一项利用健康理念问卷对巴尔干地区国家保健专业人员和学生进行补充和替代医学认知的横断面调查

Objective

To conduct a study on attitudes, knowledge, and use of complementary and alternative medicine (CAM) therapies in Serbia. Available data about CAM therapies in the region are scarce, opinions lacking from health sector. Balkan region countries had a delay in issuing national policies on CAM therapies.

Methods

The questionnaire used was based on previously validated CAM Health Belief Questionnaire (CHBQ), formulated as 5-item Likert type scale, adjusted for local environment. Health care students and professionals were evaluated. The questionnaire comprehended 10 closed questions on attitudes, knowledge and use of CAM therapies. This survey was conducted in eight cities of Serbia, January 2010–July 2011. A total of 797 participants was included. The second group of participants was 145 healthcare professionals (50 academic staff, 64 clinical staff, 19 pharmacists, 6 other clinical branch specialists and 6 nurses). Data were collected by an interview. Examinees could acquire maximum of 70 points, 35 representing neutral attitude.

Results

Students of dentistry (54.65±6.07) were better informed on CAM therapies than medicine students (50.26±7.92). Pharmacy students (51.16±7.10) accepted low-scientific CAM. Pharmacists scored better than university professors (55.12±6.55 vs. 50.29±9.50). Primary health care professionals had better awareness than pharmacists in dispensing pharmacies. Both groups of participants preferred use of vitamins over any other CAM therapy.

Conclusion

These pioneering efforts in the region exposed weaknesses in CAM attitudes of current and future health care professionals. Nevertheless, awareness on alternative medicine treatment choices is growing among Balkan prescribers. Supportive legal framework would facilitate dissemination of CAM medical practices.     

Traditional Chinese Medicine for Modern Treatment of Parkinson''s Disease

Parkinson’s disease (PD) is a chronic and progressive degenerative disorder of brain commonly seen among the elderly. As conventionally medical therapy is of limited relief and potential side effects, complementary and alternative medicine (CAM) has attracted growing public and professional attention. Therapies such as acupuncture, musical/rhythmic therapy and deep brain stimulation have been gradually proved positively in clinic. In this review, we retrospected the scientifific or evidence-based-medicine advances of application and research for modern treatment of PD by CAM, especially traditional Chinese medicine in categories.     

Integrating complementary therapies into mainstream cancer care: which way forward?

Although viewed with scepticism by the medical and scientific community, complementary and alternative medicine (CAM) is being used by about 50% of Australians. Integrative medicine is a holistic approach to cancer care, with some CAM of proven effectiveness being used as adjuvants to conventional medical treatments. However, there is little evidence of a systematic process of evaluation or dialogue between mainstream cancer medicine and CAM providers in Australia. Collaboration, guidance and support for relevant research in this area are needed. The key elements of a process of furthering integrative medicine include improving knowledge about CAM; addressing uncertainties about CAM efficacy and safety; improving communication about CAM between medical practitioners and patients, and between medical practitioners and CAM practitioners; introducing regulatory frameworks and credentialing of CAM practitioners; and addressing ethical issues.     

补充替代医学国际使用情况分析

中医药属于世界补充替代医学的重要组成部分，把握补充替代医学的国际形势以及中医药在其中的地位是中医药国际化的基础。本文通过分析国际社会补充替代医学的使用率、应用病种、使用者的社会人口学特征以及医学经济学情况等，探索提升中医药在海外的声誉和使用率的可行途径。     

补充和替代医学在儿童哮喘治疗中的应用

补充和替代医学为主流医学之外能补充主流医学不足的其他医学。在西方国家主流医学即指西医。儿童哮喘是儿童时期主要慢性呼吸系统疾病之一,哮喘处理不当可导致哮喘患者长期患病,发展为成人哮喘,也是导致哮喘死亡的一个主要原因。近年来,除了主流医学疗法外,国际上也主张对儿童哮喘进行一些补充和替代医学疗法的治疗,通过常规疗法与补充和替代医学疗法相结合可能使儿童哮喘得到更好的控制。     

补充与替代疗法治疗肠易激综合征的研究进展

肠易激综合征是临床常见的功能性胃肠病之一。由于多数患者的症状经过一线药物治疗后仍不能得到较好改善，许多患者为获得更好的治疗效果，转向选择补充与替代疗法进行治疗。然而，由于研究质量和数量的限制，大部分治疗肠易激综合征的补充与替代疗法并未被相关共识和指南所推荐。本文从补充与替代疗法的分类入手，从天然产品、身心治疗、传统医药3个方面就目前国内外常用的补充与替代疗法治疗肠易激综合征的研究进行概述，以期为临床工作者和患者更好地了解和应用提供帮助。     

Complementary and Alternative Medicine Therapies for Chronic Pain

Pain afflicts over 50 million people in the US, with 30.7% US adults suffering with chronic pain. Despite advances in therapies, many patients will continue to deal with ongoing symptoms that are not fully addressed by the best conventional medicine has to offer them. The patients frequently turn to therapies outside the usual purview of conventional medicine(herbs, acupuncture, meditation, etc.) called complementary and alternative medicine(CAM). Academic and governmental groups are also starting to incorporate CAM recommendations into chronic pain management strategies. Thus, for any physician who care for patients with chronic pain, having some familiarity with these therapies—including risks and benefits—will be key to helping guide patients in making evidence-based, well informed decisions about whether or not to use such therapies. On the other hand, if a CAM therapy has evidence of both safety and efficacy then not making it available to a patientwho is suffering does not meet the need of the patient. We summarize the current evidence of a wide variety of CAM modalities that have potential for helping patients with chronic pain in this article. The triad of chronic pain symptoms, ready access to information on the internet, and growing patient empowerment suggest that CAM therapies will remain a consistent part of the healthcare of patients dealing with chronic pain.     

中草药临床研究的评价

补充替代医学正被广泛应用,并呈现出良好的增长趋势。随着寻求补充替代医学疗法的人口比例的增长,无论是补充替代医学被单独使用,还是与传统的对抗疗法联合应用,对补充替代医学临床报告质量的研究变得日益迫切。大部分这种质量研究是针对那些主要目的在于为临床医师提供参考的临床研究报告,我们发现,在解释临床研究的结果及其意义时,人们不得不面对其方法学质量低劣的问题。如何解决这个问题,将是我们面临的巨大挑战。临床医师要有效地利用这些科学研究的文献,就必须熟悉循证医学的基本原则。本文的目的在于向临床医师介绍临床研究评价的概念,使他们在阅读研究论文时能带着评判的眼光,以便更好地评价论文中的研究结果,并将其合理地运用到自己的日常医疗实践中去。本文主要讨论了以下六个方面的问题:(1)循证医学的基本原理;(2)临床研究的类型;(3)证据的分级;(4)应用临床试验报告统一标准评价随机对照试验报告的质量;(5)随机对照试验方法学质量的评分;(6)中草药临床研究质量评价的有关问题。     

Does Use of CAM for Specific Health Problems Increase With Reduced Access to Care?

The objective of this paper was to determine predictors of complementary and alternative medicine (CAM) use among individuals with specific health problems. Data were derived from the 1998 Medical Expenditure Panel Survey (MEPS). After adjustment for potential confounders, individuals with perceived barriers to obatining care were more likely to use any CAM treatment (OR 2.16), herbal therapy (OR 2.70) and spiritual care (OR 3.99) for a specific health problem. Individuals dissatisfied with their familys access to care were more likely to use acupuncture (OR 3.43). Dissatisfaction with quality of care was associated with increased use of spiritual therapy (OR 4.74). Perceptions of inadequate access to health care may contribute to utilization of CAM therapies; such therapies in this instance appear to be used as an alternative to mainstream medicine.     

美国补充替代医学的科研现状及其与中国中医药研究的比较

美国对包括中医药在内的补充替代医学的研究日益关注。研究规模与投入不断增加。中医疗法的偏重、东西方知识背景、思维方式以及对中医理论认可程度的不同导致中国和美国在中医学研究的内容和思路上存在差异。     

Which medicine? Whose standard? Critical reflections on medical integration in China

There is a prevailing conviction that if traditional medicine (TRM) or complementary and alternative medicine (CAM) are integrated into healthcare systems, modern scientific medicine (MSM) should retain its principal status. This paper contends that this position is misguided in medical contexts where TRM is established and remains vibrant. By reflecting on the Chinese policy on three entrenched forms of TRM (Tibetan, Mongolian and Uighur medicines) in western regions of China, the paper challenges the ideology of science that lies behind the demand that all traditional forms of medicine be evaluated and reformed according to MSM standards. Tibetan medicine is used as a case study to indicate the falsity of a major premise of the scientific ideology. The conclusion is that the proper integrative system for TRM and MSM is a dual standard based system in which both TRM and MSM are free to operate according to their own medical standards.     

The model of western integrative medicine: The role of Chinese medicine

The basic concept of integrative medicine(IM) is that by combining mainstream(biomedicine) with complementary and alternative medicine(CAM), synergistic therapeutic effects can be attained.When the methods of mind/body medicine(MBM) are added to this combination,as in Western countries,a new concept emerges that drastically changes the approach toward illness. It is interesting to note that the joining of traditional Chinese medicine and Western medicine in the early days of the Peoples’ Republic of China preceded the Western model of IM by almost 50 years.Several elements that make up the key components of IM as practiced today in the West were already present in the Chinese version of IM,and Chinese medicine has played and continues to play an important role in advancing IM.However,one of the major differences between the Chinese and the Western models of IM today,besides MBM and some other treatment options,is that Western integrative medicine(WIM) strictly requires its CAM methods to be supported by scientific evidence. The therapeutic methods of IM and their applications are many and varied.However,they are most frequently employed to treat chronic medical conditions,e.g.,bronchial asthma,rheumatic disease, chronic inflammatory bowel disorder and chronic pain.Other fields in which IM may be applied are internal medicine(inflammatory bowel diseases and cardiovascular diseases),musculoskeletal disorders,oncology (chemotherapy-induced side effects),obstetrics and gynecology(dysmenorrhea,endometriosis,infertility and menopausal complaints),pediatrics,geriatrics,neurology(migraine and chronic headache),and psychiatry (anxiety and depression). The concept of WIM is discussed here in detail by reviewing its scope and implications for the practice of medicine and focusing on the role of Chinese medicine in WIM.     

Integrative medicine — Traditional Chinese medicine, A model ?

The paper explores the concept of integrative medicine(IM) in relation to complementary and alternative medicine(CAM).It contrasts IM available in China to its availability in the West.The second part of the paper highlights tools which could facilitate opportunities for IM.The paper concludes with a plea to ensure and maintain the integrity of traditional Chinese medical practice,and to continue to increase developing the evidence base through a funded European Coordination Action between EU member stat...     

Evidence-based practice method of integrative Chinese and Western medicine based on literature retrieval through PICO question and complementary and alternative medicine topics

An evidence-based practice method according to literature retrieval through PICO （Patients,Intervention,Comparison,Outcome） questions and complementary and alternative medicine （CAM） topics,which can obtain helpful evidence for guiding clinical practice,was introduced with a practical example in this paper.The knowledge of diseases and Western medicine treatment can be acquired by literature retrieval through PICO question,while searching by CAM topics may provide evidence for Chinese medicine （CM）.Thus the author held that literature retrieval through both PICO question and CAM topics was an ideal evidencebased practice method for integrative Chinese and Western medicine （ICWM）.However,since the standard in CM evidence hierarchy is still under study,the value of the CAM thematic retrieval method remains very limited.In the future,studies on the definition and hierarchy of CM evidences and the herb-drug interaction between Western and Chinese medicine during a combination therapy should be strengthened to improve the status of ICWM evidence-based practice.     

The use of Complementary and Alternative Medicine by Asian women of Hawai'i in the treatment of breast cancer

This qualitative investigation examined complementary and alternative medicine (CAM) by Hawai'i Asian women breast cancer survivors. The majority of participants felt that the conventional treatment they received was adequate in treating their cancer but was impersonal in nature leaving them feeling abandoned. Many sought CAM to improve their quality of life. Additional research on CAM and the patient-physician relationship is urgently needed.     

基于文献挖掘的国际补充替代医学研究现状与趋势分析

目的：把握目前国际补充替代医学（complementary and alternative medicine, CAM）研究的发展态势,为我国中医药相关工作的开展提供参考依据和科学的量化信息支持。 方法：以PubMed数据库为检索源,国际CAM科技论文为研究对象,采用普赖斯指数增长定律、布拉德福定律等信息计量学经典方法和关联规则等文本挖掘技术,对目前国际CAM研究的文献增长规律,高生产力国家、机构,核心期刊,以及研究的热点、前沿领域进行系统、全面的分析。 结果：1998~2010年,国际CAM科技论文量呈上升趋势,且增长规律符合普赖斯指数增长定律;开展CAM研究的国家和地区范围广泛;期刊分布核心趋势明显;高等院校是研究的主体;植物药、针灸、心身疗法、整体疗法等是研究的热点疗法;肿瘤（乳腺癌）、慢性疾病（中风、糖尿病、高血压）、心身疾病（心理应激、焦虑、抑郁、精神障碍）、疼痛（下腰背痛、颈痛）等则是采用CAM疗法进行干预的主要病症。 结论：CAM研究将继续增加;肿瘤的CAM防治研究仍是世界范围内的关注重点;主要疗法的临床疗效、安全性与生物学基础是CAM研究的重要任务;心身疗法研究不断增多,临床疗效与生物机制研究是关键;CAM干预症状受到重视,研究前景广阔;CAM符合并有助于促进现代医学模式的发展与完善;中医药是CAM研究的重要领域,中国的优势地位面临挑战。     

异常黑胆质病证的维医研究进展

体液论是维吾尔医药学最基本、最重要的学说。这一学说认为许多复杂性疾病常由异常黑胆质所致，其在维吾尔族、哈萨克族等新疆主体民族发病率高,并具有一定的族群发病特点。在长期医学实践中，维医对这些复杂性疾病形成了独特的辨证诊断方法及特色方药。本文就维医异常黑胆质病证的系统研究进展做一综述。     

补充替代医学治疗在妊娠相关下腰痛患者中应用的研究进展

妊娠相关下腰痛（PLBP）是指妊娠引起的第十二肋骨与臀折区域之间的疼痛,其发生率高达50%。PLBP可导致孕妇躯体功能障碍、睡眠障碍,增加不良分娩结局和产后抑郁发生风险等。采取具有针对性的干预措施对预防和缓解PLBP具有重要意义。由于妊娠期用药特殊性,补充替代医学（CAM）在妊娠相关疾病的治疗中发挥着重要作用。本文对CAM治疗PLBP相关研究进行综述,分别阐述运动疗法、手法治疗、针灸疗法、物理因子疗法等对PLBP预防及干预策略的研究进展,旨在为国内开展预防和缓解PLBP的研究提供借鉴。     

Use of complementary and alternative medicine in Hawaii cancer patients

This research investigated complementary and alternative medicine (CAM) use by Hawai'i cancer patients. Thirty-six percent of patients used CAM, most commonly religious/spiritual therapy and herbal treatments. CAM use was linked with younger age, female gender, Catholic religion, and more education. More research is needed to inform decision-making.     

caCORE——美国癌症研究的生物信息核心框架

近十年来基因组学和蛋白质组学的快速发展为医学生物学的研究提供了前所未有的机遇.一方面,大规模、高通量的基因和蛋白质的测定工作产生了大量有价值的各类数据;而另一方面,因数据标准的缺乏、数据兼容和整合的艰难而妨碍了人们去充分有效地共享数据,进而更好地促进各自领域的发展.生物信息学也因此成为当今生物医学研究发展必不可少的一个手段.本文就美国国家癌症研究所(National Cancer Institute,NCI)以癌症研究为试点所建立的一个生物信息核心框架caCORE(cancer Common Ontologic Reference Environment)作一简短介绍.