REFERENCES.
1. Steinsbekk A, Fønnebø V. Users of homeopaths in Norway in 1998, compared to previous users and GP patients. Homeopathy 2003;92:3–10. Department of Community Medicine and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
aslak.steinsbekk@medisin.ntnu.noAbstract.
AIM: Homeopathy is the form of complementary medicine most frequently used in Norway. This study describes complaints and characteristics of patients who visited Norwegian homeopaths in 1998, comparing them with those who visited homeopaths in 1985 and general practice patients.
METHODS: We conducted a survey of 1097 patients visiting 80 Norwegian homeopaths in 1998 and compared them with a similar survey in 1985 (1072 consultations) and a 1989 survey of general practice patients (90,458 consultations).
RESULTS: One in four of patients visiting homeopaths in 1998 were children between 0 and 9 years of age, compared to one in ten in 1985 and in general practice. Almost half of the patients in 1998 had used prescription drugs provided by a medical doctor the previous month for the same complaints they presented to the homeopath. In 1998 patients sought homeopathy most often because of respiratory and skin complaints. In 1985 the most common reasons were musculo-skeletal and digestive problems. Four of the five commonest reasons for encounter in homeopathic practice in 1998 were also found among the five commonest reasons for general practice consultations.
CONCLUSION: Patients currently visiting homeopaths differ in age and to some extent in complaints compared to previous users of homeopathy and general practice patients.
http://www.ncbi.nlm.nih.gov/pubmed/125879892. Trichard M, Lamure E, Chaufferin G. Study of the practice of homeopathic general practitioners in France. Homeopathy 2003;92:135–139. Laboratoires BOIRON, 20 rue de la Libération, Sainte-Foy-Lès-Lyon 69 110, France.
etudes-economie@boiron.frAbstract.
Little is known about the practice of homeopathic general practitioners (GPs) in France. We report a descriptive, cross-sectional study on this subject. The aim was to acquire a clearer idea of (1) the type of patients who consult homeopathic GPs and (2) the type of treatment provided by such GPs, in terms of diagnoses, prescriptions and costs. The survey was carried out on a representative sample of the French homeopathic GP population and covered three seasons of the year. The data was collected by means of a questionnaire which GPs completed for each consulting patient. It emerged that the type of patients who consult homeopathic GPs are chiefly women, between the ages of 20 and 54, living in an urban environment, not in employment, covered by National Health Insurance for Salaried Workers, and belonging to a Mutual Benefit Association. The most common reasons for consultation were ENT disorders, stress and anxiety. The homeopathic GPs mainly used homeopathy to treat these disorders. On average, four medicinal products per patient were prescribed per 2-month course of treatment, for an average reimbursed cost of 3.78 Euros.
http://www.ncbi.nlm.nih.gov/pubmed?term=Trichard%20M%2C%20Lamure%20E%2C%20Chaufferin%20G.%20Study3. Becker-Witt C, Lüdtke R, Weisshuhn T E, Willich S N. Diagnoses and treatment in homeopathic medical practice. Forsch Komplementärmed Klass Naturheilkd 2004;11:98–103. Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin, Berlin, Germany.
Abstract.
BACKGROUND: Despite increasing interest in complementary medicine worldwide, there has been no systematic large-scale documentation of medical homeopathic care.
OBJECTIVE: We therefore conducted a prospective cohort study aimed at characterizing patients seeking homeopathic care and their treatment.
PATIENTS AND METHODS: From September 1997 to June 1999, patients of all age groups who were visiting a homeopathic care center for the first time were included consecutively in the study and followed up for 24 months. Diagnostic procedures and prescriptions were documented using specific case report forms.
MAIN OUTCOME MEASURES: Diagnoses (ICD-9), medical history, consultations, and prescriptions.
RESULTS: A total of 3,981 patients were included in the study, 2,851 adults (29% men, mean age 42.5 +/- 13.1 years; 71% women, 39.9 +/- 12.4 years) and 1,130 children (52% boys, 6.5 +/- 3.9 years; 48% girls, 7.0 +/- 4.3 years). Almost all patients suffered from chronic conditions for 10.3 +/- 9.8 (adults) and 4.3 +/- 3.7 years (children). The most frequent diagnoses were allergic rhinitis in adult males, headache in adult females, and atopic dermatitis in children (both genders). The typical homeopathic initial consultations took 117 +/- 43 minutes for adults and 86 +/- 36 minutes for children, not varying much between primary diagnoses. In the observed 2 years the patients had on average 8.6 +/- 9.3 (adults) and 8.9 +/- 9.6 (children) consultations, approximately 50% each by telephone and face-to-face. Physicians most often prescribed the classical 'great' remedies (like sepia, sulfur, natrium mur., lycopodium), but in total, nearly 600 different homeopathic remedies were used.
CONCLUSIONS: Our study provides a wealth of data on the medical practice of classical homeopathy. In terms of treatment, polychrests are used frequently, although it should be noted that a large proportion of patients received 'small remedies' instead. Most patients are treated for chronic diseases. The present results will, in concert with follow-up outcome analysis, aid in determining the effectiveness of medical homeopathic practice.
http://www.ncbi.nlm.nih.gov/pubmed/151383744. Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges L V, Jonas W. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials.
Lancet. 1997 Sep 20;350(9081):834-43. Münchener Modell, Centre for Complementary Medicine Research, Technische Universität/Ludwig-Maximillans-Universität, München, Germany.
Erratum in:
Lancet 1998 Jan 17;351(9097):220.
Comment in:
Lancet. 1997 Sep 20;350(9081):825.
Lancet. 1998 Jan 31;351(9099):365; author reply 367-8.
Lancet. 1997 Sep 20;350(9081):824.
Lancet. 1998 Jan 31;351(9099):365; author reply 367-8.
Lancet. 1998 Jan 31;351(9099):368.
Lancet. 1998 Jan 31;351(9099):367.
Lancet. 1998 Jan 31;351(9099):365-6; author reply 367-8.
Lancet. 1998 Jan 31;351(9099):366; author reply 367-8.
Lancet. 1998 Jan 31;351(9099):366; author reply 367-8.
Lancet. 1998 Jan 31;351(9099):366-7; author reply 367-8.
Abstract.
BACKGROUND: Homeopathy seems scientifically implausible, but has widespread use. We aimed to assess whether the clinical effect reported in randomised controlled trials of homeopathic remedies is equivalent to that reported for placebo.
METHODS: We sought studies from computerised bibliographies and contracts with researchers, institutions, manufacturers, individual collectors, homeopathic conference proceedings, and books. We included all languages. Double-blind and/or randomised placebo-controlled trials of clinical conditions were considered. Our review of 185 trials identified 119 that met the inclusion criteria. 89 had adequate data for meta-analysis, and two sets of trial were used to assess reproducibility. Two reviewers assessed study quality with two scales and extracted data for information on clinical condition, homeopathy type, dilution, "remedy", population, and outcomes.
FINDINGS: The combined odds ratio for the 89 studies entered into the main meta-analysis was 2.45 (95% CI 2.05, 2.93) in favour of homeopathy. The odds ratio for the 26 good-quality studies was 1.66 (1.33, 2.08), and that corrected for publication bias was 1.78 (1.03, 3.10). Four studies on the effects of a single remedy on seasonal allergies had a pooled odds ratio for ocular symptoms at 4 weeks of 2.03 (1.51, 2.74). Five studies on postoperative ileus had a pooled mean effect-size-difference of -0.22 standard deviations (95% CI -0.36, -0.09) for flatus, and -0.18 SDs (-0.33, -0.03) for stool (both p < 0.05).
INTERPRETATION: The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition. Further research on homeopathy is warranted provided it is rigorous and systematic.
http://www.ncbi.nlm.nih.gov/pubmed/93106015. Ernst E. A systematic review of homeopathy. Br J Clin Pharmacol 2002:54:577–582
Department of Complementary Medicine, School of Sport & Health Sciences, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT UK.
E.Ernst@exeter.ac.ukAbstract.
Homeopathy remains one of the most controversial subjects in therapeutics. This article is an attempt to clarify its effectiveness based on recent systematic reviews. Electronic databases were searched for systematic reviews/meta-analysis on the subject. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of them related to re-analyses of one landmark meta-analysis. Collectively they implied that the overall positive result of this meta-analysis is not supported by a critical analysis of the data. Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.
http://www.ncbi.nlm.nih.gov/pubmed/124926036. Shang A, Huwiler-Muntener K, Nartey L, Juni P, Dorig S, Sterne J A, Pewsner D, Egger M. Are the clinical effects of homoeopathy placebo efects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet. 2005 Aug 27-Sep 2;366(9487):726-32.
Department of Social and Preventive Medicine, University of Berne, Berne, Switzerland.
Comment in:
Lancet. 2005 Aug 27-Sep 2;366(9487):691-2.
Lancet. 2005 Dec 17;366(9503):2081; author reply 2083-6.
Lancet. 2005 Dec 17;366(9503):2081-2; author reply 2083-6.
Lancet. 2005 Dec 17;366(9503):2082-3; author reply 2083-6.
Lancet. 2005 Dec 17;366(9503):2083; author reply 2083-6.
Homeopathy. 2006 Jan;95(1):61-2.
Abstract.
BACKGROUND: Homoeopathy is widely used, but specific effects of homoeopathic remedies seem implausible. Bias in the conduct and reporting of trials is a possible explanation for positive findings of trials of both homoeopathy and conventional medicine. We analysed trials of homoeopathy and conventional medicine and estimated treatment effects in trials least likely to be affected by bias.
METHODS: Placebo-controlled trials of homoeopathy were identified by a comprehensive literature search, which covered 19 electronic databases, reference lists of relevant papers, and contacts with experts. Trials in conventional medicine matched to homoeopathy trials for disorder and type of outcome were randomly selected from the Cochrane Controlled Trials Register (issue 1, 2003). Data were extracted in duplicate and outcomes coded so that odds ratios below 1 indicated benefit. Trials described as double-blind, with adequate randomisation, were assumed to be of higher methodological quality. Bias effects were examined in funnel plots and meta-regression models.
FINDINGS: 110 homoeopathy trials and 110 matched conventional-medicine trials were analysed. The median study size was 65 participants (range ten to 1573). 21 homoeopathy trials (19%) and nine (8%) conventional-medicine trials were of higher quality. In both groups, smaller trials and those of lower quality showed more beneficial treatment effects than larger and higher-quality trials. When the analysis was restricted to large trials of higher quality, the odds ratio was 0.88 (95% CI 0.65-1.19) for homoeopathy (eight trials) and 0.58 (0.39-0.85) for conventional medicine (six trials).
INTERPRETATION: Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects.
http://www.ncbi.nlm.nih.gov/pubmed/161255897. Vickers A J, Smith C. Homeopathic oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database Syst Rev. 2004;(1):CD001957.
Integrative Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York, 10021, USA.
Update in:
Cochrane Database Syst Rev. 2006;3:CD001957.
Update of:
Cochrane Database Syst Rev. 2000;(2):CD001957.
Abstract.
BACKGROUND: Influenza is a highly infectious viral disease that is particularly common in the winter months. Oscillococcinum is a patented, commercially available homoeopathic medicine. The rationale for its use in influenza comes from the homoeopathic principle of 'let like be cured by like'. The medicine is manufactured from wild duck heart and liver, which are said to be reservoirs for influenza viruses.
OBJECTIVES: To determine whether homoeopathic Oscillococcinum or similar medicines are more effective than placebo in the prevention and treatment of influenza and influenza-like syndromes.
SEARCH STRATEGY: The Cochrane Central Register of Controlled Trials (CENTRAL) issue 2, 2003; MEDLINE (January 1966 to June 2003) and EMBASE (1980 to June 2003) were searched, using the term "homeopathy" with "influenza", "respiratory tract", "infection", "cough", "virus" and "fever". The manufacturers of Oscillococcinum were contacted for information.
SELECTION CRITERIA: Placebo-controlled trials of Oscillococcinum or homeopathically-prepared influenza virus, influenza vaccine or avian liver in the prevention and treatment of influenza and influenza-like syndromes.
DATA COLLECTION AND ANALYSIS: Two reviewers extracted data and assessed methodological quality independently.
MAIN RESULTS: Seven studies were included in the review, three prevention trials (n = 2265) and four treatment trials (n = 1194). Only for two studies was there sufficient information to complete data extraction fully. There was no evidence that homoeopathic treatment can prevent influenza-like syndrome (relative risk 0.64, 95% confidence interval 0.28 to 1.43). Oscillococcinum treatment reduced length of influenza illness by 0.28 days (95% confidence interval 0.50 to 0.06). Oscillococcinum also increased the chance of a patient considering treatment effective (relative risk 1.08; 95% CI 1.17, 1).
REVIEWER'S CONCLUSIONS: Though promising, the data are not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndrome. Further research is warranted but required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.
http://www.ncbi.nlm.nih.gov/pubmed/14973976Есть более новые исследования этого автора на эту же тему:
Cochrane Database Syst Rev. 2006 Jul 19;3:CD001957.
Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes.
Vickers AJ, Smith C.
Memorial Sloan-Kettering Cancer Center, Integrative Medicine Service, 1275 York Avenue, New York, NY 10021, USA.
vickersa@mskcc.orgUpdate in:
Cochrane Database Syst Rev. 2009;(3):CD001957.
Update of:
Cochrane Database Syst Rev. 2004;(1):CD001957.
Abstract.
BACKGROUND: Influenza is a highly infectious viral disease that is particularly common in the winter months. Oscillococcinum is a patented, commercially available homoeopathic medicine. The rationale for its use in influenza comes from the homoeopathic principle of 'let like be cured by like'. This medicine is manufactured from wild duck heart and liver, which are said to be reservoirs for influenza viruses.
OBJECTIVES: To determine whether homoeopathic Oscillococcinum or similar medicines are more effective than placebo in the prevention and treatment of influenza and influenza-like syndromes.
SEARCH STRATEGY: We updated the electronic searches on the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006); MEDLINE (January 1966 to February 2006) and EMBASE (1980 to February 2006). The manufacturers of Oscillococcinum were contacted for information.
SELECTION CRITERIA: Placebo-controlled trials of Oscillococcinum or homeopathically-prepared influenza virus, influenza vaccine or avian liver in the prevention and treatment of influenza and influenza-like syndromes.
DATA COLLECTION AND ANALYSIS: Two authors extracted data and assessed methodological quality independently.
MAIN RESULTS: Seven studies were included in the review, three prevention trials (number of participants (n) = 2265) and four treatment trials (n = 1194). Only two studies reported sufficient information to complete data extraction fully. There was no evidence that homoeopathic treatment can prevent influenza-like syndrome (relative risk (RR) 0.64, 95% confidence interval (CI) 0.28 to 1.43). Oscillococcinum treatment reduced the length of influenza illness by 0.28 days (95% CI 0.50 to 0.06). Oscillococcinum also increased the chances that a patient considered treatment to be effective (RR 1.08; 95% CI 1.17 to 1.00).
AUTHORS' CONCLUSIONS: Though promising, the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes. Further research is warranted but the required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.
http://www.ncbi.nlm.nih.gov/pubmed/168559818. Jonas W B, Linde K, Ramirez G. Homeopathy and rheumatic disease. Rheum Dis Clin North Am. 2000 Feb;26(1):117-23, x. Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
wjonas@mxa.usuhs.milAbstract.
Despite a growing interest in uncovering the basic mechanisms of arthritis, medical treatment remains symptomatic. Current medical treatments do not consistently halt the long-term progression of these diseases, and surgery may still be needed to restore mechanical function in large joints. Patients with rheumatic syndromes often seek alternative therapies, with homeopathy being one of the most frequent. Homeopathy is one of the most frequently used complementary therapies worldwide.
http://www.ncbi.nlm.nih.gov/pubmed/106801999. Bell IR, Lewis DA 2nd, Brooks AJ, Schwartz GE, Lewis SE, Walsh BT, Baldwin CM.
Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology (Oxford). 2004 May;43(5):577-82. Epub 2004 Jan 20.
Department of Psychiatry, Mel and Enid Zuckerman Arizona College of Public Health at the University of Arizona, Tucson, USA.
IBELL@U.ARIZONA.EDUAbstract.
OBJECTIVE: To assess the efficacy of individualized classical homeopathy in the treatment of fibromyalgia.
METHODS: This study was a double-blind, randomized, parallel-group, placebo-controlled trial of homeopathy. Community-recruited persons (N = 62) with physician-confirmed fibromyalgia (mean age 49 yr, s.d. 10 yr, 94% women) were treated in a homeopathic private practice setting. Participants were randomized to receive oral daily liquid LM (1/50,000) potencies with an individually chosen homeopathic remedy or an indistinguishable placebo. Homeopathic visits involved joint interviews and concurrence on remedy selection by two experienced homeopaths, at baseline, 2 months and 4 months (prior to a subsequent optional crossover phase of the study which is reported elsewhere). Tender point count and tender point pain on examination by a medical assessor uninvolved in providing care, self-rating scales on fibromyalgia-related quality of life, pain, mood and global health at baseline and 3 months, were the primary clinical outcome measures for this report.
RESULTS: Fifty-three people completed the treatment protocol. Participants on active treatment showed significantly greater improvements in tender point count and tender point pain, quality of life, global health and a trend toward less depression compared with those on placebo.
CONCLUSIONS: This study replicates and extends a previous 1-month placebo-controlled crossover study in fibromyalgia that pre-screened for only one homeopathic remedy. Using a broad selection of remedies and the flexible LM dose (1/50,000 dilution factor) series, the present study demonstrated that individualized homeopathy is significantly better than placebo in lessening tender point pain and improving the quality of life and global health of persons with fibromyalgia.
http://www.ncbi.nlm.nih.gov/pubmed?term=clinical[Title]%20AND%20status[Title]%20AND%20fibromyalgia[Title]%20AND%20patients[Title]%20AND%20treated[Title]
10. Gmünder R, Kissling R. The efficacy of homeopathy in the treatment of chronic low back pain compared to standardized physiotherapy. [Article in German]. Z Orthop Ihre Grenzgeb. 2002 Sep-Oct;140(5):503-8. Abteilung für Physikalische Medizin und Rheumatologie, Orthopädische Universitätsklinik Balgrist, Zürich, Switzerland.
Abstract.
AIM: The aim of this pilot project was to evaluate the efficacy of treatment of chronic low back pain during two months either by homeopathy or by standardised physiotherapy.
METHOD: 43 patients suffering from chronic low back pain were included in this controlled, randomised prospective study. They were divided in two treatment groups: homeopathy and standardised physiotherapy. Based on the initial and final clinical investigations, the Oswestry questionnaire and the visual analogue scale, that were assessed at the beginning, at the end and 18.5 months after therapy, the results were statistically evaluated. A further questionnaire documented the acceptance of treatment.
RESULTS: A comparison of the groups from the beginning to the end of treatment reveals a significant decrease of the Oswestry score in patients treated by homeopathy. This tendency could not be confirmed 18.5 months later. Homeopathy was well accepted by most of the patients.
CONCLUSIONS: Based on these results, nothing can be said against attempting treatment of chronic low back pain by means of homeopathy. Further research is recommended to confirm the results of our investigation, using a larger number of patients, a third treatment group, homeopathy double blinded.
http://www.ncbi.nlm.nih.gov/pubmed?term=Gm%C3%BCnder%20R%2C%20Kissling%20R11. Weatherley-Jones E, Nicholl J P, Thomas K J, Parry G J, McKendrick M W, Green S T, Stanley P J, Lynch S P. A randomised, controlled, triple-blind trial of the efficacy of homeopathic treatment for chronic fatigue syndrome. J Psychosom Res. 2004 Feb;56(2):189-97. Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
e.weatherley-jones@sheffield.ac.ukComment in:
J Psychosom Res. 2004 Nov;57(5):503; author reply 504.
Abstract.
OBJECTIVE: There is no management regime for chronic fatigue syndrome (CFS) that has been found to be universally beneficial and no treatment can be considered a "cure". Patients with CFS may use complementary and alternative medicine (CAM). Our aim was to evaluate homeopathic treatment in reducing subjective symptoms of CFS.
METHOD: Using a triple-blind design (patient and homeopath blind to group assignment and data analyst blind to group until after initial analyses to reduce the possibility of bias due to data analyst), we randomly assigned patients to homeopathic medicine or identical placebo. One hundred and three patients meeting the Oxford criteria for CFS were recruited from two specialist hospital out patient departments. Patients had monthly consultations with a professional homeopath for 6 months. Main outcome measures were scores on the subscales of the Multidimensional Fatigue Inventory (MFI) and proportions of each group attaining clinically significant improvements on each subscale. Secondary outcome measures were the Fatigue Impact Scale (FIS) and the Functional Limitations Profile (FLP). Ninety-two patients completed treatment in the trial (47 homeopathic treatment, 45 placebo). Eighty-six patients returned fully or partially completed posttreatment outcome measures (41 homeopathic treatment group who completed treatment, 2 homeopathic treatment group who did not complete treatment, 38 placebo group who completed treatment, and 5 placebo group who did not complete treatment).
RESULTS: Seventeen of 103 patients withdrew from treatment or were lost to follow-up. Patients in the homeopathic medicine group showed significantly more improvement on the MFI general fatigue subscale (one of the primary outcome measures) and the FLP physical subscale but not on other subscales. Although group differences were not statistically significant on four out of the five MFI subscales (the primary outcome measures), more people in the homeopathic medicine group showed clinically significant improvement. More people in the homeopathic medicine group showed clinical improvement on all primary outcomes (relative risk=2.75, P=.09).
CONCLUSIONS: There is weak but equivocal evidence that the effects of homeopathic medicine are superior to placebo. Results also suggest that there may be nonspecific benefits from the homeopathic consultation. Further studies are needed to determine whether these differences hold in larger samples.
http://www.ncbi.nlm.nih.gov/pubmed?term=Weatherley-Jones%20E%2C%20Nicholl12. Berrebi A, Parant O, Ferval F, Thene M, Ayoubi J M, Connan L, Belon P. Treatment of pain due to unwanted lactation with a homeopathic preparation given in the immediate post-partum period [Article in French]. J Gynecol Obstet Biol Reprod (Paris). 2001 Jun;30(4):353-7. Fédération de Gynécologie-Obstétrique, Service de Pharmacie, CHU La Grave, 31052 Toulouse Cedex, France.
Abstract.
Dopaminergic agonists, such as Parlodel((R)), are now widely used to inhibit lactation. However, some countries, such as the United States, no longer use these drugs in this indication because of their sometimes serious adverse effects. In this context, the authors tested a homeopathic treatment designed for parturients unable or not wanting to breastfeed. The APIS MELLIFICA 9 CH and BRYONIA 9 CH combination was chosen for its anti-inflammatory and analgesic effects. 71 patients were included in this double-blind placebo-controlled study. All received basic treatment comprising naproxen and fluid restriction. A significant improvement of lactation pain (main criterion of the study) was observed in parturients treated with homeopathy (p<0.02 on D2 and p<0.01 on D4). A similar effect (p<0.05 on D4) was observed for breast tension and spontaneous milk flow. No significant difference was observed for the other criteria of the study. The homeopathic combination studied was therefore effective on the pain of lactation and should be integrated into the therapeutic armamentarium.
http://www.ncbi.nlm.nih.gov/pubmed?term=Berrebi%20A%2C%20Parant%20O%2C%20Ferval13. Chapman E H, Weintraub R J, Milburn M A, Pirozzi T O, Woo E. Homeopathic treatment of mild traumatic brain injury: A randomized, double-blind, placebo-controlled clinical trial. J Head Trauma Rehabil 1999;14:521–542. Harvard University School of Medicine, Boston, MA, USA.
Abstract.
BACKGROUND: Mild traumatic brain injury (MTBI) affects 750,000 persons in the United States annually. Five to fifteen percent have persistent dysfunction and disability. No effective, standard pharmacological treatment exists specifically for this problem. We designed a pilot research project to study the clinical effectiveness of homeopathic medicine in the treatment of persistent MTBI.
METHOD: A randomized, double-blind, placebo-controlled trial of 60 patients, with a four-month follow-up (N = 50), was conducted at Spaulding Rehabilitation Hospital (SRH). Patients with persistent MTBI (mean 2.93 years since injury, SD 3.1) were randomly assigned to receive a homeopathic medicine or placebo. The primary outcome measure was the subject-rated SRH-MBTI Functional Assessment, composed of three subtests: a Difficulty with Situations Scale (DSS), a Symptom Rating Scale (SRS), and a Participation in Daily Activities Scale (PDAS). The SRH Cognitive-Linguistic Test Battery was used as the secondary measure.
RESULTS: Analysis of covariance demonstrated that the homeopathic treatment was the only significant or near-significant predictor of improvement on DSS subtests (P =.009; 95% CI -.895 to -.15), SRS (P =.058; 95% CI -.548 to.01) and the Ten Most Common Symptoms of MTBI (P =.027; 95% CI -.766 to -.048). These results indicate a significant improvement from the homeopathic treatment versus the control and translate into clinically significant outcomes.
CONCLUSIONS: This study suggests that homeopathy may have a role in treating persistent MTBI. Our findings require large-scale, independent replication.
http://www.ncbi.nlm.nih.gov/pubmed?term=Chapman%20E%20H%2C%20Weintraub%20R%20J%2C%20Milburn14. Jacobs J, Jonas W B, Jimémez-Pérez M, Crothers D. Homeopathy for childhood diarrhea: combined results and metaanalysis from three randomized, controlled clinical trials. Pediatr Infect Dis J. 2003 Mar;22(3):229-34. Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA.
jjacobs@igc.orgAbstract.
BACKGROUND: Previous studies have shown a positive treatment effect of individualized homeopathic treatment for acute childhood diarrhea, but sample sizes were small and results were just at or near the level of statistical significance. Because all three studies followed the same basic study design, the combined data from these three studies were analyzed to obtain greater statistical power.
METHODS: Three double blind clinical trials of diarrhea in 242 children ages 6 months to 5 years were analyzed as 1 group. Children were randomized to receive either an individualized homeopathic medicine or placebo to be taken as a single dose after each unformed stool for 5 days. Parents recorded daily stools on diary cards, and health workers made home visits daily to monitor children. The duration of diarrhea was defined as the time until there were less than 3 unformed stools per day for 2 consecutive days. A metaanalysis of the effect-size difference of the three studies was also conducted.
RESULTS: Combined analysis shows a duration of diarrhea of 3.3 days in the homeopathy group compared with 4.1 in the placebo group (P = 0.008). The metaanalysis shows a consistent effect-size difference of approximately 0.66 day (P = 0.008).
CONCLUSIONS: The results from these studies confirm that individualized homeopathic treatment decreases the duration of acute childhood diarrhea and suggest that larger sample sizes be used in future homeopathic research to ensure adequate statistical power. Homeopathy should be considered for use as an adjunct to oral rehydration for this illness.
http://www.ncbi.nlm.nih.gov/pubmed?term=1263458315. Harrison H, Fixsen A, Vickers A. A randomized comparison of homeopathic and standard care for the treatment of glue ear in children. Complement Ther Med 1999;7:132–135.
Abstract.
OBJECTIVE: To pilot a model for determining whether homoeopathic treatment of children suffering from glue ear is more effective than standard GP care at producing a return to normal hearing (a hearing loss of less than 20 dB) within 12 months.
DESIGN: Non-blind, randomized controlled trial.
SETTING: General practice in two locations in southern England.
SUBJECTS: Thirty-three children aged 18 months to 8 years with otitis media with effusion, hearing loss > 20 dB and an abnormal tympanogram.
OUTCOME MEASURES: Hearing loss, tympanogram, referrals to specialists and number of courses of antibiotics at 12 month follow-up.
RESULTS: A higher proportion of children receiving homoeopathic care had a hearing loss less then 20 dB at follow-up (64 vs 56%), though this difference did not reach statistical significance (95% confidence interval for the difference between means of -25 and 42%). More homoeopathy patients than controls had a normal tympanogram (75 vs 31%, P = 0.015). Referrals to specialists and antibiotic consumption was lower in the homoeopathy group, though differences between groups did not reach statistical significance.
CONCLUSION: Further research comparing homoeopathy to standard care is warranted. Assuming recovery rates of 50 and 30% in homoeopathy and standard care groups respectively, 270 patients would be needed for a definitive trial.
http://www.ncbi.nlm.nih.gov/pubmed?term=Harrison%20H%2C%20Fixsen%20A%2C%20Vickers16. Fisher P, Scott D L. A randomized controlled trial of homeopathy in rheumatoid arthritis. Rheumatology (Oxford) 2001;40:1052–1055. Royal London Homoeopathic Hospital, Great Ormond Street, London, UK.
Abstract.
OBJECTIVE: To test the hypothesis that homeopathy is effective in reducing the symptoms of joint inflammation in rheumatoid arthritis (RA).
METHOD: This was a 6-month randomized, cross-over, double-blind, placebo-controlled, single-centre study set in a teaching hospital rheumatology out-patient clinic. The participants of the study were 112 patients who had definite or classical RA, were seropositive for rheumatoid factor and were receiving either stable doses of single non-steroidal anti-inflammatory drugs (NSAIDs) for > or =3 months or single disease-modifying anti-rheumatic drugs (DMARDs) with or without NSAIDs for > or =6 months. Patients who were severely disabled, had taken systemic steroids in the previous 6 months or had withdrawn from DMARD therapy in the previous 12 months were excluded. Two series of medicines were used. One comprised 42 homeopathic medicines used for treating RA in 6cH (10(-12)) and/or 30cH (10(-30)) dilutions (a total of 59 preparations) manufactured to French National Pharmacopoeia standards, the other comprised identical matching placebos. The main outcome measures were visual analogue scale pain scores, Ritchie articular index, duration of morning stiffness and erythrocyte sedimentation rate (ESR).
RESULTS: Fifty-eight patients completed the trial. Over 6 months there were significant decreases (P<0.01 by Wilcoxon rank sum tests) in their mean pain scores (fell 18%), articular indices (fell 24%) and ESRs (fell 11%). Fifty-four patients withdrew before completing the trial. Thirty-one changed conventional medication, 10 had serious intercurrent illness or surgery, 12 failed to attend and three withdrew consent. Placebo and active homeopathy had different effects on pain scores; mean pain scores were significantly lower after 3 months' placebo therapy than 3 months' active therapy (P=0.032 by Wilcoxon rank sum test). Articular index, ESR and morning stiffness were similar with active and placebo homeopathy.
CONCLUSIONS: We found no evidence that active homeopathy improves the symptoms of RA, over 3 months, in patients attending a routine clinic who are stabilized on NSAIDs or DMARDs.
http://www.ncbi.nlm.nih.gov/pubmed?term=Fisher%20P%2C%20Scott%20D17. Schirmer K P, Fritz M, Jäckel W H. Wirksamkeit von Formica rufa und Eigenblut-Injektionen bei Patienten mit ankylosierender Spondylitis: eine doppelblinde, randomisierte Studie. Z Rheumatol 2000;59:321–329. [Article in German]. Argental-Klinik 88316 Isny-Neutrauchburg.
Abstract.
While complementary medicine and homeopathy is becoming an increasingly prominent part of the health care practices, there is a lack of controlled studies concerning their effectiveness. In our study, we wanted to answer the question whether a combination of Formica rufa D6 and reinjection of the patient's own blood is superior to injection of placebo. 104 patients with ankylosing spondylitis entered a prospective, randomized, double-blind study. During four weeks they received twice weekly either 1 ml of Formica rufa D6 in combination with 0.5 ml of blood or 1.5 ml NaCl intramuscular. Before and after therapy, mobility, thoracic excursion and doctor's overall assessment were measured in addition to patient's health status, using a German version of the Arthritis Impact Measurement Scales, before and after therapy as well as four, twelve, and twenty-four weeks later. We were not able to detect any statistical difference between treatment and placebo group in any of the parameters measured. Therefore, the therapy under study may not be regarded effective.
http://www.ncbi.nlm.nih.gov/pubmed?term=Schirmer%20K%20P%2C%20Fritz%20M%2C18. Jacobs J, Springer D A, Crothers D. Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial. Pediatr Infect Dis J 2001;20:177–183
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, USA.
jjacobs@igc.orgAbstract.
BACKGROUND: The use of antibiotics in the initial treatment of acute otitis media is currently being questioned. Homeopathy has been used historically to treat this illness, but there have been no methodologically rigorous trials to determine whether there is a positive treatment effect.
METHODS: A randomized double blind placebo control pilot study was conducted in a private pediatric practice in Seattle, WA. Seventy-five children ages 18 months to 6 years with middle ear effusion and ear pain and/or fever for no more than 36 h were entered into the study. Children received either an individualized homeopathic medicine or a placebo administered orally three times daily for 5 days, or until symptoms subsided, whichever occurred first. Outcome measures included the number of treatment failures after 5 days, 2 weeks and 6 weeks. Diary symptom scores during the first 3 days and middle ear effusion at 2 and 6 weeks after treatment were also evaluated.
RESULTS: There were fewer treatment failures in the group receiving homeopathy after 5 days, 2 weeks and 6 weeks, with differences of 11.4, 18.4 and 19.9%, respectively, but these differences were not statistically significant. Diary scores showed a significant decrease in symptoms at 24 and 64 h after treatment in favor of homeopathy (P < 0.05). Sample size calculations indicate that 243 children in each of 2 groups would be needed for significant results, based on 5-day failure rates.
CONCLUSIONS: These results suggest that a positive treatment effect of homeopathy when compared with placebo in acute otitis media cannot be excluded and that a larger study is justified.
http://www.ncbi.nlm.nih.gov/pubmed?term=18.%09Jacobs%20J%2C%20Springer%20%2C19. Bonne O, Shemer Y, Goali Y, Katz M, Shalev-Arieh Y. A randomized, double-blind, placebo-controlled study of classical homeopathy in generalized anxiety disorder. J Clin Psychiatry 2003;64:282–287. Department of Psychiatry, Hadassah University Medical School and the Department of Psychiatry, Hadassah University Hospital, Jerusalem, Israel.
bonneo@intra.nimh.nih.govAbstract.
BACKGROUND: Homeopathy is commonly used for the treatment of medical and psychological conditions. Such prevalent use, however, is not supported by robust, methodologically sound research. This study evaluates the effect of homeopathic treatment in generalized anxiety disorder, a prevalent mental disorder characterized by an enduring pattern of excessive apprehension and distress and by mental and bodily complaints.
METHOD: Forty-four patients with DSM-IV generalized anxiety disorder participated in a randomized, double-blind, placebo-controlled 10-week trial of individually tailored homeopathic remedy. Homeopathic therapy was administered by an expert who followed the traditional routines of homeopathic diagnosis and prescription. Thirty-nine subjects completed the study (20 in the active treatment group and 19 in the placebo group). Subjects' symptoms were rated before treatment and after 5 and 10 weeks of treatment, with the Hamilton Rating Scale for Anxiety (HAM-A) as main outcome measure. Additional measures of outcome included the Brief Symptom Inventory, the Psychological General Well-Being Index, the Hamilton Rating Scale for Depression, the Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and a Visual Analogue Scale of subjective distress.
RESULTS: Significant (p <.05) improvement in most measures, including the HAM-A, was observed in both the active treatment and placebo groups, yet no group effect was observed.
CONCLUSION: The effect of homeopathic treatment on mental symptoms of patients with generalized anxiety disorder did not differ from that of placebo. The improvement in both conditions was substantial. Improvement of such magnitude may account for the current belief in the efficacy of homeopathy and the current increase in the use of this practice.
http://www.ncbi.nlm.nih.gov/pubmed?term=Bonne%20O%2C%20Shemer20. White A, Slade P, Hunt C, Hart C A, Ernst E. Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomized placebo controlled trial. Thorax 2003;58:317–321
Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter EX2 4NT, UK.
adrian.white@pms.ac.ukComment in:
Thorax. 2003 Sep;58(9):827; author reply 828.
Thorax. 2003 Sep;58(9):826-7; author reply 828.
Thorax. 2003 Sep;58(9):826; author reply 828.
Thorax. 2003 Sep;58(9):826; author reply 828.
Thorax. 2003 Sep;58(9):827-8; author reply 828.
Abstract.
BACKGROUND: Homeopathy is frequently used to treat asthma in children. In the common classical form of homeopathy, prescriptions are individualised for each patient. There has been no rigorous investigation into this form of treatment for asthma.
METHODS: In a randomised, double blind, placebo controlled trial the effects of individualised homeopathic remedies were compared with placebo medication in 96 children with mild to moderate asthma as an adjunct to conventional treatment. The main outcome measure was the active quality of living subscale of the Childhood Asthma Questionnaire administered at baseline and follow up at 12 months. Other outcome measures included other subscales of the same questionnaire, peak flow rates, use of medication, symptom scores, days off school, asthma events, global assessment of change, and adverse reactions.
RESULTS: There were no clinically relevant or statistically significant changes in the active quality of life score. Other subscales, notably those measuring severity, indicated relative improvements but the sizes of the effects were small. There were no differences between the groups for other measures.
CONCLUSIONS: This study provides no evidence that adjunctive homeopathic remedies, as prescribed by experienced homeopathic practitioners, are superior to placebo in improving the quality of life of children with mild to moderate asthma in addition to conventional treatment in primary care.
http://www.ncbi.nlm.nih.gov/pubmed?term=White%20A%2C%20Slade21. Jonas W B, Anderson R L, Crawford C C, Lyons J S. A systematic review of the quality of homeopathic clinical trials. BMC Complement Altern Med 2001;1:12. Samueli Institute for Information Biology and Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
wjonas@siib.orgAbstract.
BACKGROUND: While a number of reviews of homeopathic clinical trials have been done, all have used methods dependent on allopathic diagnostic classifications foreign to homeopathic practice. In addition, no review has used established and validated quality criteria allowing direct comparison of the allopathic and homeopathic literature.
METHODS: In a systematic review, we compared the quality of clinical-trial research in homeopathy to a sample of research on conventional therapies using a validated and system-neutral approach. All clinical trials on homeopathic treatments with parallel treatment groups published between 1945-1995 in English were selected. All were evaluated with an established set of 33 validity criteria previously validated on a broad range of health interventions across differing medical systems. Criteria covered statistical conclusion, internal, construct and external validity. Reliability of criteria application is greater than 0.95.
RESULTS: 59 studies met the inclusion criteria. Of these, 79% were from peer-reviewed journals, 29% used a placebo control, 51% used random assignment, and 86% failed to consider potentially confounding variables. The main validity problems were in measurement where 96% did not report the proportion of subjects screened, and 64% did not report attrition rate. 17% of subjects dropped out in studies where this was reported. There was practically no replication of or overlap in the conditions studied and most studies were relatively small and done at a single-site. Compared to research on conventional therapies the overall quality of studies in homeopathy was worse and only slightly improved in more recent years.
CONCLUSIONS: Clinical homeopathic research is clearly in its infancy with most studies using poor sampling and measurement techniques, few subjects, single sites and no replication. Many of these problems are correctable even within a "holistic" paradigm given sufficient research expertise, support and methods.
http://www.ncbi.nlm.nih.gov/pubmed?term=Jonas%20W%20B%2C%20Anderson22. Schmidt K, Ernst E. MMR vaccination advice over the internet. Vaccine 2003;21:1044–1047
Complementary Medicine, Peninsula Medical School, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT, UK.
katja.schmidt@pms.ac.ukAbstract.
We wanted to investigate what advice UK homeopaths, chiropractors and general practitioners give on measles, mumps and rubella vaccination programme (MMR) vaccination via the Internet. Online referral directories listing e-mail addresses of UK homeopaths, chiropractors and general practitioners and private websites were visited. All addresses thus located received a letter of a (fictitious) patient asking for advice about the MMR vaccination. After sending a follow-up letter explaining the nature and aim of this project and offering the option of withdrawal, 26% of all respondents withdrew their answers. Homeopaths yielded a final response rate (53%, n = 77) compared to chiropractors (32%, n = 16). GPs unanimously refused to give advice over the Internet. No homeopath and only one chiropractor advised in favour of the MMR vaccination. Two homeopaths and three chiropractors indirectly advised in favour of MMR. More chiropractors than homeopaths displayed a positive attitude towards the MMR vaccination. Some complementary and alternative medicine (CAM) providers have a negative attitude towards immunisation and means of changing this should be considered.
http://www.ncbi.nlm.nih.gov/pubmed?term=MMR%20vaccination%20advice%20over%20the%20internet23. Lehrke P, Nübling M, Hofmann F, Stössel U. Impfverhalten und Impfeinstellung bei ärzten mit und ohne Zusatzbezeichnung Homöopathie. Monatsschr Kinderheilkd 2004;152:752–757
24. Thompson E, Barron S, Spence D. A preliminary audit investigating remedy reactions including adverse events in routine homeopathic practice. Homeopathy 2004;93:203–209. Bristol Homeopathic Hospital, United Bristol Healthcare Trust, Cotham Hill, Bristol BS6 6PD, UK.
elizabeth.thompson@ubht.swest.nhs.ukAbstract.
Homeopathic medicines are regarded as safe but practitioners report several types of healing or remedy reactions including aggravations, new symptoms and recurrence of old symptoms, some of which could be regarded as side effects or unwanted effects. Some remedy reactions may be regarded as adverse events. AUDIT QUESTIONS: Do such reactions occur within our unit, and if so, how frequently? Do patients regard these events as "adverse"?
METHODS: The audit was carried out in the Bristol Homeopathic Hospital Outpatient Department. All patients were given a questionnaire to complete when at their first follow-up consultation approx 6-10 weeks after their first appointment. One hundred and sixteen patients were sampled over a 2-month period.
RESULTS: Reactions were frequent: 28 out of the 116 (24%) patients, experienced an aggravation. Thirteen patients (11%) reported an adverse event even though 5 of those were patients who also reported an aggravation followed by an overall improvement of their symptoms. Thirty-one patients described new symptoms (27%) and 21(18%), a return of old symptoms. Those experiencing the latter appeared to have better outcomes.
CONCLUSIONS: Remedy reactions are common in clinical practice; some patients experience them as adverse events. Systematically recording side effects would facilitate our understanding of these reactions and would enable standards to be set for audit of information and patient care.
http://www.ncbi.nlm.nih.gov/pubmed/15532700В поисках ссылок нашел ещё две интересных статьи.
Clin Rheumatol. 2010 May;29(5):457-64. Epub 2010 Jan 23. A systematic review of homoeopathy for the treatment of fibromyalgia. Perry R, Terry R, Ernst E. Department of Complementary Medicine, Peninsula Medical School, 25 Victoria Park Road, Exeter, Devon, EX2 4NT, UK.
rachel.perry@pms.ac.ukAbstract.
Homoeopathy is often advocated for fibromyalgia (FM) and many FM patients use it. To critically evaluate all randomised clinical trials (RCTs) of homoeopathy as a treatment for FM, six electronic databases were searched to identify all relevant studies. Data extraction and the assessment of the methodological quality of all included studies were done by two independent reviewers. Four RCTs were found, including two feasibility studies. Three studies were placebo-controlled. None of the trials was without serious flaws. Invariably, their results suggested that homoeopathy was better than the control interventions in alleviating the symptoms of FM. Independent replications are missing. Even though all RCTs suggested results that favour homoeopathy, important caveats exist. Therefore, the effectiveness of homoeopathy as a symptomatic treatment for FM remains unproven.
http://www.ncbi.nlm.nih.gov/pubmed/20099019Homeopathy. 2003 Apr;92(2):92-8. Homeopathic aggravations: a systematic review of randomised, placebo-controlled clinical trials. Grabia S, Ernst E. Master of Public Health Program, University of Wisconsin-La Crosse, USA.
Abstract.
Homeopathic aggravations have often been described anecdotally. However, few attempts have been made to scientifically verify their existence. This systematic review aimed at comparing the frequency of homeopathic aggravations in the placebo and verum groups of double-blind, randomised clinical trials. Eight independent literature searches were carried out to identify all such trials mentioning either adverse effects or aggravations. All studies thus found were validated and data were extracted by both authors. Twenty-four trials could be included. The average number of aggravations was low. In total, 50 aggravations were attributed to patients treated with placebo and 63 to patients treated with homoeopathically diluted remedies. We conclude that this systematic review does not provide clear evidence that the phenomenon of homeopathic aggravations exists.
http://www.ncbi.nlm.nih.gov/pubmed/12725251 02 апреля 2011, 20:25
Британская служба здравоохранения продолжит поддерживать гомеопатию.
Национальная служба здравоохранения Великобритании (NHS) продолжит поддерживать гомеопатию, несмотря на протесты медицинских специалистов. Об этом сообщила заместитель министра здравоохранения страны Энн Милтон (Anne Milton), передает The Daily Telegraph.
По словам Милтон, методы лечения, наиболее подходящие для конкретных пациентов, будут выбирать региональные отделения NHS. Замминистра здравоохранения добавила, что при выборе лечения медики будут руководствоваться его безопасностью, а также клинической и экономической эффективностью.
По данным британского Общества гомеопатов (Society of Homeopaths), ежегодно на поддержку гомеопатии NHS тратит около 4 миллионов фунтов. На территории Соединенного королевства работают четыре больницы, специализирующиеся на гомеопатических методах лечения.
В конце июня 2010 года участники ежегодной конференции Британской медицинской ассоциации (BMA) проголосовали за прекращение финансовой поддержки гомеопатии со стороны NHS. Специалисты отмечали, что по результатам многочисленных клинических испытаний эффективность гомеопатических препаратов не выходит за рамки эффекта плацебо. По мнению медиков, поддерживая гомеопатию, британское общество отходит от научных принципов и возвращается к магическому восприятию действительности.
http://medportal.ru/mednovosti/news/2010/07/27/brhomeo/
