Homeopathy

Homeopathy

اسلاید 1: www.tabaye.ir

اسلاید 2: HomeopathyEleanor BatesTinsley Harrison SocietyNovember 8, 2005

اسلاید 3: Complementary and Alternative MedicineTraditional Alternative MedicineAcupuncture AyurvedaHomeopathyNaturopathyChinese/OrientalMind-Body InterventionsCognitive Behavioral TherapyMeditationBiofeedbackHypnosisPrayerArt, Music, DanceBiologically Based TherapiesDietary SupplementsHerbal MedicineManipulative and Body-Based MethodsChiropracticsMassageEnergy TherapiesElectromagnetic Therapy

اسلاید 4: Complementary and Alternative Medicine36% of adults are using some form of CAMCAM is used greater by WomenPeople with higher educational levelsPeople who have been hospitalized in the past yearFormer smokers

اسلاید 5: RegulationThe National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Governments lead agency for scientific research on CAM.Homeopathy is regulated by the US Food and Drug Administration (FDA).Required to list indications, ingredients, dilutions, and instructions for safe use

اسلاید 6: History of HomeopathyLate 1700’s – developed in Germany by Samuel Hahnemann1825 – Introduced in the US by Hans Burch Gram1835 – 1st homeopathic medical college – Allentown, PennsylvaniaBy the turn of the 20th century, 8 % of all American medical practitioners were homeopaths, and there were 20 homeopathic medical colleges and more than 100 homeopathic hospitals in the United States.Negatively affected by medical advances, including recognition of the mechanisms of disease and antiseptic techniquesBegan to revive in the 1960’s

اسلاید 7: HomeopathyHomeo (similar) and pathos (suffering)“Principle of Similars”: Any substance that can create symptoms in a healthy person can be used to treat similar symptoms in a sick person.“Principle of Potentization”: Diluting a substance, with vigorous shaking at each step of dilution, makes the remedy more, not less, effective by extracting the vital essence of the substance.

اسلاید 8: MechanismWater molecules are thought to form clusters that may be unique to the original substance that was dissolved. Samal and Geckeler discovered an inverse relationship between the aggregate size and concentration of the solutes.On dilution, spherical clusters appeared, which were seen to aggregate in steps resulting in a size increase with decreasing concentration.Samal S and Geckeler KE. Chem Commun 2001; 2224-25.

اسلاید 9: TreatmentMostly derived from natural substances that come from plants, minerals, or animals Used to treat acute and chronic illnesses, as well as to prevent diseasesUsed most often to treat arthritis, asthma, colds, flu, and allergiesThe choice of medicine is based on a person’s total symptom picture.Homeopathic Pharmacopoeia of the United States contains guidelines for homeopathic remedies.

اسلاید 10: TreatmentFollow-up on problem in 2-6 weeks after start of the treatmentPatients may experience homeopathic aggravation.Doses are repeated as necessary, and treatment is discontinued upon resolution of the problem.Remedies may be changed as the condition and the associated symptoms change.Changes to diet and lifestyle are often recommended, as well.

اسلاید 11: SafetyEndrezzi et al. studied adverse drug events related to homeopathic encounters in 335 follow-up visits in 181 patients. 9 (2.68%) adverse reactions were reported.No medical therapy was required to treat any of the adverse events.Adverse events exist, but are rare and not severe.Endrizzi C et al. Homeopathy 2005; 94: 233-240.

اسلاید 12: Does it Work?Results of controlled trials have been contradictory.

اسلاید 13: Not placeboPatient assessment: Greater improvement after homeopathic versus conventional treatmentPhysician assessment: More favorable for children who had received homeopathic treatmentWitt C et al. Comp Ther Med 2005; 13: 79-86. Witt et al. compared conventional treatment versus homeopathy.

اسلاید 14: Quality of life:Physical component score increased in homeopathically treated patientsMental component no significant differenceWitt C et al. Comp Ther Med 2005; 13: 79-86.

اسلاید 15: Not placebo89 studiesOR 2.45 (2.05-2.93) in favor of homeopathy26 studies of higher qualityOR 1.66 (1.33-2.08)Homeopathy not completely due to placeboInsufficient evidence that any single type of homeopathic treatment is clearly effective in any one clinical conditionLinde K et al. Lancet 1997; 350: 834-43.

اسلاید 16: Not placeboLinde et al. revisited their initial study (1997).Higher quality studies tended to yield less positive results.All studies: OR 2.45 (2.05-2.93)Jadad > 3: OR 1.81(1.41-2.32) – 28% decreaseIVS > 5: OR 1.97 (1.50-2.59) – 22% decreaseJadad > 3 AND IVS > 5: OR 1.72 – 30% decrease“…likely that our meta-analysis at least overestimated the effects of homeopathic treatments.”Linde K et al. J Clin Epidemiol 1999; 52; 631-36.

اسلاید 17: Linde K et al. J Clin Epidemiol 1999; 52; 631-36.

اسلاید 18: PlaceboShang et al. compared trials of homeopathy with those of conventional medicine and estimated treatment effects.They found no convincing evidence that homeopathy was superior to placebo OR 0.88 (0.65-1.19)Whereas, for conventional medicine, a significant difference was found.OR 0.58 (0.39-0.85)Clinical effects of homeopathy are placebo effects.Shang A et al. Lancet 2005; 366: 726-32.

اسلاید 19: ConclusionsAlthough trials of homeopathic treatment have not yet provided a definitive answer, there are many reports of clinical benefit.In addition, dismissal of homeopathy by practicing clinicians may increase the likelihood that patients will not communicate about integrative remedies. If homeopathy appears to be helpful and safe, then scientifically valid explanations or proofs of this alternative system of medicine may not be necessary.

اسلاید 20: Resourceshttp://nccam.nih.gov/Endrizzi C, Rossi E, Crudeli L, Garibaldi D. Harm in homeopathy: Aggravations, adverse drug events or medication errors? Homeopathy 2005; 94: 233-240.Frye, JC. Herbal and homeopathic medicine: Understanding the difference. Seminars in Integrative Medicine 2003; 1: 158-66.Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges LV, Jonas WB. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997; 350: 834-43.Linde K, Scholz M, Ramirez G, Clausius N, Melchart D, Jomas WB. Impact of study quality on outcome in placebo-controlled trials of homeopathy. J Clin Epidemiol 1999; 52; 631-36.Samal S and Geckeler KE. Unexpected solute aggregation in water on dilution. Chem Commun 2001; 2224-25.Shang A, Huwiler-Műntener K, Nartey L, Jűni P, Dörig S, Sterne JAC, Pewsner D, Egger M. Are the clinical effects of homeopathy placebo effects? Comparitive study of placebo-controlled trials of homeopathy and allopathy. Lancet 2005; 366: 726-32. Vickers A and Zollman C. ABC of complementary medicine: Homeopathy. BMJ 1999; 319: 1115-18.Witt C, Keil T, Dagmar S, Roll S, Vance W, Wegscheider K, Willich SN. Outcome and costs of homeopathic and conventional treatment strategies: A comparative cohort study in patients with chronic disorders. Comp Ther Med 2005; 13: 79-86.