Schieman Colin, Rudmik Luke R, Dixon Elijah, Sutherland Francis, Bathe Oliver F
Department of Surgery, University of Calgary, Calgary, Alta.
Can J Surg. 2009 Oct;52(5):422-6.
The use of complementary and alternative medicine (CAM) is becoming more common, particularly among cancer patients. We sought to define the frequency of CAM use among general surgery, hepatobiliary and surgical oncology patients and to define some of the determinants of CAM use in patients with benign and malignant disease.
We asked all patients attending the clinics of 3 hepatobiliary/surgical oncology surgeons from 2002 to 2005 to voluntarily respond on first and subsequent visits to a questionnaire related to the use of CAM. We randomly selected patients for review.
We reviewed a total of 490 surveys from 357 patients. Overall CAM use was 27%. There was significantly more CAM use among cancer (34%) versus noncancer patients (21%; p = 0.008), and the use of CAM was more common in patients with unresectable cancer (51%) than resectable cancer (22%; p < 0.001). There was no significant difference in use between men and women. There did not appear to be a change in CAM use with progression of cancer. The most common CAM was herbs or supplements (58% of all users), which were most frequently used by patients with malignant disease. Among the 27 herbs reported to be ingested, 10 are associated with bleeding and hepatotoxicity, as described in the literature.
Prospective studies evaluating surgical outcomes related to CAM use are needed.
补充和替代医学(CAM)的使用正变得越来越普遍,尤其是在癌症患者中。我们试图确定普通外科、肝胆外科和外科肿瘤患者中使用CAM的频率,并确定一些良性和恶性疾病患者使用CAM的决定因素。
我们要求2002年至2005年在3位肝胆/外科肿瘤外科医生诊所就诊的所有患者在首次就诊及后续就诊时自愿回答一份与使用CAM相关的问卷。我们随机选择患者进行复查。
我们共复查了来自357名患者的490份调查问卷。总体CAM使用率为27%。癌症患者(34%)的CAM使用率显著高于非癌症患者(21%;p = 0.008),不可切除癌症患者(51%)使用CAM比可切除癌症患者(22%;p < 0.001)更常见。男性和女性在使用上没有显著差异。随着癌症进展,CAM的使用似乎没有变化。最常见的CAM是草药或补充剂(占所有使用者的58%),恶性疾病患者最常使用。在报告摄入的27种草药中,有10种与文献中描述的出血和肝毒性有关。
需要进行前瞻性研究来评估与使用CAM相关的手术结果。