巴西补充与替代医学(CAM)运用概况

Prevalence of Complementary and Alternative Medicine(CAM)Use in Brazil

目的:评估巴西补充与替代医学(CAM)运用的普及情况。方法:利用巴西国家健康调查(PNS)2013年对本国成年人使用CAM疗法(如针灸、顺势疗法、药用植物和草药)的调查数据,采用逻辑回归模型(95%CI)评估CAM的使用频率。结果:巴西CAM使用率为4.5%。使用CAM频率较高的群体为:女性(AOR=1.42),年龄>40岁(AOR=1.64),受教育程度较高(AOR=2.35),来自巴西北部及南部地区(AOR=2.02,AOR=1.67),P值均<0.001。社会经济地位方面,上层阶级使用针灸和顺势疗法的频率高于其他阶级,低收入群体使用药用植物和草药的频率较高。研究发现使用CAM治疗的患者超过一半是在医疗保健系统之外进行的,与其他治疗方式相比,巴西统一卫生系统(SUS)在CAM的资金投入最少。结论:巴西卫生部应加大对CAM从业人员专业能力建设的资金投入,为卫生服务机构开展CAM治疗提供更多机会,积极鼓励更多巴西人民接受CAM疗法。

Objective:To evaluate the prevalence of CAM use in Brazil.Methods:This was a cross-sectional study performed as an epidemiological survey,with data from the National Health Survey,2013 that evaluated a sample of adult Brazilians.The outcome was the use of CAM therapies,such as acupuncture,homeopathy,medicinal plants and herbal medicines in the last 12 months.We employed a logistic regression model(95%CI)to evaluate the chances of CAM use.Results:The prevalence of CAM use in Brazil was 4.5%.The subjects with higher chances to use CAM were:women(AOR=1.42),aged > 40(AOR=1.64),with higher educational levels(AOR=2.35),and residents at North(AOR=2.02)and South(AOR=1.67)regions of Brazil,all with P<0.001.According to the socioeconomic status,subjects from upper classes had higher chances to use acupuncture and homeopathy when compared to the other classes,and individuals from lower classes had higher chances to use medicinal plants and herbal medicines.Almost half of all individuals reporting CAM use did so outside the health care system.The Brazilian Unified Health System(SUS)was the least used funding for CAM when compared to other types of funding.Conclusion:We recommend that the ministry of health invests in capacity building for health professionals who work with CAM,providing structure for those practices in health services,increasing the access of CAM therapies for SUS users,and improving the registering of information about those therapies,encouraging the use of CAM by the Brazilian population.