摘要
补充和替代医学(CAM)的使用在心血管疾病患者中很普遍虽然为了解CAM的类型及其普及率作了很多努力,但是目前尚不清楚患者是否优先采用CAM而非接受循证治疗采用自报方式,对2001年3月1日至2002年10月31日间前瞻性登记的急性冠状动脉综合征入院治疗患者中CAM和循证治疗的使用情况进行了调查采用Poisson回归模型,在596例确诊冠状动脉疾病(CAD)的患者中,评估了使用CAM是否与较低的阿司匹林、β阻断剂和他汀类药物使用率具有独立相关性所有CAD患者中有19%使用CAM使用CAM的患者中非高加索人(31%vs12%)、未保险(12%vs7%)、
Complementary and alternative medicine(CAM) use is common in patients with cardiovascular disease. Although numerous efforts have sought to understand CAM types and the prevalence of CAM, whether patients preferentially use CAM instead of evidence-based therapies is unknown. Self-reported use of CAM and evidence-based therapies in a prospective registry of hospitalized patients with acute coronary syndrome from March 1, 2001 to October 31, 2002 were examined. Poisson regression models were used to assess whether CAM use was independently associated with lower rates of aspirin, β -blocker, and statin use in 596 patients with established coronary artery disease(CAD). Overall, CAM use was 19% in patients with CAD. Higher proportions of patients who used CAM were non-Caucasian(31% vs 12% ), uninsured(12% vs 7% ), economically burdened(58% vs 29% ), and had depression(13% vs 6% , p< 0.05 for all). Patients who used CAM were more likely to use β blockers(64% vs 46% , p=0.008) and as likely to use aspirin(73% vs 74% , p=0.90) and statins(71% vs 68% , p=0.76) as non-CAM users. Adjusting for demographic and clinical factors did not change results(CAM users: RR 1.27, 95% confidence interval[CI] 1.01 to 1.60 for using β blockers, RR 0.97, 95% CI 0.85 to 1.11 for using aspirin, and RR 1.05, 95% CI 0.87 to 1.28 for using statins). In conclusion, although CAM users with established CAD have worse socioeconomic status than nonusers, we found no evidence that they were less compliant with evidence-based therapies.
