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顺势疗法的批判性概述。

A critical overview of homeopathy.

作者信息

Jonas Wayne B, Kaptchuk Ted J, Linde Klaus

机构信息

Samueli Institute for Information Biology, 121 South Saint Asaph Street, Suite 200, Alexandria, VA 22314, USA.

出版信息

Ann Intern Med. 2003 Mar 4;138(5):393-9. doi: 10.7326/0003-4819-138-5-200303040-00009.

Abstract

Homeopathy is a 200-year-old therapeutic system that uses small doses of various substances to stimulate autoregulatory and self-healing processes. Homeopathy selects substances by matching a patient's symptoms with symptoms produced by these substances in healthy individuals. Medicines are prepared by serial dilution and shaking, which proponents claim imprints information into water. Although many conventional physicians find such notions implausible, homeopathy had a prominent place in 19th-century health care and has recently undergone a worldwide revival. In the United States, patients who seek homeopathic care are more affluent and younger and more often seek treatment for subjective symptoms than those who seek conventional care. Homeopathic remedies were allowed by the 1939 Pure Food and Drug Act and are available over the counter. Some data--both from randomized, controlled trials and laboratory research--show effects from homeopathic remedies that contradict the contemporary rational basis of medicine. Three independent systematic reviews of placebo-controlled trials on homeopathy reported that its effects seem to be more than placebo, and one review found its effects consistent with placebo. There is also evidence from randomized, controlled trials that homeopathy may be effective for the treatment of influenza, allergies, postoperative ileus, and childhood diarrhea. Evidence suggests that homeopathy is ineffective for migraine, delayed-onset muscle soreness, and influenza prevention. There is a lack of conclusive evidence on the effectiveness of homeopathy for most conditions. Homeopathy deserves an open-minded opportunity to demonstrate its value by using evidence-based principles, but it should not be substituted for proven therapies.

摘要

顺势疗法是一种有200年历史的治疗体系,它使用小剂量的各种物质来刺激自身调节和自我修复过程。顺势疗法通过将患者的症状与这些物质在健康个体中产生的症状相匹配来选择物质。药物通过 serial dilution(连续稀释)和摇晃制备,支持者声称这会将信息印记到水中。尽管许多传统医生认为这些观念难以置信,但顺势疗法在19世纪的医疗保健中占有重要地位,并且最近在全球范围内复兴。在美国,寻求顺势疗法治疗的患者比寻求传统治疗的患者更富裕、更年轻,并且更常因主观症状寻求治疗。顺势疗法药物在1939年的《纯净食品和药品法案》中被允许使用,并且可以在柜台购买。一些数据——来自随机对照试验和实验室研究两者——显示顺势疗法药物的效果与当代医学的理性基础相矛盾。三项关于顺势疗法的安慰剂对照试验的独立系统评价报告称,其效果似乎不止是安慰剂,而一项评价发现其效果与安慰剂一致。也有随机对照试验的证据表明顺势疗法可能对治疗流感、过敏、术后肠梗阻和儿童腹泻有效。有证据表明顺势疗法对偏头痛、延迟性肌肉酸痛和预防流感无效。对于大多数病症,缺乏关于顺势疗法有效性的确凿证据。顺势疗法值得有一个开明的机会,通过使用循证原则来证明其价值,但它不应替代已被证实的疗法。

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