Teut Michael, Dahler Joern, Hirschberg Ute, Luedtke Rainer, Albrecht Henning, Witt Claudia M
Trials. 2013 Apr 5;14:96. doi: 10.1186/1745-6215-14-96.
Homeopathic drug proving is a basic concept in homeopathy. This study aimed to record symptoms produced by a homeopathic drug compared with placebo.
This multicentre, randomised, double-blind, placebo-controlled phase 1 trial consisted of a 7-day run-in period, a 5-day intervention period and a 16-day post-intervention observation period. Subjects, investigators and statisticians were blinded for intervention groups and identity of the homeopathic drug. Subjects in the intervention group received Okoubaka aubrevillei (potency C12) and subjects in the placebo group received the optically identical sucrose globules. Dosage in both groups was five globules taken five times per day over a maximum period of 5 days. Subjects documented the symptoms they experienced in a semistructured online diary. The primary outcome parameter was the number of characteristic proving symptoms compared with placebo after a period of 3 weeks. Characteristic symptoms were categorised using content analysis. Secondary outcome parameters were the qualitative differences in profiles of characteristic and proving symptoms and the total number of all proving symptoms. The number of symptoms was quantitatively analysed on an intention-to-treat basis using analyses of covariance with the subject's expectation and baseline values as covariates.
Thirty-one subjects were included (19 Okoubaka and 12 placebo). Data for 29 participants could be analysed. No significant differences in number of characteristic symptoms in both groups were observed between Okoubaka (mean±standard deviation 5.4±6.0) and placebo (4.9±5.6). The odds ratio for observation of a characteristic symptom was 1.11 (95% confidence interval 0.4 to 3.05, P=0.843). Females and subjects expecting a higher number of symptoms at baseline or feeling more sensitive to homeopathic drugs experienced more characteristic symptoms regardless of allocation. The qualitative analysis showed an inter-coder reliability of 0.69 (95% confidence interval 0.62 to 0.76). The qualitative comparison of symptom profiles was inconclusive.
Combined results of qualitative and quantitative methods did not result in a significant difference of characteristic proving symptoms between O. aubrevillei C12 and placebo. The qualitative comparison of the symptom profiles leaves some open questions. The nocebo effect might be a plausible explanation for most of the phenomena observed in this trial.
ClinicalTrials.gov: NCT01061229.
顺势疗法药物验证是顺势疗法的一个基本概念。本研究旨在记录与安慰剂相比,顺势疗法药物所产生的症状。
这项多中心、随机、双盲、安慰剂对照的1期试验包括一个7天的导入期、一个5天的干预期和一个16天的干预后观察期。受试者、研究者和统计人员对干预组和顺势疗法药物的身份均不知情。干预组的受试者服用奥库巴卡(效力C12),安慰剂组的受试者服用外观相同的蔗糖小球。两组的剂量均为每天服用5次,每次5个小球,最长服用5天。受试者在半结构化的在线日记中记录他们所经历的症状。主要结局参数是3周后与安慰剂相比的特征性验证症状数量。使用内容分析法对特征性症状进行分类。次要结局参数是特征性症状和验证症状概况的定性差异以及所有验证症状的总数。症状数量在意向性分析基础上进行定量分析,使用协方差分析,将受试者的期望和基线值作为协变量。
纳入31名受试者(19名服用奥库巴卡,12名服用安慰剂)。可对29名参与者的数据进行分析。奥库巴卡组(均值±标准差5.4±6.0)和安慰剂组(4.9±5.6)在特征性症状数量上未观察到显著差异。观察到特征性症状的优势比为1.11(95%置信区间0.4至3.05,P = 0.843)。无论分配情况如何,女性以及基线时预期症状数量较多或对顺势疗法药物感觉更敏感的受试者经历的特征性症状更多。定性分析显示编码者间信度为0.69(95%置信区间0.62至0.76)。症状概况的定性比较尚无定论。
定性和定量方法的综合结果表明,奥库巴卡C12与安慰剂之间在特征性验证症状方面无显著差异。症状概况的定性比较留下了一些未解决的问题。对于本试验中观察到的大多数现象,反安慰剂效应可能是一个合理的解释。
ClinicalTrials.gov:NCT01061229。