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Dtsch Med Wochenschr 2012; 137(11): 547-551
DOI: 10.1055/s-0031-1298996
Übersicht | Review article
Komplementärmedizin, Neurologie
© Georg Thieme Verlag KG Stuttgart · New York

Anwendung alternativer und komplementärer Therapieverfahren im klinischen Alltag am Beispiel von Patienten mit Multipler Sklerose

Utilization of alternative and complementary therapies in clinical praxis using multiple sclerosis as an example
S. Mews
1   Klinik und Poliklinik für Neurologie, Arbeitsgruppe Neuroimmunologie, Universitätsklinikum Rostock
,
U. K. Zettl
1   Klinik und Poliklinik für Neurologie, Arbeitsgruppe Neuroimmunologie, Universitätsklinikum Rostock
› Author Affiliations
Further Information

Publication History

25 August 2011

08 December 2011

Publication Date:
06 March 2012 (online)

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Zusammenfassung

Die Grenze zwischen alternativen und komplementären Therapien (AKT) einerseits und konventionellen Therapien andererseits ist unscharf und wird kontrovers diskutiert. Darüber hinaus fehlen für die meisten AKT Wirksamkeitsnachweise, bei einigen AKT gibt es sogar Hinweise auf nachteilige Folgen für den Patienten (z. B. Gesundheitsschäden, hohe Kosten). Das weit gefächerte und kaum überschaubare Behandlungsspektrum der AKT wird nach der Definition des „National Center of Complementary and Alternative Medicine“ in fünf Kategorien eingeteilt: alternative Medizinsysteme, Mind-Body-Interventionen, biologisch-basierende Therapien, manipulierende und körperbasierte Therapien und Energietherapien. AKT sind kulturkreisübergreifend weitverbreitet und finden bei vielen unterschiedlichen Krankheitsbildern Anwendung. Die Gründe für die Anwendung von AKT sind für die einzelnen Entitäten vielfältig und werden am Beispiel der Multiplen Sklerose (MS), der "Krankheit mit tausend Gesichtern", diskutiert. Es wurde wiederholt gezeigt, dass viele Patienten ohne Wissen ihres behandelnden Arztes AKT anwenden. Die Wünsche der Patienten nach aktiver Therapieteilnahme, nichts therapeutisch unversucht zu lassen sowie die Unzufriedenheit mit der konventionellen Behandlung und eine negative Arzt-Patienten-Beziehung haben einen entscheidenden Einfluss auf die Anwendung von AKT. Für den behandelnden Arzt leitet sich daraus ab, über das Angebotsspektrum von AKT gut informiert zu sein und gegenüber dem Patienten Offenheit bezüglich des Themas zu signalisieren, um den Patienten umfassend und optimal zu beraten. Andererseits besteht die Gefahr, dass sich der Patient synchron oder seriell in zwei unterschiedlichen Therapieszenarien bewegt, ohne seinen Arzt zu informieren.

Abstract

The discrimination between complementary and alternative medicine / therapies (CAM) at one hand and conventional treatment at the other hand is vague and still under controversial discussion. Furthermore, most CAM lacks evidence for effectiveness, and in some cases for some CAM potential health risks or high costs are reported. The countless methods and treatments of CAM have been categorized by National Center of Complementary and Alternative Medicine into five groups: alternative medical systems, mind-body-interventions, biologically-based therapies, manipulating and body-based therapies, and energy therapies. CAM are known and used cross-cultural and are applied to a variety of different medical conditions. Patients report manifold reasons for using CAM, which will be discussed on the sample of patients with multiple sclerosis. It was shown often, that patients use CAM without informing their attending physician. Applying CAM is essentially affected by wishes of patients for active therapy attendance, dissatisfaction with conventional treatment and negative patient-physician-relation. Therefore, the attending physician should be well informed about CAM and should be open to talk about CAM to advice the patient to his best knowledge. Otherwise the patient may move synchronously or serial into two separated therapy settings without informing his attending physician, which may cause health or financial damage.

Schlüsselwörter

Multiple Sklerose - alternative Medizin - Komplementärmedizin - Arzt-Patient-Beziehung

Keywords

multiple sclerosis - complementary medicine - alternative medicine - patient-physician-relation
 

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