)。使用多种由从业者辅助的CAM与未来住院风险的显著降低或增加无关(HR=1.86;95%置信区间=0.96 - 3.63)。
结论
虽然这些分析存在局限性,但本研究采用了客观的健康指标来调查CAM疗法的潜在健康影响,发现自行使用两种或更多CAM疗法与住院总体风险适度降低相关。相比之下,使用由从业者辅助的CAM没有显示出保护作用。