Forschende Komplementarmedizin最新文献

Background: Upper respiratory tract infections (URTI) are very common and associated with considerable healthcare costs. We evaluated the clinical benefit of a homeopathic add-on therapy.

Patients and methods: In this randomized controlled multinational clinical trial, patients (age range 1-65 years) with feverish URTI received either on-demand symptomatic standard treatment (ST group: paracetamol, ambroxol, and/or oxymetazoline), or homeopathic medication (IFC group: Influcid®) for 7 days plus the same on-demand standard treatment. URTI symptoms were assessed using the Wisconsin Upper Respiratory Symptom Survey-21. Response at day 4, defined as absence of fever and absence or very mild degree of URTI symptoms, was the primary outcome measure.

Results: 523 patients (265 IFC group, 258 ST group) were randomized in 12 Ukrainian and 10 German centers. The responder rate on day 4 was 15.4% in the IFC group and 6.7% in the ST group (x0394;IFC-ST = 8.7%, 95% confidence interval 2.9-14.5%). The IFC group used less symptomatic medication, and symptoms were alleviated 1-2 days earlier. 3 and 8 adverse events (AEs) in the IFC and ST group, respectively, were assessed as possibly treatment-related; 2 out of the 3 AEs in the IFC group were possibly related to symptomatic therapy, 1 (vomiting) to IFC treatment.

Conclusion: The homeopathic treatment shortened URTI duration, reduced the use of symptomatic medication, and was well tolerated.

Background: The present study investigated the effect of fenugreek seeds powder and its alcoholic extract on metabolic activity of drug-metabolizing enzymes CYP2D6 and CYP3A4.

Materials and methods: Dextromethorphan (DEX) was used as a probe for measuring metabolic activity, based on its CYP2D6- and CYP3A4-mediated metabolism to dextrorphan (DOR) and 3-methoxymorphinan (3-MM), respectively. For the in vitro investigations, DEX (25µM) was incubated with human liver microsomes and NADPH and tested with and without the fenugreek extract. For the in vivo study, phase I, 6 subjects received a single dose of DEX (30 mg); in phase II, after washout period, the fenugreek seeds powder was administered for 1 week and DEX was administered with its last dose.

Results: In vitro, fenugreek extract inhibits CYP2D6-mediated O-demethylation of DEX. Higher concentrations (50 and 100µg/ml) of extract inhibit CYP2D6 and CYP3A4 activity. In vivo results indicated that fenugreek does not significantly inhibit CYP2D6 and CYP3A4 metabolic activity. There was no significant change in the levels of DEX metabolites (DOR 12% and 3-MM 9%) excreted in urine and their urine metabolic ratios (P values: 0.257 and 0.333 DEX/DOR and DEX/3-MM, respectively).

Conclusion: In vitro and in vivo observations suggested that fenugreek may not have substantial effect on the metabolic activity of CYP2D6 and CYP3A4.

Background: Deriving clinical indications for the HIV nosode by conducting a double-blind, placebo-controlled homeopathic pathogenetic trial (HPT) with the aim to introduce a new nosode to the profession.

Method: The HPT was conducted in 22 volunteers, 15 of which received HIV nosode in 30c potency pills, while 7 received identical placebo pills orally, once a week, for 4 weeks. The volunteers' symptoms during initial 7 days of run-in period were noted. All symptoms for both groups produced during run-in period were excluded from final analysis. Informed consent form, approval by Ethics Committee, laboratory investigations as well as safety and ethical measures were provided. The volunteers were trained to write data in prescribed diaries, and the data were analyzed.

Results: The HPT of the HIV nosode exhibited qualitatively distinct symptoms, which can be applied in clinical practice. Number of symptoms reported in verum group was 130, in placebo group 60. Quantitative pathogenetic index was 0.285 in verum group, 0.238 in placebo group; qualitative pathogenetic index was 0.1402 in the verum group as compared to placebo (0.0907). Safe use was documented.

Conclusion: This study brought in guiding symptoms, which will help the profession to employ this nosode in practice.

Background: Several homeopathic remedies are applied in the treatment of periodontal inflammation. However, little is known about their basic active principles. Therefore, we aimed at investigating the effects of homeopathic drugs in periodontal inflammation by observing lymphocyte migration activity in vitro.

Material and methods: Lymphocytes from blood samples of 3 periodontitis patients and 3 matched healthy volunteers were extracted and embedded in collagen matrix migration assays together with highly diluted (D12 and C200) aqueous extracts from Mercurius solubilis, Silicea, Sulphur, Tuberculinum, or placebo. Lymphocyte migration and lymphocyte speed were observed in a 60-min time frame. Statistical analysis was performed using univariate statistics and SiZer time series analysis.

Results: While C-dilutions did not reveal clear differences between placebo and substances, strong effects were observed in D-dilutions compared to placebo. The strongest effects were achieved in lymphocytes exposed to Sulfur D12. While most specific effects were observed in Sulphur D12 showing an activating effect on periodontitis patient lymphocytes (mean activity: 11,1% (placebo) vs. 23,8% (verum)), there was no effect in healthy volunteers (25,8% (placebo) vs. 25,6% (verum)). SiZer analysis confirmed this effect to be significant.

Conclusion: The basic active principles of highly diluted substances are still a matter of controversial debate. Although conclusions are limited due to low sample size, results from our pilot study might encourage further investigations on the role of highly diluted Sulphur in the treatment of periodontitis. Apart from a reproduction study with Sulphur, other immunological experiments, i.e. the investigation of cell limes via flow cytometry, should be performed to underpin these results.

Background: Bryophyllum pinnatum has been introduced in anthroposophic medicine in Europe and is nowadays also widely used in conventional medicine. The aim of this study was to assess the prescriptions in the field of gynaecology and obstetrics in Switzerland and to document potential effects and possible adverse events of B. pinnatum.

Patients and methods: Private practices and clinics for obstetrics and gynaecology were asked to document each prescription of B. pinnatum for their female patients during 31 months with an online questionnaire.

Results: At the University Hospital Zurich, at the Cantonal Hospital Winterthur as well as at 2 private practices, a total of 174 women and 208 prescriptions of B. pinnatum were recorded (several prescriptions per patient were possible). Most of the patients were pregnant (87%). B. pinnatum was prescribed as a tocolytic agent to 83% of all patients and to 95% of all pregnant patients and showed a good or a very good effectiveness. Further, 14% of the patients received B. pinnatum for sedation against their restlessness during the day and 5% for sedation against sleep problems. A decrease of the restlessness was achieved for these 2 indications. 13% of the patients suffered from a hyperactive bladder and in two-thirds of them the effectiveness of the treatment with B. pinnatum was classified as very good. In 92% of the cases, Bryophyllum 50% chewable tablets were prescribed.

Conclusions: In conventional gynaecology and obstetrics, B. pinnatum is predominantly prescribed for pregnant women in case of prematurel abour, against restlessness and for hyperactive bladder. B. pinnatum showed a good effectiveness with a high benefit in the treatment of hyperactivity-associated health problems.

Background: Seasonal allergic rhinitis (SAR), also known as hay fever, is a widespread chronic respiratory disease. In treatment of SAR the use of complementary therapies is increasing, but little has been published about homeopathic complex remedies so far. Therefore, we think it is time to conduct and publish an appropriate observational study.

Methods: Course of single symptoms, impairment of quality of life, general efficacy, and tolerability of a homeopathic complex remedy containing active substances on a low dilution level have been assessed and analyzed. Altogether, 123 patients with a history of allergic rhinitis of up to 45 years have been observed for about 4 weeks.

Results: The majority of symptoms were shown to improve substantially and the patients' quality of life increased clearly. The overall symptom score decreased significantly from 10.3 ± 4.7 to 3.9 ± 3.1 points (p < 0.0001), and reduction of impairment of quality of life from 5.7 ± 2.3 to 1.9 ± 1.8 score points was also significant (p < 0.0001). Rating of efficacy of study medication was markedly better than efficacy rating of previous therapies (p = 0.0193). Apart from one temporary allergic reaction, the treatment was well tolerated.

Conclusion: The homeopathic complex remedy (Pascallerg®) tested in this observational study offers a useful option in treatment of SAR in children and adults.

We aimed to evaluate if acupuncture can improve clinical benefits and patient satisfaction after gynaecological surgery supported by enhanced recovery after surgery (ERAS) programmes. Therefore, we evaluated patient as well as clinical outcome in patient recovery after surgery. We searched MEDLINE, PubMed and EMBASE for articles dealing with post-operative acupuncture and extracted 9 suitable studies. We expected acupuncture to alleviate surgical stress, reduce emetic symptom and accelerate recovery from complications in pre-, intra-, and post-operative phases. Gastrointestinal motility and coldness achieved the full improvement rate of 50%. With regard to post-operative nausea and vomiting, 3 studies showed more than 30% and 1 showed 16% improvement. Sore throat and urinary retention achieved a mild improvement rate of 16% and 12%, respectively. In this study, we demonstrated that acupuncture can enhance recovery in gynaecological surgery without adverse effects and thus should be considered in ERAS.

Background: In the context of the first-time evaluation of the quality and problems of integrative postgraduate medical training (PGMT) at German and Swiss anthroposophic hospitals, all 240 trainees and all 214 trainers were asked to propose options for problem solutions.

Method: The study included a cross-sectional questionnaire survey with sections for further comments. The data were evaluated with qualitative content analysis (Mayring). 56 (51.8%) out of 108 responding trainees and 54 (54%) out of 100 responding trainers had given potential solutions. Both groups were analyzed together.

Results: On internal level, recommendations comprised re-orientation on a leadership basis, i.e. elevation of PGMT to a core element of hospital policy in anthroposophic medicine (AM), as well as better personnel policy; trainers with more professional and teaching competency in AM; structured and extended continual education program; coordination of PGMT with ward and hospital organization; and work load reduction for physicians through process optimization and resource planning. Externally, the recommendations embraced financial support; external training programs; networking of anthroposophic hospitals in PGMT; implementation of a common competence center for anthroposophic PGMT; conventional and anthroposophic PGMT curriculums; and improvement of science base and public discourse of AM.

Conclusion: The proposed options for problem solving in PGMT at anthroposophic hospitals emerge from concrete problem perceptions of the trainers and trainees. They can serve as a basis for concrete improvements of PGMT in AM that could be implemented professionally and in an international context. The preconditions for this are given through the already existing establishment of AM at universities and through the good international connections of anthroposophic hospitals and anthroposophic physicians' associations.

Background: The aim of this study was to investigate whether the combination of conventional treatment and Panax notoginseng (PN group) is superior to conventional treatment alone (CG group) in reducing the clinical symptoms of patients with multiple fractured ribs and pulmonary contusions.

Patients and methods: We retrospectively analyzed the medical records of patients treated for multiple fractured ribs and pulmonary contusions with either conventional treatment (n = 17) or P. notoginseng (n = 18). Visual analog scale (VAS) pain scores and arterial oxygen saturation were measured at baseline and at 1 and 2 weeks following treatment. The duration of mechanical ventilation, systemic analgesics, and hospital stay were also recorded.

Results: VAS scores in the PN group were lower than in the CG group at 1 week (p < 0.01) and at 2 weeks (p < 0.05). Arterial oxygen saturation in both groups was higher after treatment than at baseline (p < 0.05), but there was no statistically significant difference between the 2 groups (p > 0.05). The duration of mechanical ventilation, systemic analgesics administration, and hospital stay in the PN group was remarkably decreased as compared to the CG group (p < 0.05).

Conclusion: Combining conventional treatment and P. notoginseng seems to be an efficient method that can improve the clinical symptoms of multiple fractured ribs and pulmonary contusions.