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在智障患者中使用顺势疗法的最佳现有证据是什么?

What is the best available evidence for using homeopathy in patients with intellectual disabilities?

作者信息

Shaddel Farshad, Ghazirad Marjan, Bryant Mark

机构信息

University of Oxford.

Dermot Rowe Library, Oxford Learning Disability, United Kingdom.

出版信息

Iran J Pediatr. 2014 Aug;24(4):339-44. Epub 2014 Jul 4.

Abstract

OBJECTIVE

The debate about the effectiveness of homeopathy hits the headlines from time to time. Reported evidences for the role of homeopathy in psychiatric illness relevant to people with intellectual disabilities are patchy and inconsistent. In this review we summarize the best available evidence for the use of homeopathy to treat the psychiatric disorders common in this population.

METHODS

Systematic literature review was conducted through February 2012 to July 2012 in AMED, CINHAL, BNI, EMBASE, MEDLINE, PSYCHINFO and GOOGLE SCHOLAR. In the next steps thirty eight homeopathic associations were contacted and a top-up literature search was done on Scopus and World of Science databases till March 2014. Twelve relevant clinical trials were identified and included in this study. The quality of each trial was assessed by the Oxford quality scoring system (Known as Jadad score) as well as subjective review by two reviewers independently (good versus poor). Findings : The largest body of evidence pertained to the use of homeopathy in the treatment of attention deficit hyperactivity disorder (ADHD). There is heterogeneity in the quality of trials and also the outcome of studies but overall our findings suggest some potential for using homeopathy in ADHD. Current evidences do not support the use of homeopathy for treatment of speech and language difficulties. There was only one trial concerning the use of homeopathy in Autistic Spectrum Disorder. This was of a poor quality and unable to provide any recommendation.

CONCLUSION

Whilst acknowledging the risk of publication and language bias in our study, the currently available evidences are neither conclusive nor comprehensive enough to give us a clear picture for the use of homeopathy in patients with intellectual disabilities. There are large gaps in the body of evidence concerning the role of homeopathy in the treatment of common disorders in intellectual disability, such as autism, challenging behavior or developmental arrest in childhood.

摘要

目的

顺势疗法有效性的争论不时成为头条新闻。关于顺势疗法在与智力残疾者相关的精神疾病中所起作用的报道证据零散且不一致。在本综述中,我们总结了使用顺势疗法治疗该人群常见精神障碍的最佳现有证据。

方法

于2012年2月至2012年7月在医学文摘数据库(AMED)、护理学与健康领域数据库(CINHAL)、英国护理索引数据库(BNI)、荷兰医学文摘数据库(EMBASE)、医学期刊数据库(MEDLINE)、心理学文摘数据库(PSYCHINFO)和谷歌学术进行系统文献综述。接下来,联系了38个顺势疗法协会,并在Scopus和科学世界数据库上进行补充文献检索,直至2014年3月。确定了12项相关临床试验并纳入本研究。每项试验的质量由牛津质量评分系统(即雅达评分)以及两名评审员独立进行主观评估(分为好与差)。结果:最大量的证据涉及顺势疗法在治疗注意力缺陷多动障碍(ADHD)中的应用。试验质量和研究结果存在异质性,但总体而言,我们的研究结果表明顺势疗法在ADHD治疗中有一定潜力。目前的证据不支持使用顺势疗法治疗言语和语言障碍。关于顺势疗法在自闭症谱系障碍中的应用仅有一项试验。该试验质量较差,无法提供任何建议。

结论

虽然承认我们的研究存在发表和语言偏倚风险,但目前可得的证据既不确凿也不够全面,无法让我们清楚了解顺势疗法在智力残疾患者中的应用情况。关于顺势疗法在治疗智力残疾常见疾病(如自闭症、挑战性行为或儿童发育停滞)中的作用,证据体系存在很大差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5243/4339554/7236bd48abdc/IJPD-24-339-g001.jpg

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