成人医疗实践中的多种维生素:证据,风险和务实的处方
Pedro M Neves1, Sofia Almeida1, Vital Domingues2
1Internal Medicine, Unidade Local de Saúde de Santo António, Porto, PRT.
Cureus
|February 23, 2026
概括
多种维生素对特定的缺陷和高风险群体有好处,但对营养良好成年人的一般预防没有好处. 常规使用提供有限的益处和潜在的危害,需要有针对性的补充和患者教育.
科学领域:
- 内部医学 内部医学
- 营养科学 营养科学
- 预防医学 预防医学
背景情况:
- 多种维生素和矿物质补充剂的使用广泛,通常在正式的医疗指导之外.
- 支持复合维生素广泛预防性健康益处的证据仍然没有确定性.
- 内科医生需要有关适当使用多种维生素的指导,考虑益处和风险.
研究的目的:
- 综合证据验证的适用情况,临床益处和多维生素-矿物质补充剂的危害.
- 为内部医生提供关于多维生素使用的务实处方方法.
- 评估复合维生素对死亡率,心血管事件和癌症等艰难结果的疗效.
主要方法:
- 对2000年至2025年8月期间的指导方针,随机试验和元分析进行叙述性审查.
- 专注于有关全因死亡率,心血管事件,癌症和认知的高水平证据.
- 与内科相关的优先条件,包括吸收不良,减肥手术和衰老.
主要成果:
- 多种维生素对于记录的缺陷和高风险状态是合理的 (例如,吸收不良,腹术后手术,酒精使用障碍,怀孕,虚弱).
- 在一般营养良好的成年人中,复合维生素不能减少心血管事件或死亡率;预防癌症的好处是边际的.
- 潜在的风险包括高维生素症,药物营养相互作用,掩盖缺陷和取代健康饮食习惯.
结论:
- 常规的多种维生素处方对一般营养良好的成年人提供了很少的临床益处,除了特定的缺乏状态之外.
- 基于查和测试的有针对性的营养补充剂比广泛的多维生素使用更为可取.
- 内科医生应指导患者适当使用补充剂,监测安全性,并强调饮食优先策略.
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