Department of General Practice, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu, China.
PLoS One. 2020 Sep 29;15(9):e0239674. doi: 10.1371/journal.pone.0239674. eCollection 2020.
The potential effects of botanical dietary supplements (BDS) in the treatment of asthma have been proposed. However, the evidence of the effects of BDS use among patients with COPD is limited. The objective of our study was to exam the trends and effects of BDS use among US adults with COPD.
A serial, cross-sectional study was conducted by using data of the NHANSE from 1999 to 2016 (n = 53,348). COPD (n = 2,580) was identified by using self-reported diagnosis history, and any BDS use was identified in the past 30 days. The prevalence of BDS use was calculated for respondents with and without COPD. Simple linear regression models were applied to test for trends in BDS use. Multiple logistic regression models were used to identify the factors of BDS use and patients' clinical outcomes, including all-cause hospitalization and abnormal hemoglobin levels, associated with BDS use. The results were weighted to represent national estimates.
The prevalence of BDS use was greater among participants who had COPD compared to the referent group (mean 16.77% vs. 15.11%, p = 0.044). The trend of BDS use decreased from 1999 through 2016 in COPD group (p = 0.0023), but the trend remained stable in the non-COPD group (P>0.05). Results of multivariate logistic regression models showed that patients with higher family income (≥100% FPL) and graduated from college were more likely to use BDS compared with non-users. BDS use was associated with a lower likelihood of having all-cause hospitalization (adjusted odds ratio = 0.64; 95% CI 0.45-0.92) and abnormal levels of hemoglobin (adjusted odds ratio = 0.67; 95% CI 0.49-0.92) among adult COPD patients, after adjusting for covariates.
The overall use of BDS decreased during 1999 through 2016 for US adults with COPD. The potential benefit of these supplemental medications use for clinical outcomes might exist for adult COPD patients.
植物性膳食补充剂（BDS）在哮喘治疗中的潜在作用已被提出。然而，关于 COPD 患者使用 BDS 的证据有限。我们的研究目的是考察美国 COPD 患者中使用 BDS 的趋势和效果。
使用 1999 年至 2016 年 NHANSE 的数据进行了一系列横断面研究（n=53348）。通过自我报告的诊断史确定 COPD（n=2580），并在过去 30 天内确定任何 BDS 使用情况。计算了有和没有 COPD 的受访者中 BDS 使用的流行率。应用简单线性回归模型来测试 BDS 使用的趋势。应用多因素逻辑回归模型来确定 BDS 使用的因素以及与 BDS 使用相关的患者临床结果，包括全因住院和血红蛋白异常水平。结果进行了加权处理，以代表全国估计数。
与参照组相比，患有 COPD 的参与者中 BDS 使用的流行率更高（均值 16.77% vs. 15.11%，p=0.044）。在 COPD 组中，从 1999 年到 2016 年，BDS 使用的趋势呈下降趋势（p=0.0023），但在非 COPD 组中趋势保持稳定（P>0.05）。多因素逻辑回归模型的结果表明，与非使用者相比，家庭收入较高（≥100%联邦贫困线）和大学毕业的患者更有可能使用 BDS。BDS 使用与全因住院的可能性降低相关（调整后的优势比=0.64；95%CI 0.45-0.92）和血红蛋白异常水平（调整后的优势比=0.67；95%CI 0.49-0.92），在调整协变量后。
1999 年至 2016 年期间，美国 COPD 患者整体使用 BDS 的情况有所减少。这些补充药物治疗对临床结果可能对成年 COPD 患者有益。
