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Raak CK, Scharbrodt W, Berger B, Büssing A, Schönenberg-Tu A, Martin DD, Robens S, Ostermann T. Hypericum perforatum to Improve Postoperative Pain Outcome After Monosegmental Spinal Sequestrectomy (HYPOS): Results of a Randomized, Double-Blind, Placebo-Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:407-417. [PMID: 35171041 DOI: 10.1089/jicm.2021.0389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: Patients undergoing lumbar spine surgery often suffer from severe radicular postoperative pain leading to the prescription of high-dose opioids. In Integrative Medicine, Hypericum perforatum is known as a remedy to relieve pain caused by nerve damage. Objectives: This trial investigated whether homeopathic Hypericum leads to a reduction in postoperative pain and a decrease in pain medication compared with placebo. Design: Randomized double blind, monocentric, placebo controlled clinical trial. Settings/Location: Department of Neurosurgery, Community Hospital Herdecke. Subjects: Inpatients undergoing lumbar sequestrectomy surgery. Interventions: Homeopathic treatment versus placebo in addition to usual pain management. Outcomes Measures: Primary endpoint was pain relief measured with a visual analog scale. Secondary endpoints were the reduction of inpatient postoperative analgesic medication and change in sensory and affective pain perception. Results: Baseline characteristics were comparable between the groups. Pain perception between baseline and day 3 did not significantly differ between the study arms. With respect to pain medication, total morphine equivalent doses did not differ significantly. However, a statistical trend and a moderate effect (d = 0.432) in the decrease of pain medication consumption in favor of the Hypericum group was observed. Conclusion: This is the first trial of homeopathy that evaluated the efficacy of Hypericum C200 after lumbar monosegmental spinal sequestrectomy. Although no significant differences between the groups could be shown, we found that patients who took potentiated Hypericum in addition to usual pain management showed lower consumption of analgesics. Further investigations, especially with regard to pain medication, should follow to better classify the described analgesic reduction. Clinical Trial Registration Number: German Clinical Trials Register No: DRKS00007913.
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Affiliation(s)
- Christa K Raak
- Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany.,Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, Herdecke, Germany
| | - Wolfram Scharbrodt
- Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, Herdecke, Germany
| | - Bettina Berger
- Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany
| | - Arndt Büssing
- Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany
| | - Anna Schönenberg-Tu
- Integrative Neuromedicine, Community Hospital Herdecke, Witten/Herdecke University, Herdecke, Germany
| | - David D Martin
- Institute of Integrative Medicine, Witten/Herdecke University, Herdecke, Germany
| | - Sibylle Robens
- Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Witten, Germany
| | - Thomas Ostermann
- Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Witten, Germany
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Abstract
Personalized medicine is based on intraspecies differences. It is axiomatic that small differences in genetic make-up can result in dramatic differences in response to drugs or disease. To express this in more general terms: in any given complex system, small changes in initial conditions can result in dramatically different outcomes. Despite human variability and intraspecies variation in other species, nonhuman species are still the primary model for ascertaining data for humans. We call this practice into question and conclude that human-based research should be the primary means for obtaining data about human diseases and responses to drugs.
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Affiliation(s)
| | - Andre Menache
- Americans For Medical Advancement, 2251 Refugio Rd, Goleta, CA 93117, USA
| | - Mark J Rice
- Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610-0254, USA
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Greek R, Shanks N. Complex systems, evolution, and animal models. STUDIES IN HISTORY AND PHILOSOPHY OF BIOLOGICAL AND BIOMEDICAL SCIENCES 2011; 42:542-544. [PMID: 22035727 DOI: 10.1016/j.shpsc.2011.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 03/31/2011] [Accepted: 07/03/2011] [Indexed: 05/31/2023]
Abstract
In this paper, we respond to arguments made concerning our position regarding animal models (Shelley, 2010) by briefly examining the fact that animals (human and nonhuman) are complex systems that have different evolutionary trajectories. This historical fact has implications for using animals as predictive models for human response to drugs and disease.
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Affiliation(s)
- Ray Greek
- Americans For Medical Advancement, 2251 Refugio Rd, Goleta, CA 93117, USA.
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Rice MJ. The institutional review board is an impediment to human research: the result is more animal-based research. Philos Ethics Humanit Med 2011; 6:12. [PMID: 21649895 PMCID: PMC3127833 DOI: 10.1186/1747-5341-6-12] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 06/07/2011] [Indexed: 05/15/2023] Open
Abstract
Biomedical research today can be generally classified as human-based or nonhuman animal-based, each with separate and distinct review boards that must approve research protocols. Researchers wishing to work with humans or human tissues have become frustrated by the required burdensome approval panel, the Institutional Review Board. However, scientists have found it is much easier to work with the animal-based research review board, the Institutional Animal Care and Use Committee. Consequently, animals are used for investigations even when scientists believe these studies should be performed with humans or human tissue. This situation deserves attention from society and more specifically the animal protection and patient advocate communities, as neither patients nor animals are well served by the present situation.
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Affiliation(s)
- Mark J Rice
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL 32610-0254, USA.
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