Wong Anthony P, Clark Ann L, Garnett Elizabeth A, Acree Michael, Cohen Stanley A, Ferry George D, Heyman Melvin B
Department of Pediatrics and Medicine, University of California, San Francisco, CA 94143-0136, USA.
J Pediatr Gastroenterol Nutr. 2009 Jan;48(1):55-60. doi: 10.1097/MPG.0b013e318169330f.
We examined the use of complementary and alternative medicine (CAM) at 3 US pediatric medical centers, comparing a group of children with inflammatory bowel disease (IBD) with children presenting with chronic constipation.
Surveys were administered by postal mail and at pediatric IBD centers in San Francisco, Houston, and Atlanta from 2001 to 2003. A comparison group consisting of pediatric patients with chronic constipation also was surveyed. Data were analyzed by t tests and by exact tests of contingency tables.
In all, 236 surveys were collected from the IBD group; 126 surveys were collected from the chronic constipation comparison group. CAM therapies were used by 50% in the IBD group and 23% in the chronic constipation group. The overall regional breakdown of CAM use in IBD revealed no differences, although the types of CAM therapy used varied by site. The most commonly used CAM therapies in the IBD group were spiritual interventions (25%) and nutritional supplements (25%). Positive predictors for CAM use in IBD include the patient's self-reported overall health, an increase in the number of side effects associated with allopathic medications, white ethnicity, and parental education beyond high school.
This is the first US study to characterize CAM use in pediatric patients with IBD with another chronic gastrointestinal disorder. CAM use was twice as common with the IBD group compared with the chronic constipation group. Regional variations exist with the types of CAM therapy used. Practitioners should know that half of their pediatric patients with IBD may be using CAM in conjunction with or as an alternative to other treatments and that certain predictors can help identify those using CAM therapies.
我们在美国的3家儿科医疗中心对补充和替代医学(CAM)的使用情况进行了调查,比较了一组炎症性肠病(IBD)患儿和慢性便秘患儿。
2001年至2003年通过邮寄方式并在旧金山、休斯顿和亚特兰大的儿科IBD中心进行了调查。还对一组患有慢性便秘的儿科患者进行了调查。数据通过t检验和列联表精确检验进行分析。
IBD组共收集到236份调查问卷;慢性便秘对照组收集到126份调查问卷。IBD组中50%的患儿使用了CAM疗法,慢性便秘组中这一比例为23%。IBD组中CAM使用的总体区域分布没有差异,尽管不同地点使用的CAM疗法类型有所不同。IBD组中最常用的CAM疗法是精神干预(25%)和营养补充剂(25%)。IBD组中使用CAM的阳性预测因素包括患者自我报告的总体健康状况、与传统药物相关的副作用数量增加、白人种族以及父母受过高中以上教育。
这是美国第一项对患有IBD的儿科患者与另一种慢性胃肠疾病患者使用CAM情况进行描述的研究。与慢性便秘组相比,IBD组使用CAM的情况是其两倍。在使用的CAM疗法类型上存在区域差异。从业者应该知道,他们一半的IBD儿科患者可能在结合使用CAM或用其替代其他治疗方法,并且某些预测因素可以帮助识别那些使用CAM疗法的患者。