Utilization and Impact of Complementary and Alternative Medicines in Symptomatic Autoimmune Hepatitis Patients.
Utilization and Impact of Complementary and Alternative Medicines in Symptomatic Autoimmune Hepatitis Patients.
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DOI：
10.1007/s10620-021-07112-0
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发表时间：
2022-07
影响因子：
3.1
通讯作者：
Lammert, Craig
中科院分区：
文献类型：
--
作者：
Gelow, Kayla;Chalasani, Sai;Green, Kelsey;Lammert, Craig
补充和替代医学(CAM)的使用已变得越来越普遍。它在慢性肝病患者中也很常见，但使用的范围、深度和安全性尚不清楚。本研究旨在探讨自身免疫性肝炎(AIH)患者细胞黏附分子(CAM)的使用情况及规律。在为期6周的研究期间，每周向AIH Facebook社区(共有4700名成员)张贴电子邀请函，以完成一份22个项目的特定于CAM的问卷。合格标准为年龄、 ≥ 、18岁和主治医师诊断的急性心肌梗死。参与者中曾经使用过CAM的流行率为56.4%，近42%的人在AIH诊断后使用过CAM。在确诊后报告使用CAM的患者中，53.7%(51/95)表示CAM用于缓解AIH相关现象，最常针对的是肝脏炎症/纤维化(67.7%)、疲劳(51%)、关节疼痛(47.1%)和睡眠问题(45.1%)。最常见的身体CAM策略是锻炼(49.5%)和瑜伽(34%)，而最常见的消耗性CAM策略包括更健康的饮食(45.3%)、大麻二醇制剂(45.3%)和益生菌(44.3%)。75%的人报告说，CAM改善了AIH的症状，没有报告严重的不良事件。CAM在AIH患者中的使用很普遍，但提供者历来未能记录他们患者的CAM策略。除了固有的药物诱导的肝损伤风险之外，药物与药物的相互作用仍然是一个令人担忧的问题，并可能改变AIH的基线免疫抑制水平。尽管大多数人发现CAM方法可以改善靶向症状，但所有人都无法改变医生长期开出的药物的疗程。网上版载有补充材料，可在10.1007/s10620-021-07112-0查阅。
Complementary and alternative medicine (CAM) use has become increasingly common. It is also prevalent in patients with chronic liver disease, but the scope, depth, and safety of use is not well known. This study aimed to evaluate the prevalence and patterns of CAM use in autoimmune hepatitis (AIH) patients. Electronic invitation to complete a 22 item CAM-specific questionnaire was posted weekly to well-established AIH Facebook communities (combined membership of 4700 individuals) during a 6-week study period. Age ≥ 18 years and AIH diagnosis made by a treating physician were the eligibility criteria. The prevalence of ever CAM use among participants was 56.4%, and nearly 42% used CAM after AIH diagnosis. Among those reporting CAM use after diagnosis, 53.7% (51/95) indicated CAM was used to mitigate AIH-related phenomenon, most often targeting liver inflammation/fibrosis (67.7%), fatigue (51%), joint pain (47.1%), and sleep issues (45.1%). Most frequent physical CAM strategies were exercise (49.5%) and yoga (34%), whereas most frequent consumable CAM included healthier eating (45.3%), cannabidiol preparations (45.3%), and probiotics (44.3%). Seventy-five percent reported that CAM improved AIH symptoms and no severe adverse events were reported. CAM use in AIH patients is prevalent, yet providers have historically failed to document their patient’s CAM strategies. Beyond inherent drug-induced liver injury risk, drug-drug interactions remain a concern and could alter baseline immunosuppression levels in AIH. Despite a majority found CAM approaches that improved targeted symptoms, all were unable to alter the course of chronically prescribed medications by physicians. The online version contains supplementary material available at 10.1007/s10620-021-07112-0.
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影响因子：
5
作者：
Greco, Carol M.;Nakajima, Claire;Manzi, Susan
通讯作者：
Manzi, Susan
影响因子：
4.2
作者：
Bailey, Regan L.;Gahche, Jaime J.;Picciano, Mary Frances
通讯作者：
Picciano, Mary Frances
影响因子：
13.5
作者：
Lammert, Craig;Einarsson, Stefan;Chalasani, Naga
通讯作者：
Chalasani, Naga
影响因子：
2.9
作者：
Henson, Jacqueline B.;Brown, Cristal L.;Muir, Andrew J.
通讯作者：
Muir, Andrew J.
DOI：
10.1002/hep.28813
发表时间：
2017-01
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Navarro VJ;Khan I;Björnsson E;Seeff LB;Serrano J;Hoofnagle JH
通讯作者：
Hoofnagle JH