Lantos Paul M, Shapiro Eugene D, Auwaerter Paul G, Baker Phillip J, Halperin John J, McSweegan Edward, Wormser Gary P
Divisions of Pediatric Infectious Diseases and General Internal Medicine, Duke University Medical Center, Durham, North Carolina.
Departments of Pediatrics, Epidemiology of Microbial Diseases and Investigative Medicine, Yale University Schools of Medicine and of Public Health and Graduate School of Arts and Sciences, New Haven, Connecticut.
Clin Infect Dis. 2015 Jun 15;60(12):1776-82. doi: 10.1093/cid/civ186. Epub 2015 Apr 6.
Some patients with medically unexplained symptoms or alternative medical diagnoses suspect that they chronically suffer from the tick-borne infection Lyme disease. These patients are commonly targeted by providers of alternative therapies. This study was designed to identify and characterize the range of unorthodox alternative therapies advertised to patients with a diagnosis of Lyme disease.
Internet searches using the Google search engine were performed to identify the websites of clinics and services that marketed nonantimicrobial therapies for Lyme disease. We subsequently used the PubMed search engine to identify any scientific studies evaluating such treatments for Lyme disease. Websites were included in our review so long as they advertised a commercial, nonantimicrobial product or service that specifically mentioned utility for Lyme disease. Websites with patient testimonials (such as discussion groups) were excluded unless the testimonial appeared as marketing on a commercial site.
More than 30 alternative treatments were identified, which fell into several broad categories: these included oxygen and reactive oxygen therapy; energy and radiation-based therapies; nutritional therapy; chelation and heavy metal therapy; and biological and pharmacological therapies ranging from certain medications without recognized therapeutic effects on Borrelia burgdorgeri to stem cell transplantation. Review of the medical literature did not substantiate efficacy or, in most cases, any rationale for the advertised treatments.
Providers of alternative therapies commonly target patients who believe they have Lyme disease. The efficacy of these unconventional treatments for Lyme disease is not supported by scientific evidence, and in many cases they are potentially harmful.
一些有医学上无法解释的症状或患有其他医学诊断疾病的患者怀疑自己长期患有蜱传感染莱姆病。这些患者通常是替代疗法提供者的目标人群。本研究旨在识别和描述向被诊断为莱姆病的患者宣传的非正统替代疗法的范围。
使用谷歌搜索引擎进行互联网搜索,以识别推销莱姆病非抗菌疗法的诊所和服务机构的网站。随后,我们使用PubMed搜索引擎识别评估此类莱姆病治疗方法的任何科学研究。只要网站宣传一种专门提及对莱姆病有用的商业性非抗菌产品或服务,就将其纳入我们的综述。带有患者推荐(如讨论组)的网站被排除,除非该推荐出现在商业网站的营销内容中。
识别出30多种替代疗法,可分为几大类:包括氧气和活性氧疗法;基于能量和辐射的疗法;营养疗法;螯合和重金属疗法;以及从某些对伯氏疏螺旋体无公认治疗效果的药物到干细胞移植等生物和药物疗法。对医学文献的回顾并未证实所宣传疗法的疗效,在大多数情况下,也未证实其任何理论依据。
替代疗法提供者通常将认为自己患有莱姆病的患者作为目标人群。这些非传统的莱姆病治疗方法的疗效没有科学证据支持,而且在许多情况下可能有害。