Kaiboriboon Kitti, Guevara Marie, Alldredge Brian K
Department of Neurology, University of California, San Francisco, California, USA.
Epilepsia. 2009 Aug;50(8):1927-32. doi: 10.1111/j.1528-1167.2009.02090.x. Epub 2009 Apr 19.
To determine the prevalence of herb and dietary supplement use and to provide a comprehensive analysis of factors influencing the use of these products in patients with epilepsy.
We performed a cross-sectional study using self-administered questionnaires in a selected group of patients who were receiving care at a tertiary epilepsy center. Logistic regression was used to measure the association between the demographic variables and herb and dietary supplement use. In addition, we performed a MEDLINE search for each of the herb and dietary products used by our patients to determine the effect of these products on seizures and on their potential for interactions with other drugs metabolized by the liver.
One hundred eighty-seven patients completed the survey. Fifty-six percent of this group of patients with epilepsy used herbs and dietary supplements at the time of the survey. A considerable portion (71%) of these patients reported the use of these products to their physician, and most of them relied on their physicians as the primary source of information. Most of the patients used dietary supplement for health promotion rather than to specifically benefit their epilepsy condition. Approximately one-third of patients used herb or dietary supplements that had the potential to increase seizures (16%) or to interact with hepatically metabolized drugs (19%). The most powerful independent predictors of herb and dietary supplement use were partial epilepsy [odds ratio (OR) 3.36; 95% confidence interval (CI) 1.27-8.88] and Caucasian race (OR 3.55; 95% CI 1.11-11.34).
Patients with epilepsy commonly used dietary supplements along with their antiepileptic medications. The majority of these patients used herb and dietary supplements for health promotion rather than because of dissatisfaction with conventional treatment. It is important that physicians involved in the care of patients with epilepsy routinely inquire about the use of dietary supplements and that they make use of reliable resources to assess the safety of these products with regard to modification of seizure risk and the potential for interactions with antiepileptic drugs.
确定草药和膳食补充剂的使用 prevalence，并对影响癫痫患者使用这些产品的因素进行全面分析。
我们在一家三级癫痫中心接受治疗的一组选定患者中，使用自填式问卷进行了一项横断面研究。采用逻辑回归来衡量人口统计学变量与草药和膳食补充剂使用之间的关联。此外，我们对患者使用的每种草药和膳食产品进行了 MEDLINE 检索，以确定这些产品对癫痫发作的影响以及它们与肝脏代谢的其他药物相互作用的可能性。
187 名患者完成了调查。在调查时，这组癫痫患者中有 56% 使用草药和膳食补充剂。这些患者中有相当一部分（71%）向他们的医生报告了使用这些产品的情况，并且他们中的大多数将医生作为主要信息来源。大多数患者使用膳食补充剂是为了促进健康，而不是专门为了改善他们的癫痫病情。大约三分之一的患者使用了有可能增加癫痫发作（16%）或与肝脏代谢药物相互作用（19%）的草药或膳食补充剂。草药和膳食补充剂使用的最有力独立预测因素是部分性癫痫 [比值比 (OR) 3.36；95% 置信区间 (CI) 1.27 - 8.88] 和白种人（OR 3.55；95% CI 1.11 - 11.34）。
癫痫患者通常在服用抗癫痫药物的同时使用膳食补充剂。这些患者中的大多数使用草药和膳食补充剂是为了促进健康，而不是因为对传统治疗不满意。参与癫痫患者护理的医生常规询问膳食补充剂的使用情况，并利用可靠资源评估这些产品在改变癫痫发作风险和与抗癫痫药物相互作用可能性方面的安全性，这一点很重要。
