Kosiyakul Punchika, Jitprapaikulsan Jiraporn, Rattanathamsakul Natthapon, Siritho Sasitorn, Sangsai Onpawee, Aueaphatthanawong Kamonchanok, Engchuan Montira, Prayoonwiwat Naraporn
Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Siriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Curr Ther Res Clin Exp. 2024 Apr 25;100:100749. doi: 10.1016/j.curtheres.2024.100749. eCollection 2024.
Complementary and alternative medications (CAM) are common among patients with multiple sclerosis (MS) for physical and psychological support. However, there is insufficient data regarding the application of CAM in the different cultures and beliefs of each community as well as patient's status.
To evaluate the prevalence and modalities of the use of CAM among patients with central nervous system idiopathic inflammatory demyelinating diseases (CNS-IIDD) in a tertiary care hospital.
A cross-sectional study was conducted at Siriraj Hospital from June to December 2021 involving patients with MS, neuromyelitis optic spectrum disorders (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), idiopathic transverse myelitis (iTM), and optic neuritis (ON) to examine the prevalence and mode of CAM use and its correlation with patient characteristics.
There were 107 patients. The diagnoses were MS (38), NMOSD (55), MOGAD (5), iTM (7), and ON (2). Most of the patients were female (89.7%), and 61.7% were diagnosed over 5 years. The mean Expanded Disability Status Scale was 2.63 (S.D., 2.38), and the median ambulation index was 0 (range 0-8.5). There were 68 patients (63.6%) with a history of CAM use for at least 3 months, while those with current use decreased to 62 (58.5%). Vitamins and minerals were the most commonly used, particularly vitamin D (97.1%) and calcium (47.7%). Both treatments were primarily prescribed (95.3%) rather than self-administered (24.3%). The main reasons for the use of CAM were to strengthen their health (48.6%) and relieve existing symptoms (28.0%).
The use of CAM is common among patients with Thai CNS-IIDD. Further exploration of patient perspectives and preferences regarding CAM usage may contribute to a more comprehensive management approach for patients with CNS-IIDD.
补充和替代药物（CAM）在多发性硬化症（MS）患者中很常见，用于获得身体和心理支持。然而，关于CAM在每个社区的不同文化和信仰以及患者状况中的应用数据不足。
评估三级护理医院中中枢神经系统特发性炎性脱髓鞘疾病（CNS-IIDD）患者使用CAM的患病率和方式。
2021年6月至12月在诗里拉吉医院进行了一项横断面研究，纳入了患有MS、视神经脊髓炎谱系障碍（NMOSD）、髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）、特发性横贯性脊髓炎（iTM）和视神经炎（ON）的患者，以检查CAM使用的患病率、方式及其与患者特征的相关性。
共有107例患者。诊断包括MS（38例）、NMOSD（55例）、MOGAD（5例）、iTM（7例）和ON（2例）。大多数患者为女性（89.7%），61.7%的患者诊断时间超过5年。扩展残疾状态量表的平均值为2.63（标准差为2.38），步行指数中位数为0（范围为0 - 8.5）。有68例患者（63.6%）有至少3个月的CAM使用史，而当前仍在使用的患者降至62例（58.5%）。维生素和矿物质是最常用的，尤其是维生素D（97.1%）和钙（47.7%）。这两种治疗主要是遵医嘱使用（95.3%），而非自行服用（24.3%）。使用CAM的主要原因是增强健康（48.6%）和缓解现有症状（28.0%）。
CAM在泰国CNS-IIDD患者中使用很普遍。进一步探索患者对CAM使用的观点和偏好可能有助于为CNS-IIDD患者制定更全面的管理方法。
