Vlieger Arine M, Blink Marjolein, Tromp Ellen, Benninga Marc A
Department of Pediatrics, St Antonius Hospital, PO Box 2500, 3430 EM Nieuwegein, Netherlands.
Pediatrics. 2008 Aug;122(2):e446-51. doi: 10.1542/peds.2008-0266. Epub 2008 Jul 28.
Many pediatric patients use complementary and alternative medicine, especially when facing a chronic illness for which treatment options are limited. So far, research on the use of complementary and alternative medicine in patients with functional gastrointestinal disease has been scarce. This study was designed to assess complementary and alternative medicine use in children with different gastrointestinal diseases, including functional disorders, to determine which factors predicted complementary and alternative medicine use and to assess the willingness of parents to participate in future studies on complementary and alternative medicine efficacy and safety.
The prevalence of complementary and alternative medicine use was assessed by using a questionnaire for 749 children visiting pediatric gastroenterology clinics of 9 hospitals in the Netherlands. The questionnaire consisted of 35 questions on the child's gastrointestinal disease, medication use, health status, past and future complementary and alternative medicine use, reasons for its use, and the necessity of complementary and alternative medicine research.
In this study population, the frequency of complementary and alternative medicine use was 37.6%. A total of 60.3% of this group had used complementary and alternative medicine specifically for their gastrointestinal disease. This specific complementary and alternative medicine use was higher in patients with functional disorders than organic disorders (25.3% vs 17.2%). Adverse effects of allopathic medication, school absenteeism, age <or=11 years, and a low effect of conventional treatment were predictors of specific complementary and alternative medicine use. Almost all (93%) of the parents considered it important that pediatricians initiate complementary and alternative medicine research, and 51% of parents were willing to participate in future complementary and alternative medicine trials.
Almost 40% of parents of pediatric gastroenterology patients are turning to complementary and alternative medicine for their child. Lack of effectiveness of conventional therapy, school absenteeism, and adverse effects of allopathic medication are more important predictors of complementary and alternative medicine use than the type of gastrointestinal disease. Because evidence on most complementary and alternative medicine modalities in children with gastrointestinal disorders is lacking, there is an urgent need for research in this field.
许多儿科患者使用补充和替代医学，尤其是在面对治疗选择有限的慢性病时。到目前为止，关于补充和替代医学在功能性胃肠病患者中的使用研究很少。本研究旨在评估不同胃肠疾病（包括功能性疾病）患儿对补充和替代医学的使用情况，确定哪些因素可预测补充和替代医学的使用，并评估家长参与未来补充和替代医学疗效与安全性研究的意愿。
通过问卷调查评估了荷兰9家医院儿科胃肠病诊所的749名儿童补充和替代医学的使用情况。问卷包含35个问题，涉及儿童的胃肠疾病、药物使用、健康状况、过去和未来补充和替代医学的使用情况、使用原因以及补充和替代医学研究的必要性。
在该研究人群中，补充和替代医学的使用频率为37.6%。该组中共有60.3%的人专门针对其胃肠疾病使用补充和替代医学。功能性疾病患者的这种特定补充和替代医学使用率高于器质性疾病患者（25.3%对17.2%）。对抗疗法药物的不良反应、缺课、年龄≤11岁以及传统治疗效果不佳是特定补充和替代医学使用的预测因素。几乎所有（93%）家长认为儿科医生开展补充和替代医学研究很重要，51%的家长愿意参与未来的补充和替代医学试验。
儿科胃肠病患者中近40%的家长为孩子寻求补充和替代医学。与胃肠疾病类型相比，传统疗法效果不佳、缺课以及对抗疗法药物的不良反应是补充和替代医学使用更重要的预测因素。由于缺乏关于胃肠疾病患儿大多数补充和替代医学方式的证据，该领域迫切需要开展研究。
