Cowan Robert P
Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Headache. 2014 Jun;54(6):1097-102. doi: 10.1111/head.12364. Epub 2014 Apr 25.
Complementary and Alternative Medicine (CAM) approaches are widely used among individuals suffering from headache. The medical literature has focused on the evidence base for such use and has largely ignored the fact that these approaches are in wide use despite that evidence base.
This article focuses on the uses of CAM by patients and suggests strategies for understanding and addressing this use without referring back to the evidence base. The rationale for this discussion pivots on the observation that patients are already using these approaches, and for many there are anecdotal and historical bases for use which patients find persuasive in the absence of scientific evidence.
Until such time as the body of scientific literature adequately addresses non-conventional approaches, physicians must acknowledge and understand, as best as possible, CAM approaches which are in common use by patients. This is illustrated with a case study and examples from practice. This article does not review the evidence base for various CAM practices as this has been done well elsewhere.
补充和替代医学（CAM）方法在头痛患者中广泛使用。医学文献关注此类使用的证据基础，并且很大程度上忽略了尽管有证据基础但这些方法仍被广泛使用这一事实。
本文关注患者对补充和替代医学的使用，并提出在不参考证据基础的情况下理解和应对这种使用的策略。该讨论的基本依据基于这样的观察，即患者已经在使用这些方法，而且对许多患者来说，在缺乏科学证据的情况下，使用这些方法有轶事和历史依据，患者认为这些依据很有说服力。
在科学文献充分探讨非常规方法之前，医生必须尽可能承认并理解患者常用的补充和替代医学方法。本文通过一个案例研究和实践中的例子对此进行了说明。本文不回顾各种补充和替代医学实践的证据基础，因为其他地方已经对此进行了很好的阐述。
