Department of Homeotherapy, Heidenheim Hospital, Teaching Hospital of The University of Ulm, Schloßhaustraße 100, 89522 Heidenheim, Germany.
Evid Based Complement Alternat Med. 2013;2013:578274. doi: 10.1155/2013/578274. Epub 2013 May 22.
Introduction. The aim of the presented observational case series was to evaluate the experience in treating patients with community-acquired pneumonia (CAP) within integrative medicine, particularly anthroposophic medicine in a well-experienced and specialized unit. Patients and Methods. Patients with proven CAP were evaluated (CAP-study group) based on a retrospective chart review. To estimate the severity of pneumonia, the pneumonia severity index (PSI) was applied. Treatment efficacy was evaluated regarding body temperature, CRP level, leukocytes blood count, the need to be treated on ICU, and mortality. Results were compared with the inpatient data of the Pneumonia PORT Validation Cohort. Results. 15/18 patients of the CAP-study group belonged to risk class groups I-III (low and moderate risk), 2 patients to risk class IV, and one patient to risk class V (severe pneumonia). 16/18 patients were treated with anthroposophic medicine only and 2/18 got additionally antibiotic therapy (both of risk class IV). A significant reduction of body temperature, CRP level, and leukocytes blood count has been obtained by applying anthroposophic medicine, while neither complications nor pneumonia-related death occurred. Compared with the control group there was no significant difference in mortality rate, whereby no patient had to be treated on the ICU, but the duration of hospital stay was significantly longer in the presented series. Conclusion. Inpatient treatment of CAP with anthroposophic medicine without the use of antibiotics may achieve reasonable results in selected cases. Additional larger sized prospective controlled trials should further clarify the role of AM in the treatment of CAP.
简介。本观察性病例系列研究的目的是评估在综合医学（尤其是人智学医学）领域中治疗社区获得性肺炎（CAP）患者的经验，尤其是在经验丰富和专业的单位中。通过回顾病历评估确诊为 CAP 的患者（CAP 研究组）。为了评估肺炎的严重程度，应用肺炎严重指数（PSI）。根据体温、C 反应蛋白（CRP）水平、白细胞计数、是否需要入住 ICU 以及死亡率来评估治疗效果。结果与肺炎 PORT 验证队列的住院数据进行了比较。结果。CAP 研究组的 18 例患者中，15 例属于风险等级 I-III 组（低危和中危），2 例属于风险等级 IV 组，1 例属于风险等级 V 组（重症肺炎）。18 例患者中，16 例仅接受人智学医学治疗，2 例接受人智学医学加抗生素治疗（均属于风险等级 IV 组）。应用人智学医学治疗后，体温、CRP 水平和白细胞计数显著降低，且未发生并发症或肺炎相关死亡。与对照组相比，死亡率无显著差异，无患者需要入住 ICU，但本研究中住院时间明显延长。结论。在不使用抗生素的情况下，采用人智学医学治疗 CAP 可在某些特定情况下取得合理的效果。需要进一步开展更大规模的前瞻性对照试验以明确 AM 在 CAP 治疗中的作用。
