Liu Shaonan, Lai Jiaqi, Wu Lei, Guo Xinfeng
Evidence-based Medicine & Clinical Research Service Group, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, Guangdong Province, People's Republic of China.
Respiratory Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, Guangdong Province, People's Republic of China.
Patient Prefer Adherence. 2021 Jul 8;15:1529-1535. doi: 10.2147/PPA.S316872. eCollection 2021.
The patient's preference plays an important role in clinical practice. There currently is no available evidence regarding the perception and attitudes of patients with chronic obstructive pulmonary disease (COPD) towards the use of Chinese medicine (CM) approaches. This study was designed to explore preferences and factors associated with CM among COPD patients.
A pilot survey was conducted among COPD patients using a structured, pre-tested questionnaire. The perceptions of CM therapies (including herbal medicine, non-pharmacotherapies), and expected clinical outcomes were investigated based on patient preference. Factors associated with preference of treatment scenarios were estimated in order of importance.
Thirty patients were enrolled in the survey, including 27 males and 3 females. Two-thirds of the patients preferred integrative Chinese and Western medicine for the treatment of COPD. Chinese patent medicines and CM decoction therapy were more popular than CM injections. The preferred non-drug therapy was point application, followed by acupuncture, Tai chi, or Qigong. More than 70% of patients reported that important clinical outcomes were improvements in lung function (77%) and dyspnea, cough, and sputum symptoms (73%), followed by exercise endurance (50%). Besides clinical efficacy, costs and side effects were also important factors for treatment selection.
This pilot study showed that Chinese patent medicine and CM decoctions were preferred options for complementary medicines to combine with routine pharmacotherapy for COPD treatment according to the patients' preferences. The improvement of dyspnea, cough symptoms, and lung function was the most desired clinical outcomes for patients. Quicker symptom relief, lower costs, and fewer side effects were key attributes for the treatment selection. Further research with a larger sample size is needed to definitively address the comprehensive conclusion.
患者的偏好在临床实践中起着重要作用。目前尚无关于慢性阻塞性肺疾病(COPD)患者对使用中医药方法的认知和态度的可用证据。本研究旨在探讨COPD患者对中医药的偏好及相关因素。
采用一份经过结构化、预测试的问卷对COPD患者进行了初步调查。基于患者偏好,调查了对中医疗法(包括草药、非药物疗法)的认知以及预期的临床结果。按重要性顺序估计了与治疗方案偏好相关的因素。
30名患者参与了调查,其中男性27名,女性3名。三分之二的患者更喜欢中西医结合治疗COPD。中成药和中药汤剂疗法比中药注射剂更受欢迎。首选的非药物疗法是穴位敷贴,其次是针灸、太极拳或气功。超过70%的患者报告称,重要的临床结果是肺功能改善(77%)以及呼吸困难、咳嗽和咳痰症状改善(73%),其次是运动耐力提高(50%)。除临床疗效外,费用和副作用也是治疗选择的重要因素。
这项初步研究表明,根据患者偏好,中成药和中药汤剂是与COPD常规药物治疗相结合的补充药物的首选。呼吸困难、咳嗽症状和肺功能改善是患者最期望的临床结果。更快的症状缓解、更低的费用和更少的副作用是治疗选择的关键属性。需要进行更大样本量的进一步研究以明确得出全面结论。