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Dutta S, Ganguly S, Mukherjee SK, Ghosh P, Hazra P, Roy AS, Shaikh AR, Ali SS, Sadhukhan S, Koley M, Saha S. Efficacy of individualized homeopathic medicines in intervening the progression of pre-hypertension to hypertension: A double-blind, randomized, placebo-controlled trial. Explore (NY) 2021; 18:279-286. [PMID: 34147344 DOI: 10.1016/j.explore.2021.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/04/2022]
Abstract
CONTEXT Pre-hypertension remains a significant public health challenge and appropriate intervention is required to stop its progression to hypertension and/or cardiovascular diseases. OBJECTIVE To study the effects of individualized homeopathic medicines (IH) against placebo in intervening with the progression of pre-hypertension to hypertension. DESIGN Double-blind, randomized, two parallel arms, placebo-controlled trial. SETTING Outpatient departments of D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India. PATIENTS Ninety-two patients suffering from pre-hypertension; randomized to receive either IH (n = 46) or identical-looking placebo (n = 46). INTERVENTIONS IH or placebo in the mutual context of lifestyle modification (LSM) advices including dietary approaches to stop hypertension (DASH) and brisk exercises. MAIN OUTCOME MEASURES Primary - systolic and diastolic blood pressure (SBP and DBP); secondary - Measure Yourself Medical Outcome Profile version 2.0 (MYMOP-2) scores; all measured at baseline, and every month, up to 3 months. RESULTS After 3 months of intervention, the number of patients having progression from pre-hypertension to hypertension between groups were similar without any significant differences in between (all P>0.05). Reduction in BP and MYMOP-2 scores were non-significantly higher (all P>0.05) in the IH group than placebo with small effect sizes. Lycopodium clavatum, Thuja occidentalis and Natrum muriaticum were the most frequently prescribed medicines. No harms or serious adverse events were reported from either group. Thus, there was a small, but non-significant direction of effect favoring homeopathy, which ultimately rendered the trial as inconclusive. [Trial registration: CTRI/2018/10/016,026; UTN: U1111-1221-8251].
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Affiliation(s)
- Souvik Dutta
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
| | - Subhasish Ganguly
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Shyamal Kumar Mukherjee
- Principal and Administrator D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Priyanka Ghosh
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Pallavi Hazra
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Aniket Singha Roy
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Abdur Rahaman Shaikh
- Dept. of Practice of Medicine, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Sk Swaif Ali
- Dept. of Practice of Medicine, Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Howrah, Govt. of West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Satarupa Sadhukhan
- Dept. of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Block GE, Sector III, Salt Lake, Kolkata 700106, West Bengal, India; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Munmun Koley
- Dept. of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, Govt. of Uttar Pradesh, affiliated to Dr. Bhimrao Ramji Ambedkar University, Agra, Govt. of Uttar Pradesh), India
| | - Subhranil Saha
- Dept. of Repertory, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
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Sadhukhan S, Singh S, Michael J, Misra P, Parewa M, Nath A, Magotra N, Kundu N, Basu A, Ali SS, Koley M, Saha S. Individualized Homeopathic Medicines in Stage I Essential Hypertension: A Double-Blind, Randomized, Placebo-Controlled Pilot Trial. J Altern Complement Med 2021; 27:515-521. [PMID: 33760643 DOI: 10.1089/acm.2020.0222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Satarupa Sadhukhan
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Kolkata, India
| | - Subhas Singh
- Director, National Institute of Homoeopathy, Kolkata, India
| | - James Michael
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Kolkata, India
| | - Pankhuri Misra
- Department of Materia Medica, National Institute of Homoeopathy, Kolkata, India
| | - Maneet Parewa
- Department of Repertory, National Institute of Homoeopathy, Kolkata, India
| | - Arunava Nath
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Kolkata, India
| | - Nitin Magotra
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Kolkata, India
| | - Nivedita Kundu
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Kolkata, India
| | - Anamika Basu
- Department of Practice of Medicine, Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Government of West Bengal, Howrah, India
| | - Sk Swaif Ali
- Department of Practice of Medicine, Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Government of West Bengal, Howrah, India
| | - Munmun Koley
- Department of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Government of Uttar Pradesh, Lucknow, India
| | - Subhranil Saha
- Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, Kolkata, India
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Van Wassenhoven M. Priorities and methods for developing the evidence profile of homeopathy Recommendations of the ECH General Assembly and XVIII Symposium of GIRI. HOMEOPATHY 2005; 94:107-24. [PMID: 15892493 DOI: 10.1016/j.homp.2005.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
To achieve scientific acceptance, homeopathy must investigate several questions: 1. The activity of very highly diluted preparations. The consensus of the meeting was that there is clear evidence of this. 2. The content of very highly diluted homeopathic preparations. More research is needed but evidence exists that a specific signal is present in homeopathic preparations. 3. A theoretical framework in which the effects of homeopathic diluted preparations can be explained. The 'Body Information Theory' is such a theory. 4. The clinical effectiveness of homeopathy. Because they avoid the placebo effect, animal studies are a priority. For human trials using Quality of Life questionnaires, studies on the activity, content and theoretical basis of homeopathic preparations were reviewed approximately 70% of cases; more in children showed improvement. Homeopathy reduced costs and allowed a better improvement in work-days lost compared with conventional practice. Randomised controlled trials (RCTs) implicitly test the placebo hypothesis; RCTs have been performed and meta-analyses conclude that there is clear evidence of efficacy which cannot be attributed to placebo effect. Priorities depend on the audience. More research is needed especially regarding the content of homeopathic preparations and the transmission of information. Theoretical issues are also important to avoid incorrect design of research protocols. More effort should be dedicated to veterinary research. Clinical effects analysis in humans remains important. Many other questions should be prioritised, such as the potential of homeopathy to avoid invasive procedures in children and the long-term effects of homeopathy in preventing chronic complications.
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Affiliation(s)
- M Van Wassenhoven
- European Committee for Homeopathy, Chaussée de Bruxelles, B-1190 Brussels, Belgium.
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Abstract
BACKGROUND The claims made for the clinical effects of homeopathy are controversial. The results of several meta-analyses of clinical trials are positive, but they fail in general to highlight specific medical conditions that respond well to homeopathy. AIMS This review examines the cumulative research from randomised and/or double-blind clinical trials (RCTs) in homeopathy for individual medical conditions reported since 1975, and asks the question: What is the weight of the original evidence from published RCTs that homeopathy has an effect that is statistically significantly different from that in a comparative group? METHOD Analysis of the 93 substantive RCTs that compare homeopathy either with placebo or another treatment. RESULTS 50 papers report a significant benefit of homeopathy in at least one clinical outcome measure, 41 that fail to discern any inter-group differences, and two that describe an inferior response with homeopathy. Considering the relative number of research articles on the 35 different medical conditions in which such research has been carried out, the weight of evidence currently favours a positive treatment effect in eight: childhood diarrhoea, fibrositis, hayfever, influenza, pain (miscellaneous), side-effects of radio- or chemotherapy, sprains and upper respiratory tract infection. Based on published research to date, it seems unlikely that homeopathy is efficacious for headache, stroke or warts. Insufficient research prevents conclusions from being drawn about any other medical conditions. CONCLUSIONS The available research evidence emphasises the need for much more and better-directed research in homeopathy. A fresh agenda of enquiry should consider beyond (but include) the placebo-controlled trial. Each study should adopt research methods and outcome measurements linked to a question addressing the clinical significance of homeopathy's effects.
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Affiliation(s)
- R T Mathie
- Faculty of Homeopathy, 15 Clerkenwell Close, London, EC1R 0AA, UK.
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Vallance AK. Can biological activity be maintained at ultra-high dilution? An overview of homeopathy, evidence, and Bayesian philosophy. J Altern Complement Med 1998; 4:49-76. [PMID: 9553836 DOI: 10.1089/acm.1998.4.1-49] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Forty percent of general practitioners in the Netherlands practice homeopathy. With over 100 homeopathic medical schools, homeopathy is practiced in India along with conventional Western medicine in government clinics. In Britain, 42% of general practitioners refer patients to homeopaths. Two recent meta-analyses of homeopathy both indicate that there is enough evidence to show that homeopathy has added effects over placebo. Against this evidence is a backdrop of considerable scientific scepticism. Homeopathic remedies are diluted substances--some are so diluted that statistically there are no molecules present to explain their proposed biological effects (ultra-high dilutions or UHDs). Without knowledge of the evidence, most scientists would reject UHD effects because of their intrinsic implausibility in the light of our current scientific understanding. The objective of this article is to critically review the major pieces of evidence on UHD effects and suggest how the scientific community should respond to its challenge. Such evidence has been conducted on a diverse range of assays--immunologic, physiological, behavioral, biochemical, and clinical in the form of trials of homeopathic remedies. Evidence of UHD effects has attracted the attention of physicists who have speculated on their physical mechanisms. Included is a critique of several experiments that form the Benveniste affair which was sparked by a publication in Nature that advocated the existence of UHD effects of anti-immunoglobulin E (IgE) on human basophils, and is the paradigm example of how a controversial phenomenon can split the scientific community. It is argued that if the phenomenon was uncontroversial, the evidence suffices to show that UHD effects exist. However, given that the observations contradict well-established theory, normal science has to be abandoned and scientists need to decide for themselves what the likelihood of UHD effects are. Bayesian analysis describes how scientists ought rationally to change their prior beliefs in the light of evidence. Theories by Kuhn and Lakatos indicate that whether UHD effects are proved or not depends on the beliefs and behaviors of scientists in their communities. This article argues that there is as yet insufficient evidence to drive rational scientists to a consensus over UHD effects, even if they possessed knowledge of all the evidence. The difficulty in publishing high-quality UHD research in conventional journals prevents a fair assessment of UHD effects. Given that the existence of UHD effects would revolutionize science and medicine, and given the considerable empirical evidence of them, the philosophies of science tell us that possible UHD effects warrant serious investigation by conventional scientists and serious attention by scientific journals.
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Affiliation(s)
- A K Vallance
- Medical School Registry, Royal Free Hospital School of Medicine, London, United Kingdom
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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. [PMID: 9310601 DOI: 10.1016/s0140-6736(97)02293-9] [Citation(s) in RCA: 506] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Homeopathy seems scientifically implausible, but has widespread use. We aimed to assess whether the clinical effect reported in randomised controlled trials of homeopathic remedies is equivalent to that reported for placebo. METHODS We sought studies from computerised bibliographies and contracts with researchers, institutions, manufacturers, individual collectors, homeopathic conference proceedings, and books. We included all languages. Double-blind and/or randomised placebo-controlled trials of clinical conditions were considered. Our review of 185 trials identified 119 that met the inclusion criteria. 89 had adequate data for meta-analysis, and two sets of trial were used to assess reproducibility. Two reviewers assessed study quality with two scales and extracted data for information on clinical condition, homeopathy type, dilution, "remedy", population, and outcomes. FINDINGS The combined odds ratio for the 89 studies entered into the main meta-analysis was 2.45 (95% CI 2.05, 2.93) in favour of homeopathy. The odds ratio for the 26 good-quality studies was 1.66 (1.33, 2.08), and that corrected for publication bias was 1.78 (1.03, 3.10). Four studies on the effects of a single remedy on seasonal allergies had a pooled odds ratio for ocular symptoms at 4 weeks of 2.03 (1.51, 2.74). Five studies on postoperative ileus had a pooled mean effect-size-difference of -0.22 standard deviations (95% CI -0.36, -0.09) for flatus, and -0.18 SDs (-0.33, -0.03) for stool (both p < 0.05). INTERPRETATION The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition. Further research on homeopathy is warranted provided it is rigorous and systematic.
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Affiliation(s)
- K Linde
- Münchener Modell, Centre for Complementary Medicine Research, Technische Universität/Ludwig-Maximillans-Universität, München, Germany
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