Complementary and Alternative Medicines Used by Patients With Inflammatory Bowel Diseases
Complementary and Alternative Medicines Used by Patients With Inflammatory Bowel Diseases
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DOI：
10.1053/j.gastro.2016.10.004
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发表时间：
2017-02-01
期刊：
影响因子：
29.4
通讯作者：
Gibson, Peter R.
中科院分区：
文献类型：
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作者：
Cheifetz, Adam S.;Gianotti, Robert;Gibson, Peter R.
患者和医生经常对补充和替代药物 (CAM) 或非对抗疗法治疗炎症性肠病 (IBD) 的作用存在许多疑问。超过一半的 IBD 患者在病程的某个阶段使用各种形式的 CAM。我们总结了最常用和讨论的 CAM 的可用证据。我们讨论草药（如大麻和姜黄素）、益生菌、针灸、运动和身心疗法的作用证据。由于样本量较小，对这些疗法的对照研究很少；大多数研究都是不受控制的。此外，草药制剂也缺乏质量控制。设计严格的、随机的、安慰剂对照的试验一直是一个挑战，部分原因是心理干预、针灸和运动的充分盲法问题。这些障碍限制了医生对 CAM 的接受。然而，此类疗法可用于补充常规疗法并帮助缓解患者症状。我们的结论是，医生应该了解 CAM 治疗 IBD 的性质和证据，以便为询问其使用情况的患者提供合理的建议。 CAM 有潜力帮助治疗 IBD，但需要进一步研究来验证这些方法。
Patients and physicians often have many questions regarding the role of complementary and alternative medicines (CAMs), or nonallopathic therapies, for inflammatory bowel diseases (IBDs). CAMs of various forms are used by more than half of patients with IBD during some point in their disease course. We summarize the available evidence for the most commonly used and discussed CAMs. We discuss evidence for the effects of herbs (such as cannabis and curcumin), probiotics, acupuncture, exercise, and mind-body therapy. There have been few controlled studies of these therapies, which have been limited by their small sample sizes; most studies have been uncontrolled. In addition, there has been a lack of quality control for herbal preparations. It has been a challenge to design rigorous, randomized, placebo-controlled trials, in part owing to problems of adequate blinding for psychological interventions, acupuncture, and exercise. These barriers have limited the acceptance of CAMs by physicians. However, such therapies might be used to supplement conventional therapies and help ease patient symptoms. We conclude that physicians should understand the nature of and evidence for CAMs for IBD so that rational advice can be offered to patients who inquire about their use. CAMs have the potential to aid in the treatment of IBD, but further research is needed to validate these approaches.