aDepartment of Gastroenterology, Cochin Hospital, APHP, Paris bAssociation François Aupetit cEmile Roux Hospital, APHP, Limeil-Brevannes dDepartment of Gastroenterology and Hepatology, GHI Le Raincy-Montfermeil, Montfermeil, France.
Eur J Gastroenterol Hepatol. 2014 Mar;26(3):288-94. doi: 10.1097/MEG.0000000000000040.
Complementary and alternative medicines (CAM) are widely used by patients with inflammatory bowel disease (IBD). Few data have been published on the impact of CAM on the quality of life (QOL).
The aim of the study was to describe CAM use in French patients with IBD, identify characteristics associated with CAM use, and assess the impact of CAM on the QOL.
We conducted an internet survey on CAM through the French IBD patient's association website. Patients had to answer a questionnaire (LimeSurvey application) about sociodemography, IBD treatment, CAM type, socioeconomic data, and QOL using the Short IBD Questionnaire (SIBDQ). Patients noted the impact of CAM on their symptoms and on their QOL on a scale of 0-100. CAM users and nonusers were compared by univariate and multivariate analyses.
A total of 936 IBD patients responded and 767 (82.4%) filled up the whole questionnaire: 503 reported CAM use and 172 had never used. The types of CAM reported were diet-based (30.7%), body-based (25.1%), homeopathic or traditional medicine (19.6%), naturopathy (15.2%), and mind-body medicine (9.1%). The gastroenterologist was aware of CAM use in only 46% of patients. CAM users were more likely to have ulcerative colitis [odds ratio (OR)=1.78, P=0.018], clinical remission (OR=1.42, P=0.06), high level of education (OR=1.51, P=0.02), poor observance (OR=1.81, P=0.017), or to have terminated conventional treatment (OR=2.03, P=0.003). CAM users tend to have higher rates of SIBDQ scores, greater than 50 (OR=1.57, P=0.06). Improvement in symptoms and QOL was reported with all CAM types except mind medicine.
CAM use is widespread among IBD patients. CAM users report improvement in symptoms and QOL, but they tend to stop their conventional treatment. Better information about CAM might improve adherence to conventional treatment.
补充和替代医学(CAM)在炎症性肠病(IBD)患者中广泛使用。关于 CAM 对生活质量(QOL)的影响,发表的数据很少。
本研究的目的是描述法国 IBD 患者使用 CAM 的情况,确定与 CAM 使用相关的特征,并评估 CAM 对 QOL 的影响。
我们通过法国 IBD 患者协会的网站在互联网上对 CAM 进行了调查。患者必须通过 LimeSurvey 应用程序回答一份关于社会人口统计学、IBD 治疗、CAM 类型、社会经济数据和使用短炎症性肠病问卷(SIBDQ)的 QOL 的问卷。患者使用 0-100 的评分来记录 CAM 对他们症状和 QOL 的影响。通过单变量和多变量分析比较 CAM 用户和非用户。
共有 936 名 IBD 患者做出了回应,其中 767 名(82.4%)填写了完整的问卷:503 名报告使用了 CAM,172 名从未使用过。报告的 CAM 类型包括饮食为基础的(30.7%)、身体为基础的(25.1%)、顺势疗法或传统医学(19.6%)、顺势疗法(15.2%)和身心医学(9.1%)。只有 46%的患者的胃肠病医生了解 CAM 的使用情况。CAM 用户更有可能患有溃疡性结肠炎(比值比[OR]=1.78,P=0.018)、临床缓解(OR=1.42,P=0.06)、高教育水平(OR=1.51,P=0.02)、较差的遵医嘱性(OR=1.81,P=0.017)或已终止常规治疗(OR=2.03,P=0.003)。CAM 用户的 SIBDQ 评分大于 50 的比例较高(OR=1.57,P=0.06)。除心理治疗外,所有 CAM 类型都能改善症状和 QOL。
CAM 在 IBD 患者中广泛使用。CAM 用户报告症状和 QOL 改善,但他们往往会停止常规治疗。更好地了解 CAM 可能会提高对常规治疗的依从性。