慢性乙型肝炎患者的补充和替代医学方式的患病率和预测因

StephenW

Liver Int. 2019 Mar 25. doi: 10.1111/liv.14105. [Epub ahead of print]
Prevalence and predictors of complementary and alternative medicine modalities in patients with chronic hepatitis B.
Liem KS1,2, Yim C1, Ying TD1, Zanjir W1, Fung S1, Wong DK1, Shah H1, Feld JJ1,3, Hansen BE1,2,4, Janssen HLA1.
Author information

1
    Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Canada.
2
    Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands.
3
    McLaughlin-Rotman Centre for Global Health, Toronto, Canada.
4
    Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.

Abstract
BACKGROUND & AIMS:

The use of complementary and alternative medicine (CAM) in patients with chronic hepatitis B (CHB) can interact with antiviral treatment or influence health-seeking behavior. We aimed to study the use of individual CAM modalities in CHB and explore determinants of use, particularly migration-related, socio-economic and clinical factors.
METHODS:

A total of 436 CHB outpatients who attended the Toronto Centre for Liver Disease in 2015-2016 were included in this cross-sectional study. Using the comprehensive I-CAM questionnaire and health records, data were collected on socio-demographic and clinical variables and on usage of 16 CAM modalities in the last year.
RESULTS:

Sixty percent of patients were male, 74% were Asian and 46% were using antiviral treatment. Three-hundred nine (71%) patients used CAM. Vitamin/mineral preparations (45% of patients) were most commonly used. Overall CAM use and the specific use of potentially injurious CAM, such as green tea extract (9.2%) and St. John's wort (0.2%), were not associated with liver disease severity. Female sex, family history of CHB, lower serum HBV DNA, and higher socio-economic status were independently associated with bio-holistic CAM use, the clinically most-relevant CAM group (p<0.05); ethnicity, antiviral therapy use and liver disease severity were not.
CONCLUSIONS:

CAM use among CHB patients was extensive, especially use of vitamin and mineral preparations, but without direct influence on liver disease severity. Bio-holistic CAM use appeared to be associated with socio-economic status rather than with ethnicity or liver disease severity. Despite the rare use of hepatotoxins, physicians should actively inquire about it. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

chronic hepatitis B; complementary and alternative medicine; ethnicity; hepatotoxicity

PMID:
    30912219
DOI:
    10.1111/liv.14105

StephenW

肝脏国际2019年3月25日doi：10.1111 / liv.14105。 [印刷前的电子版]
慢性乙型肝炎患者的补充和替代医学方式的患病率和预测因子
Liem KS1,2，Yim C1，Ying TD1，Zanjir W1，Fung S1，Wong DK1，Shah H1，Feld JJ1,3，Hansen BE1,2,4，Janssen HLA1。
作者信息

1
    多伦多综合医院多伦多肝病中心，加拿大多伦多大学健康网络。
2
    荷兰鹿特丹鹿特丹伊拉斯姆斯大学医学中心消化内科和肝病学系。
3
    McLaughlin-Rotman全球健康中心，加拿大多伦多。
4
    加拿大多伦多大学卫生政策，管理和评估研究所。

抽象
背景与目的：

在慢性乙型肝炎（CHB）患者中使用补充和替代医学（CAM）可以与抗病毒治疗相互作用或影响寻求健康的行为。我们的目的是研究CHB中个体CAM模式的使用，并探讨使用的决定因素，特别是与迁移相关的，社会经济和临床因素。
方法：

在这项横断面研究中，共有436名CHB门诊患者参加了2015-2016多伦多肝病中心。使用全面的I-CAM调查问卷和健康记录，收集了去年社会人口统计学和临床​​变量以及16种CAM模式使用情况的数据。
结果：

60％的患者为男性，74％为亚洲人，46％为抗病毒治疗患者。三百九十（71％）名患者使用CAM。最常用的是维生素/矿物质制剂（45％的患者）。总体CAM使用和潜在有害CAM的具体使用，如绿茶提取物（9.2％）和圣约翰草（0.2％），与肝病严重程度无关。女性，CHB家族史，较低血清HBV DNA和较高的社会经济地位与生物整体CAM使用独立相关，临床上最相关的CAM组（p <0.05）;种族，抗病毒治疗使用和肝病严重程度没有。
结论：

CHB患者的CAM使用范围很广，尤其是维生素和矿物质制剂的使用，但对肝病的严重程度没有直接影响。生物整体CAM的使用似乎与社会经济状况有关，而不是与种族或肝病严重程度相关。尽管很少使用肝毒素，但医生应积极询问。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

慢性乙型肝炎;补充和替代医学;种族;肝毒性

结论：
    30912219
DOI：
    10.1111 / liv.14105