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抗微生物药物耐药时代的顺势疗法:它是治疗上呼吸道感染的可行疗法吗?

Homeopathy in the Age of Antimicrobial Resistance: Is It a Viable Treatment for Upper Respiratory Tract Infections?

作者信息

Fixsen Alison

机构信息

Department of Life Sciences, University of Westminster, London, United Kingdom.

出版信息

Homeopathy. 2018 May;107(2):99-114. doi: 10.1055/s-0037-1621745. Epub 2018 Feb 5.

Abstract

BACKGROUND

Acute upper respiratory tract infections (URTIs) and their complications are the most frequent cause of antibiotic prescribing in primary care. With multi-resistant organisms proliferating, appropriate alternative treatments to these conditions are urgently required. Homeopathy presents one solution; however, there are many methods of homeopathic prescribing. This review of the literature considers firstly whether homeopathy offers a viable alternative therapeutic solution for acute URTIs and their complications, and secondly how such homeopathic intervention might take place.

METHOD

Critical review of post 1994 clinical studies featuring homeopathic treatment of acute URTIs and their complications. Study design, treatment intervention, cohort group, measurement and outcome were considered. Discussion focused on the extent to which homeopathy is used to treat URTIs, rate of improvement and tolerability of the treatment, complications of URTIs, prophylactic and long-term effects, and the use of combination versus single homeopathic remedies.

RESULTS

Multiple peer-reviewed studies were found in which homeopathy had been used to treat URTIs and associated symptoms (cough, pharyngitis, tonsillitis, otitis media, acute sinusitis, etc.). Nine randomised controlled trials (RCTs) and 8 observational/cohort studies were analysed, 7 of which were paediatric studies. Seven RCTs used combination remedies with multiple constituents. Results for homeopathy treatment were positive overall, with faster resolution, reduced use of antibiotics and possible prophylactic and longer-term benefits.

CONCLUSIONS

Variations in size, location, cohort and outcome measures make comparisons and generalisations concerning homeopathic clinical trials for URTIs problematic. Nevertheless, study findings suggest at least equivalence between homeopathy and conventional treatment for uncomplicated URTI cases, with fewer adverse events and potentially broader therapeutic outcomes. The use of non-individualised homeopathic compounds tailored for the paediatric population merits further investigation, including through cohort studies. In the light of antimicrobial resistance, homeopathy offers alternative strategies for minor infections and possible prevention of recurring URTIs.

摘要

背景

急性上呼吸道感染(URTIs)及其并发症是基层医疗中抗生素处方最常见的原因。随着多重耐药菌的不断增多,迫切需要针对这些病症的合适替代治疗方法。顺势疗法提供了一种解决方案;然而,顺势疗法的开药方法有很多种。本文献综述首先考虑顺势疗法是否为急性URTIs及其并发症提供了可行的替代治疗方案,其次考虑这种顺势疗法干预可能如何进行。

方法

对1994年以后采用顺势疗法治疗急性URTIs及其并发症的临床研究进行批判性综述。考虑了研究设计、治疗干预、队列组、测量方法和结果。讨论的重点是顺势疗法用于治疗URTIs的程度、治疗的改善率和耐受性、URTIs的并发症、预防和长期效果,以及联合使用与单一顺势疗法药物的情况。

结果

发现多项经同行评审的研究,其中顺势疗法已用于治疗URTIs及相关症状(咳嗽、咽炎、扁桃体炎、中耳炎、急性鼻窦炎等)。分析了9项随机对照试验(RCTs)和8项观察性/队列研究,其中7项为儿科研究。7项RCTs使用了含有多种成分的联合药物。顺势疗法治疗的总体结果是积极的,症状缓解更快,抗生素使用减少,可能有预防和长期益处。

结论

规模、地点、队列和结果测量方法的差异使得对URTIs顺势疗法临床试验进行比较和归纳存在问题。然而,研究结果表明,对于无并发症的URTIs病例,顺势疗法和传统治疗至少等效,不良事件较少,治疗效果可能更广泛。针对儿科人群使用非个体化顺势疗法化合物值得进一步研究,包括通过队列研究。鉴于抗菌药物耐药性,顺势疗法为轻度感染和预防URTIs复发提供了替代策略。

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