背景:这项研究探讨了中国患者和风湿病学家对干燥综合征(SS)的中医态度和看法的异同。包括分析影响他们决策的因素。
方法:使用匿名问卷对北京三个三级医疗中心的SS患者和中国多家医院的风湿病临床医生进行了多中心调查。结果采用描述性统计分析。
结果:来自中国31个省市的患者942份有效问卷,男女比例约为1:14,平均年龄为48.81岁,和7(4,10)年的中位病程。有320份来自风湿病学家的有效问卷,覆盖中国30个省市,男女比例约为0.87:1,平均年龄为48岁,工作时间中位数为10.5(6,15)年。风湿病学家每月平均治疗15(11,50)例SS,SS占所有风湿性疾病的比例中位数为6.66%(6-10%)。许多患者认为中医可以治本,最受期待的中医疗法是中医专利处方和药茶。相反,风湿病学家高度重视中医的功效,和最常用的中草药汤。大多数医患群体对中医治疗持积极态度,以低副作用为主要优势。回归分析显示,40岁以上患者病程>4年,使用中医的概率增加了1-6倍;工作超过15年的医生在临床工作中推荐中医的概率,中医和中西医结合治疗增加了1-2倍。
结论:中医已被广泛接受并受到医患群体的关注,尤其是老年患者和有经验的风湿病专家。然而,负面偏见和缺乏关于中医治疗和SS本身的准确信息需要改进。中药剂型与疗效之间的矛盾是一大难题,和患者对方便有效的中药专利制剂的需求表明,未来的工作应集中在开发具有明确组成和机制的中药专利制剂上。
BACKGROUND: This study explored similarities and differences among Chinese patients and
rheumatologists in their attitudes towards and perceptions of traditional Chinese medicine (TCM) for Sjögren\'s syndrome (SS), including analyzing factors that influenced their decision making.
METHODS: An anonymous questionnaire was used to conduct a multicenter survey among patients with SS at three tertiary care medical centers in Beijing and among rheumatology clinicians at several hospitals across
China. Results were analyzed using descriptive statistics.
RESULTS: There were 942 valid questionnaires from patients from 31 provinces and cities in
China, with a male-to-female ratio of approximately 1:14, a mean age of 48.81 years, and a median disease duration of 7 (4, 10) years. There were 320 valid questionnaires from
rheumatologists, covering 30 provinces and cities in
China, with a male-to-female ratio of approximately 0.87:1, a mean age of 48 years, and a median work duration of 10.5 (6, 15) years. The
rheumatologists treated a median of 15 (11, 50) SS cases per month, and the median proportion of SS to all rheumatic diseases was 6.66% (6-10%). Many patients believed TCM could cure the root of the disease, and the most expected TCM therapies were TCM patent prescriptions and medicinal teas. Conversely, rheumatologists placed high value on the efficacy of TCM, and most commonly prescribed Chinese herbal decoctions. Most doctor-patient groups were positive about TCM treatment, citing the low side effects as the major advantage. Regression analysis showed that for patients over 40 years old with a course of disease > 4 years, the probability of using TCM has increased by 1-6 times; the probability of recommending TCM in clinical work of doctors who have worked for more than 15 years, TCM and integrated traditional Chinese and western medicine has increased 1-2 times.
CONCLUSIONS: TCM has become widely accepted and earned attention from doctor-patient groups, especially among older patients and experienced rheumatologists. However, negative prejudices and absence of accurate information about TCM treatments and SS itself require improvement. The contradiction between TCM dosage form and efficacy is a major problem, and patient demand for convenient and efficient TCM patent preparations suggests future work should focus on developing TCM patent preparations with clear compositions and mechanisms.