Jadhav M P, Jadhav P M, Shelke P, Sharma Y, Nadkar M
Department of Infectious Diseases, Maharashtra University of Health Sciences, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, India.
Indian J Med Sci. 2011 Feb;65(2):50-7.
Complementary and alternative medicine (CAM) has witnessed an increase in use in recent times in rheumatological conditions and is expected to have impact on the quality of life (QOL). We had planned to conduct this study to investigate the extent of use of CAM and its effect on QOL of patients at a tertiary care center.
Ethics committee approval was obtained. Sixty patients suffering from osteoarthritis (OA) and rheumatoid arthritis (RA) were enrolled as per the selection criteria, after obtaining their informed consent. Each patient was interviewed for CAM use/non-use, and Western Ontario and McMaster Universities (WOMAC) (modified) index for QOL was recorded by the study personnel.
The normality was checked by using Kolmogorov-Smirnov test. Descriptive statistics was performed and Mann-Whitney U-test was used to compare the QOL of CAM users and non-users.
Of the 60 patients enrolled with OA (10) and RA (50), 58% (35/60) used CAM. Ayurveda and massage therapy were the commonest [80% (28/35)], followed by yoga asana [34% (12/35)] and homoeopathy [20% (7/35)]. It was observed that combinations of therapies were used too. Nearly half [49% (17/35)] of the CAM users were on self-prescribed medication and 71% (25/35) of them did not inform the physician of CAM use. The QOL of CAM users (WOMAC score: 56.31 ± 6.82) was better than that of CAM non-users (WOMAC score: 60.16 ± 4.02) (P value 0.01).
Patients with RA frequently used CAM and QOL improvised with CAM use. We observed that self-administration of CAM was common and this was not informed to the treating physician.
近年来，补充和替代医学（CAM）在风湿性疾病中的使用有所增加，预计会对生活质量（QOL）产生影响。我们计划开展此项研究，以调查在一家三级护理中心CAM的使用程度及其对患者生活质量的影响。
获得伦理委员会批准。根据入选标准，在获得60例骨关节炎（OA）和类风湿关节炎（RA）患者的知情同意后将其纳入研究。研究人员对每位患者进行关于是否使用CAM的访谈，并记录西部安大略和麦克马斯特大学（WOMAC）（修订版）生活质量指数。
使用Kolmogorov-Smirnov检验检查数据的正态性。进行描述性统计，并使用Mann-Whitney U检验比较使用CAM和未使用CAM患者的生活质量。
在纳入研究的60例OA患者（10例）和RA患者（50例）中，58%（35/60）使用CAM。阿育吠陀医学和按摩疗法最为常用[80%（28/35）]，其次是瑜伽体式[34%（12/35）]和顺势疗法[20%（7/35）]。还观察到有患者使用多种疗法的组合。近一半[49%（17/35）]的CAM使用者自行用药，其中71%（25/35）未告知医生其使用CAM的情况。使用CAM患者的生活质量（WOMAC评分：56.31±6.82）优于未使用CAM的患者（WOMAC评分：60.16±4.02）（P值0.01）。
RA患者频繁使用CAM，使用CAM后生活质量得到改善。我们观察到自行使用CAM的情况很常见，且未告知治疗医生。
