Baystate Children's Hospital, Tufts University School of Medicine, Springfield, Massachusetts, USA.
Curr Opin Pediatr. 2012 Aug;24(4):539-46. doi: 10.1097/MOP.0b013e328355a214.
Although many publications have documented the use of complementary and alternative medicine (CAM) in children and adolescents, most have lacked the scientific rigor to establish clear benefits over so-called conventional medicine. We reviewed the literature published in the past year to identify the types of CAM most often studied in children, the variety of conditions to which these modalities are applied, and the methodologies used in the articles exploring the most prevalent CAM modalities.
We identified 111 published articles on CAM use in children in 2011. The most common modalities were herbal/dietary supplements, acupuncture, massage, chiropractic, and homeopathy. The most commonly studied conditions were pain, headache, attention deficit hyperactivity disorder (ADHD), asthma, and colic. Although a majority of the articles consisted of reviews, case reports, and other nonhypothesis-driven methodologies, we did find that several were randomized controlled trials, meta-analyses, or systematic reviews. These methodologies, however, rarely accounted for the majority of publications on a particular therapy or condition.
The use of CAM in children continues to occupy a niche area of interest for many providers and families, but only a minority of articles published in the past year utilized methods of sufficient rigor to provide a useful comparison to more conventional therapies.
目的综述:虽然有许多出版物记录了补充和替代医学(CAM)在儿童和青少年中的应用,但大多数都缺乏科学严谨性,无法明确其相对于所谓的常规医学的优势。我们回顾了过去一年发表的文献,以确定在儿童中最常研究的 CAM 类型、这些方法应用于各种病症的情况,以及在探索最常见的 CAM 方法的文章中使用的方法。
最新发现:我们在 2011 年确定了 111 篇关于儿童 CAM 使用的已发表文章。最常见的方法是草药/饮食补充剂、针灸、按摩、脊椎按摩和顺势疗法。最常研究的病症是疼痛、头痛、注意缺陷多动障碍(ADHD)、哮喘和绞痛。尽管大多数文章都包括综述、病例报告和其他非假设驱动的方法,但我们确实发现有几个是随机对照试验、荟萃分析或系统评价。然而,这些方法很少能将特定疗法或病症的大部分出版物都包括在内。
总结:CAM 在儿童中的应用继续是许多提供者和家庭感兴趣的一个小众领域,但在过去一年发表的少数文章中,只有少数文章采用了足够严谨的方法,与更常规的疗法进行了有用的比较。