Harvard Medical School, Division for Research and Education in Complementary and Integrative Medical Therapies, 401 Park Dr, Suite 22-A West, Boston, MA 02215, USA.
Pediatrics. 2010 Feb;125(2):249-56. doi: 10.1542/peds.2009-1406. Epub 2010 Jan 25.
Limited data are available on the use of complementary and alternative medicine (CAM) and factors associated with use among the pediatric population in the United States.
Using the 2007 National Health Interview Survey data among individuals <18 years of age (n = 9417), we compared CAM users (excluding those using vitamins and minerals) and non-CAM users. Using bivariable and multivariable logistic regression models, we examined independent associations of CAM use with sociodemographic factors, prescription medication use, delays in health care caused by access difficulties, and common medical conditions/symptoms.
In an adjusted multivariable logistic model, CAM users were more likely than non-CAM users to be adolescents rather than infants or toddlers (adjusted odds ratio [aOR]: 1.61 [95% confidence interval (CI): 1.11-2.34]); live in the West (aOR: 2.05 [95% CI: 1.62-2.59]), Northeast (aOR: 1.36 [95% CI: 1.02-1.80]), or Midwest (aOR: 1.35 [95% CI: 1.04-1.74]) compared with those in the South; more likely to have a parent with a college education (aOR: 4.33 [95% CI: 2.92-6.42]); and more likely to use prescription medication (aOR: 1.51 [95% CI: 1.19-1.92]). Pediatric CAM users were more likely to have anxiety or stress (aOR: 2.54 [95% CI: 1.89-3.42]), dermatologic conditions (aOR: 1.35 [95% CI: 1.03-1.78]), musculoskeletal conditions (aOR: 1.94 [95% CI: 1.31-2.87]), and sinusitis (aOR: 1.54 [95% CI: 1.11-2.14]). Use of CAM by a parent was strongly associated with the child's use of CAM (aOR: 3.83 [95% CI: 3.04-4.84]).
In 2007, pediatric CAM users were more likely to take prescription medications, have a parent who used CAM, and have chronic conditions such as anxiety or stress, musculoskeletal conditions, dermatologic conditions, or sinusitis. Research is required to guide pediatricians in making recommendations on CAM modalities for children including potential risks and/or benefits and interactions with conventional therapies.
关于美国儿科人群中补充和替代医学(CAM)的使用以及与使用相关的因素,数据有限。
我们使用 2007 年针对<18 岁人群的全国健康访谈调查数据(n=9417),比较了 CAM 用户(不包括使用维生素和矿物质的用户)和非 CAM 用户。使用双变量和多变量逻辑回归模型,我们检查了 CAM 使用与社会人口因素、处方药使用、因获得医疗困难而导致的医疗保健延迟以及常见医疗状况/症状之间的独立关联。
在调整后的多变量逻辑模型中,CAM 用户比非 CAM 用户更有可能是青少年,而不是婴儿或幼儿(调整后的优势比[aOR]:1.61[95%置信区间(CI):1.11-2.34]);居住在西部(aOR:2.05[95%CI:1.62-2.59])、东北部(aOR:1.36[95%CI:1.02-1.80])或中西部(aOR:1.35[95%CI:1.04-1.74]),而不是南部;父母中有大学学历的可能性更大(aOR:4.33[95%CI:2.92-6.42]);并且更有可能使用处方药(aOR:1.51[95%CI:1.19-1.92])。儿科 CAM 用户更有可能患有焦虑或压力(aOR:2.54[95%CI:1.89-3.42])、皮肤病(aOR:1.35[95%CI:1.03-1.78])、肌肉骨骼疾病(aOR:1.94[95%CI:1.31-2.87])和鼻窦炎(aOR:1.54[95%CI:1.11-2.14])。父母使用 CAM 与孩子使用 CAM 密切相关(aOR:3.83[95%CI:3.04-4.84])。
2007 年,儿科 CAM 用户更有可能服用处方药、有使用 CAM 的父母,并且更有可能患有焦虑或压力、肌肉骨骼疾病、皮肤病或鼻窦炎等慢性疾病。需要开展研究,为儿科医生提供有关儿童 CAM 方式的建议,包括潜在的风险和/或益处以及与传统疗法的相互作用。