Bedlack Richard S, Joyce Nanette, Carter Gregory T, Paganoni Sabrina, Karam Chafic
Department of Neurology, Duke University Medical Center, Durham, NC 27702, USA.
Department of Physical Medicine and Rehabilitation, University of California, Davis School of Medicine, 4860 Y Street Suite 3850, Sacramento, CA 95817, USA.
Neurol Clin. 2015 Nov;33(4):909-36. doi: 10.1016/j.ncl.2015.07.008. Epub 2015 Sep 8.
Given the severity of their illness and lack of effective disease-modifying agents, it is not surprising that most patients with amyotrophic lateral sclerosis (ALS) consider trying complementary and alternative therapies. Some of the most commonly considered alternative therapies include special diets, nutritional supplements, cannabis, acupuncture, chelation, and energy healing. This article reviews these in detail. The authors also describe 3 models by which physicians may frame discussions about alternative therapies: paternalism, autonomy, and shared decision making. Finally, the authors review a program called ALSUntangled, which uses shared decision making to review alternative therapies for ALS.
鉴于肌萎缩侧索硬化症(ALS)患者病情严重且缺乏有效的疾病修正药物,大多数ALS患者考虑尝试补充和替代疗法也就不足为奇了。一些最常被考虑的替代疗法包括特殊饮食、营养补充剂、大麻、针灸、螯合疗法和能量疗法。本文将详细介绍这些疗法。作者还描述了医生在讨论替代疗法时可以采用的三种模式:家长式作风、自主性和共同决策。最后,作者回顾了一个名为“ALS解开谜团”的项目,该项目利用共同决策来评估ALS的替代疗法。