Fisher Peter, McCarney Rob, Hasford Christian, Vickers Andrew
Royal London Homoeopathic Hospital, London, UK.
Homeopathy. 2006 Oct;95(4):215-22. doi: 10.1016/j.homp.2006.07.006.
To determine the feasibility, in terms of acceptability to patients, physicians and other staff; data return and statistical power of a study to elucidate the relative contributions of specific and non-specific effects in homeopathic treatment of dermatitis.
Randomised, controlled 4-arm trial, 2 arms double-blind.
Outpatient clinic, Royal London Homoeopathic Hospital.
Seventy-five adult patients with dermatitis.
Patients were randomly allocated to: 'fast track' open verum homeopathy, 'fast track' double-blind verum homeopathy, 'fast track' double-blind placebo homeopathy or waiting list control.
One hundred millimeter visual analogue scale of overall symptom severity; 10 point digital scores of sleep, itching, skin condition; weekly 5-point Likert scale of topical steroid use; Dermatology Life Quality Index at entry and completion.
Recruitment was below target, but the study was acceptable to staff and feasible. Blinded patients were more likely to withdraw (P=0.021, chi2 test). After correction for baseline differences and multiple comparisons, no outcome measure showed statistically significant between group differences. Blindness appeared to have a negative effect, but this was confounded by differential withdrawal.
A definitive trial of this design is unlikely to discriminate the relative contributions of the non-specific and specific effects to the outcome of homeopathic treatment of dermatitis, because of patient preference issues.
从患者、医生及其他工作人员的可接受性;数据返回情况以及一项研究的统计学效力方面,确定阐明顺势疗法治疗皮炎中特异性和非特异性效应相对贡献的可行性。
随机对照四臂试验,其中两臂为双盲试验。
伦敦皇家顺势疗法医院门诊。
75名成年皮炎患者。
患者被随机分配至:“快速通道”开放的顺势疗法真药组、“快速通道”双盲的顺势疗法真药组、“快速通道”双盲的顺势疗法安慰剂组或等待名单对照组。
整体症状严重程度的100毫米视觉模拟量表;睡眠、瘙痒、皮肤状况的10分数字评分;局部类固醇使用的每周5点李克特量表;入组时和结束时的皮肤病生活质量指数。
招募人数未达目标,但该研究为工作人员所接受且可行。双盲患者更有可能退出(P = 0.021,卡方检验)。在校正基线差异和进行多重比较后,没有观察指标显示组间差异具有统计学显著性。双盲似乎有负面影响,但这因不同的退出情况而混淆。
由于患者偏好问题,这种设计的确定性试验不太可能区分非特异性和特异性效应在顺势疗法治疗皮炎结果中的相对贡献。