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.no
Abstract.
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/12587989
2. 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.fr
Abstract.
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?t...n%20G.%20Study
3. 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/15138374
4. 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/9310601
5. 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.uk
Abstract.
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/12492603
6. 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/16125589
7. 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/14973976
Есть 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.org
Update 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/16855981
8. 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.mil
Abstract.
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/10680199
9. 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.EDU
Abstract.
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