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Homeopathy: progress and promise, a critical perspective 顺势疗法:进步与希望,一个批判的视角
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0514
JP Borneman

This lecture attempts to analyse the progress made by homeopathy in recent years, by analysing consumer awareness, sales and distribution trends of homeopathic products, and research publications. Sales of homeopathic medicines are growing rapidly, but remain a very small fraction of the total pharmaceutical market. The proportion of combination to single medicines varies widely between countries. The market is concentrated in a relatively small number of the available medicines; many available homeopathic medicines are never used. Regulation of homeopathic practitioners and medicines is problematic, the legal position varies between countries. The volume of research is growing steadily. A series of recommendations is made, including modernisation of the terminology of homeopathy, training of more practitioners, a defined research agenda and integration into the medical system.

本讲座试图通过分析消费者意识、顺势疗法产品的销售和分销趋势以及研究出版物来分析顺势疗法近年来取得的进展。顺势疗法药物的销售正在迅速增长,但在整个医药市场中仍然只占很小的一部分。各国联合用药与单一用药的比例差别很大。市场集中在相对较少的几种可用药物上;许多可用的顺势疗法药物从未使用过。顺势疗法从业者和药物的监管是有问题的,各国的法律立场各不相同。研究的数量在稳步增长。提出了一系列建议,包括顺势疗法术语的现代化、更多从业人员的培训、明确的研究议程和融入医疗系统。
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引用次数: 5
Our new title: Homeopathy 我们的新标题是:顺势疗法
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0512
P Fisher
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引用次数: 2
International press abstracts 国际新闻摘要
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0510
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引用次数: 0
Research for whom? 为谁研究?
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0508
Peter Fisher
One of the ‘side-effects’ of evidence-based medicine has been the fetishisation of research, which is sometimes treated as an end in itself. Of course medical practice should be based on evidence of its safety and effectiveness. But lack of evidence of effectiveness is quite different from evidence of lack of effectiveness. The former is often the case with homeopathy, although sceptics frequently interpret it as the latter. Research is not an end in itself, it is a tool, a collection of methods for addressing specific questions. The issue then arises, which questions, asked by whom, should clinical research in homeopathy attempt to answer? Broadly speaking there are three constituencies corresponding to three main categories of questions. The sceptical academic constituency asks ‘is there any evidence that homeopathy is not a placebo effect, that its clinical effects are not entirely attributable to non-specific effects associated with homeopathic treatment: belief, reassurance, advice etc?’ Homeopaths are more likely to pose questions about improving their practice: ‘how can we prescribe better, improve our understanding of materia medica, which prescribing strategies work best etc?’
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引用次数: 23
20 years ago: The British Homoepathic Journal, October 1981 20年前:1981年10月《英国同病杂志》
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0513
ST Land
There are three papers dealing with this vexed subject, each with a different emphasis; but all authors were agreed on three points: that there seems to be some basis for the consideration of constitution in homeopathy; that there have been rather doctrinaire approaches to the concept in the past, resulting in a rigidity of application; and that because of this, there is a danger that it can mislead in the all-important search for the totality of symptoms, the similimum. Dr Anthony Campbell’s paper, The Concept of Constitution in Homoeopathy, expresses the strongest views on the subject. The author quoted extensively from Kent’s writings, to show the latter’s surprisingly ambivalent attitude towards constitutional prescribing. He was obviously exasperated by the doctrinaire attitude of his colleagues. On the discussion of ‘temperaments’ he stated ‘We see many absurd statements in our homoeopathic literature. Many of these statements are the ex-cathedra statements of our ablest men. These are quoted and handed down as accepted and demonstrated wisdom. Our clinical reports are full of these traditional whims.’ His basic belief is very clear ‘The true basis of a homoeopathic remedy is the collection of signs and symptoms, and these must be morbid, has been the teaching of Hahnemann and his ablest followers. And such teaching is the only teaching that conforms to law.’ In fact, he insisted that the person responsible for introducing constitution was not himself, but Hering: ‘Hering introduced temperaments into the materia medica, but temperaments are not in the provings.’ This is all rather difficult to equate with his extensive use of constitutional indications in his ‘drug pictures’. Dr Campbell did not reject the idea of constitution in toto. He accepted that certain types of person may respond particularly well to certain medicines; but he objected to making it the ‘Philosopher’s Stone’. Ignatia and Constitutional Thinking in Homoeopathy, by Georg von Keller is more difficult to follow. He gave extensive descriptions of some unusual and very specific symptoms produced by Ignatia. He opposed the view that ‘constitution’ may be equated with ‘totality of symptoms’, and considered that even a single symptom would suffice if sufficiently specific. He had rather a different way of describing constitution: ‘Every patient is able to produce only the symptoms already pre-existing in the constitution.’ This could explain the variations found in provings. Constitutional Types, Dr DM Foubister’s evaluation of the concept, was read to the Faculty as early as 1968. He gave words of caution in the use of constitutional typing. Too much emphasis can be placed on the polychrests; the inexperienced may attempt to fit patients into types; many patients cannot be so classified; the emphasis needs to be on recent changes; and the remedy might be missed because the constitutional picture is not obvious. The impression gained from all this is that the issue is as much
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引用次数: 0
Treatment for hyperactive children: homeopathy and methylphenidate compared in a family setting 多动症儿童的治疗:顺势疗法和哌甲酯在家庭环境中的比较
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0506
H Frei , A Thurneysen

The sharp increase of the prescription of methylphenidate (MPD) in hyperactive children in recent years is a matter of increasing uneasiness among professionals, parents and politicians. There is little awareness of treatment alternatives. The purpose of this prospective trial was to assess the efficacy of homeopathy in hyperactive patients and to compare it MPD. The study was performed in a paediatric practice with conventional and homeopathic backgrounds. Children aged 3–17 y, conforming to the DSM-IV criteria for attention deficit hyperactivity disorder (ADHD) with a Conners Global Index (CGI) of 14 or higher were eligible for the study. All of them received an individual homeopathic treatment. When clinical improvement reached 50%, the parents were asked to reevaluate the symptoms. Those who did not improve sufficiently on homeopathy were changed to MPD, and again evaluated after 3 months. One hundred and fifteen children (92 boys, 23 girls) with a mean age of 8.3 y at diagnosis were included in the study. Prior to treatment the mean CGI was 20.63 (14–30), the mean index of the homeopathy group 20.52 and of the MPD-group 20.94. After an average treatment time of 3.5 months 86 children (75%) had responded to homeopathy, reaching a clinical improvement rating of 73% and an amelioration of the CGI of 55%. Twenty-five children (22%) needed MPD; the average duration of homeopathic (pre-) treatment in this group was 22 months. Clinical improvement under MPD reached 65%, the lowering of the CGI 48%. Three children did not respond to homeopathy nor to MPD, and one left the study. In cases where treatment of a hyperactive child is not urgent, homeopathy is a valuable alternative to MPD. The reported results of homeopathic treatment appear to be similar to the effects of MPD. Only children who did not reach the high level of sensory integration for school had to be changed to MPD. In preschoolers, homeopathy appears a particularly useful treatment for ADHD.

近年来,多动症儿童服用哌醋甲酯(MPD)的人数急剧增加,这引起了专业人士、家长和政界人士越来越多的不安。人们对其他治疗方法的认识很少。这项前瞻性试验的目的是评估顺势疗法对多动症患者的疗效,并将其与MPD进行比较。该研究在具有传统和顺势疗法背景的儿科实践中进行。符合DSM-IV注意缺陷多动障碍(ADHD)标准且康纳斯全球指数(CGI)为14或更高的3-17岁儿童符合本研究的资格。他们都接受了单独的顺势疗法治疗。当临床改善达到50%时,要求家长重新评估症状。顺势疗法没有充分改善的患者改为MPD,并在3个月后再次评估。115名儿童(92名男孩,23名女孩)被纳入研究,诊断时平均年龄为8.3岁。治疗前平均CGI指数为20.63(14-30),顺势疗法组平均指数为20.52,mpd组平均指数为20.94。平均治疗3.5个月后,86名儿童(75%)对顺势疗法有反应,达到73%的临床改善率和55%的CGI改善率。25名儿童(22%)需要MPD;顺势疗法(前)治疗的平均持续时间为22个月。MPD组临床改善达65%,CGI降低48%。三个孩子对顺势疗法和MPD都没有反应,一个离开了研究。在治疗多动症儿童不紧急的情况下,顺势疗法是MPD的一个有价值的替代方法。报道的顺势疗法治疗的结果似乎与MPD的效果相似。只有在学校没有达到高水平感觉统合的孩子才会被改为MPD。在学龄前儿童中,顺势疗法似乎是一种特别有效的治疗多动症的方法。
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引用次数: 68
Keyword index to volume 90 关键词索引卷90
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0516
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引用次数: 0
International Conference: Reuniting Art with Science; London, 22–23 February 2001 国际会议:艺术与科学的重新结合;2001年2月22日至23日,伦敦
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0509
R van Haselen , P Fisher , F Dantas
The third international research conference in the series ‘Improving the Success of Homeopathy’, orga-nised by the Royal London Homoeopathic Hospital was held at the Royal Pharmaceutical Society, London on 22 – 23 February. The theme was ‘Reuniting Art with Science’. The conference was attended by 123 people from 17 countries. Thanks to the generosity of the British Homeopathic Association, we were able to give financial support to low income attendees from countries such as Romania, the Indian subcontinent, South America and elsewhere, who would not other-wise have been able to attend. The main themes explored were ‘Art and science in homeopathy’, ‘Harvesting the richness of clinical experience’
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引用次数: 0
Very high dilutions of dexamethasone inhibit its pharmacological effects in vivo 非常高的地塞米松稀释会抑制其体内药理作用
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0496
LV Bonamin , KS Martinho , AL Nina , F Caviglia , RGW Do Rio

We evaluated the interaction of dexamethasone 10−17 and 10−33 M (equivalent to 7cH and 15cH) with dexamethasone in pharmacological concentrations, using as experimental models: acute inflammation induced by carrageenan, Ehrlich ascitic tumour, and migration of tumour infiltrating leukocytes (TIL). Male adult BALB/c mice (n=7 per group) were used in all experiments. Carrageenan (1%) was injected into the footpad for oedema evaluation and into the peritoneal cavity (i.p.), for differential counting of inflammatory cells. Ehrlich ascitic tumour cells (107 viable cells/ml) were injected i.p. and tumour cells were counted after 6 days, by the Trypan blue exclusion method. The differential TIL was counted using smears stained by hematoxylin–eosin. Treatments were made immediately after carrageenan inoculation or once a day, during Ehrlich tumour development, until the animals were killed. Animals were treated with the following preparations: (1) phosphate buffer saline (PBS) solution; (2) dexamethasone (0.5 mg/kg for inflammation model or 4 mg/kg for tumour model) mixed with dexamethasone 7cH or 15cH; (3) dexamethasone (same doses) mixed in PBS. Homeopathic dexamethasone partially blocked the anti-inflammatory effect of pharmacological dexamethasone with regard to paw oedema (two-way ANOVA, P≤0.0008) and polymorphonuclear cell migration (χ2, P=0.0001). No important differences were observed between experimental and control groups, in relation to Ehrlich tumour cells viability or count, or bodyweight, but potentised dexamethasone restored control levels of TIL viability, compared to mice treated with pharmacological doses of dexamethasone (χ2, P≤0.001). The results demonstrate that a potentised substance may change its own pharmacological effects and suggest that ultradilutions effects act mostly on host response.

我们评估了地塞米松10 - 17和10 - 33 M(相当于7cH和15cH)与药理浓度的地塞米松的相互作用,使用实验模型:卡拉胶诱导的急性炎症、埃利希腹水肿瘤和肿瘤浸润白细胞(TIL)的迁移。实验均选用雄性成年BALB/c小鼠,每组7只。将卡拉胶(1%)注射到足垫进行水肿评估,并注射到腹膜腔(i.p.)进行炎症细胞的鉴别计数。腹腔注射活细胞107个/ml, 6天后用台盼蓝排斥法计数。用苏木精-伊红染色的涂片计数差异TIL。在接种卡拉胶后立即进行治疗,或在埃利希肿瘤发展期间每天进行一次治疗,直到动物被杀死。用以下制剂处理动物:(1)磷酸盐缓冲盐水(PBS)溶液;(2)地塞米松(炎症模型0.5 mg/kg,肿瘤模型4 mg/kg)与地塞米松7cH或15cH混合;(3)地塞米松(同剂量)与PBS混合。顺势疗法地塞米松部分阻断了药理地塞米松对足跖水肿的抗炎作用(双因素方差分析,P≤0.0008)和多形核细胞迁移(χ2, P=0.0001)。实验组和对照组之间在埃利希肿瘤细胞活力、计数或体重方面没有显著差异,但与药物剂量地塞米松治疗的小鼠相比,增强地塞米松恢复了TIL活力的对照水平(χ2, P≤0.001)。结果表明,一种增强物质可能改变其自身的药理作用,并表明超稀释效应主要作用于宿主反应。
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引用次数: 41
Homeopathy in acute otitis media in children: treatment effect or spontaneous resolution? 顺势疗法治疗儿童急性中耳炎:治疗效果还是自发消退?
Pub Date : 2001-10-01 DOI: 10.1054/homp.1999.0505
H Frei , A Thurneysen

The conventional antibiotic treatment of acute otitis media (AOM) faces a number of problems, including antibiotic resistance. Homeopathy has been shown to be capable of treating AOM successfully. As AOM has a high rate of spontaneous resolution, a trial to prove any treatment-effect has to demonstrate very fast resolution of symptoms. The purpose of this study was to find out how many children with AOM are relieved of pain within 12 h after the beginning of homeopathic treatment, making additional measures unnecessary. Two hundred and thirty children with AOM received a first individualized homeopathic medicine in the paediatric office. If pain-reduction was not sufficient after 6 h, a second (different) homeopathic medicine was given. After a further 6 h, children who had not reached pain control were started on antibiotics. Pain control was achieved in 39% of the patients after 6 h, another 33% after 12 h. This resolution rate is 2.4 times faster than in placebo controls. There were no complications observed in the study group, and compared to conventional treatment the approach was 14% cheaper.

急性中耳炎(AOM)的常规抗生素治疗面临许多问题,包括抗生素耐药性。顺势疗法已被证明能够成功地治疗AOM。由于AOM有很高的自行消退率,因此要证明任何治疗效果的试验必须证明症状的快速消退。本研究的目的是了解有多少AOM患儿在开始顺势疗法治疗后12小时内疼痛得到缓解,无需采取额外措施。230名AOM患儿在儿科办公室接受了第一次个体化顺势疗法药物治疗。如果6小时后疼痛减轻不充分,则给予第二种(不同的)顺势疗法药物。6小时后,没有达到疼痛控制的儿童开始使用抗生素。6小时后39%的患者疼痛得到控制,12小时后又有33%的患者疼痛得到控制。这一解解率比安慰剂对照组快2.4倍。在研究组中没有观察到并发症,并且与传统治疗方法相比,该方法便宜14%。
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引用次数: 86
期刊
British Homoeopathic Journal
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