British Homoeopathic Journal最新文献

This study describes the results obtained from a prospective observational research of homeopathic treatment for patients suffering from headache (migraine with- and without aura and tension-type headache). Fifty-three patients were asked to complete the SF-36 questionnaire at the beginning of the treatment and after 4–6 months. The homeopathic medicine and potency were not pre-defined, but were adapted to each single patient according to individualised homeopathic prescription. Most patients (73.6%) completed the study. There was heterogeneity in the answers (patients in very poor health as well as those with only slight disorders). Analysis of the data according to the concept of ‘intention-to-treat’ showed that after therapy, the mean and median scores of all life quality dimensions rose. More than 60% of the cases experienced an improvement in pain and the limitations caused by pain, as well as in limitations in social activities and health in general. All the differences between pre/post treatment were statistically highly significant, with the strongest results in the ‘bodily pain’ and ‘vitality’ parameters (P<0.0001).

Two homeopathic pathogenetic trials (HPTs, provings), of identical design were conducted: of Acidum malicum 12 cH and Acidum ascorbicum 12 cH. Each trial included 20 healthy volunteers. Both were of double-blind, placebo-controlled, randomised, four period crossover design, with two sequences. ‘Healthy’ was defined in terms of SF-36 scores, medical judgement and blood tests. All volunteers had regular interviews with the same supervisor. No serious adverse reactions occurred. The causal relationship of each symptom with treatment was judged, blind, by the volunteer, the supervisor and a 9-item pathogenetic index. For Acidum malicum 79 symptoms were identified by the supervisor, 57 were included in the final analysis, 22 occurred in verum treatment periods. For Acidum ascorbicum, of 55 symptoms, 39 were included in the analysis. 16 occurred in verum treatment periods.

Alternative therapies in general, and homeopathy in particular, lack clear scientific evaluation of efficacy. Controlled clinical trials are urgently needed, especially for conditions that are not helped by conventional methods. The objective of this work was to assess the efficacy of homeopathic treatment in relieving symptoms associated with premenstrual syndrome (PMS). It was a randomised controlled double-blind clinical trial. Two months baseline assessment with post-intervention follow-up for 3 months was conducted at Hadassah Hospital outpatient gynaecology clinic in Jerusalem in Israel 1992–1994. The subjects were 20 women, aged 20–48, suffering from PMS. Homeopathic intervention was chosen individually for each patient, according to a model of symptom clusters. Recruited volunteers with PMS were treated randomly with one oral dose of a homeopathic medication or placebo. The main outcome measure was scores of a daily menstrual distress questionnaire (MDQ) before and after treatment. Psychological tests for suggestibility were used to examine the possible effects of suggestion. Mean MDQ scores fell from 0.44 to 0.13 (P<0.05) with active treatment, and from 0.38 to 0.34 with placebo (NS). (Between group P=0.057). Improvement >30% was observed in 90% of patients receiving active treatment and 37.5% receiving placebo (P=0.048). Homeopathic treatment was found to be effective in alleviating the symptoms of PMS in comparison to placebo. The use of symptom clusters in this trial may offer a novel approach that will facilitate clinical trials in homeopathy. Further research is in progress.

‘Constitutional types’ are a feature of homeopathy. Constitutions are constellations of mental, physical and general features. We present results of a 152-item ‘Constitutional Type Questionnaire’ (CTQ), relating to 19 major constitutional remedies. Patients referred to the Royal London Homoeopathic Hospital (RLHH) were recruited from outpatient clinics. Each remedy was assigned eight associated features. Each item is rated as it applies to the subject most of the time on a five-point scale. Grade of Membership analysis (GOM) was used for evaluation of remedy profiles. Four hundred and forty-seven individuals provided useable data. Demographic data were collected. A nine pure type solution provided the best fit to the data. Few subjects had exclusive ‘membership’ of one pure type. There are some difficulties in interpretation; for instance some groups were characterised by the absence of ‘constitutional’ features. Some pure types are coherent, recognisable types.

The results give some support to the homeopathic concept of constitution. CTQ results correlate quite well with the actual prescribing of homeopaths. Further validation with other cohorts is required and with refinement it might become a useful screening method. It cannot simulate complex information processing performed by homeopathic practitioners.

Homeopaths believe that a medicine, which causes a particular symptom in a healthy volunteer, will cure a similar symptom in a sick patient. From this phenomenon, it is possible to deduce a hypothesis: homeopaths should be able to distinguish a homeopathic medicine from a placebo by taking both and observing their effects. If true, this would support an effect of homeopathic medicines different from that of placebo. If false, it casts serious doubt on the contemporary homeopathic knowledge base and on homeopathic pathogenetic trials (HPTs) as currently practised. The study design was a double-blinded, crossover trial. It consisted of a 1-week study medication period, a 2-week washout period and a further 1-week on study medication. Bryonia in a 12c potency was chosen as the trial medication. Participants were recruited in the UK from the Faculty of Homeopathy and the Society of Homeopaths and were currently healthy, aged 18 or over with at least three years' clinical experience of homeopathy. Of the 500 recruitment packs despatched, we received 88 responses (17.6%). Seventy homeopaths were randomised of whom 50 completed the trial. In the main analysis 60% correctly identified the bottle containing Bryonia (n=40; 95% confidence interval 43%, 75%; P=0.27). There was evidence of an order effect: subjects were much more likely to think they received active Bryonia in the first rather than the second period. In this study a promising trend was observed that symptoms reported by some homeopaths may not be completely attributable to placebo. A multi-national, large-scale trial will be required to investigate this phenomena with adequate statistical power.