Gaertner Katharina, Baumgartner Stephan, Walach Harald
Institute for Integrative Medicine, University of Witten/Herdecke, Herdecke, Germany.
Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland.
Front Surg. 2021 Dec 17;8:680930. doi: 10.3389/fsurg.2021.680930. eCollection 2021.
Homeopathic is used in surgery as prevention or treatment for the reduction of pain and other sequelae of surgery. Our aim was to perform a metaanalysis of clinical trials to assess efficacy of to reduce the inflammatory response after surgery. We conducted a systematic review and metaanalysis, following a predefined protocol, of all studies on the use of homeopathic in surgery. We included all randomized and nonrandomized studies comparing homeopathic to a placebo or to another active comparator and calculated two quantitative metaanalyses and appropriate sensitivity analyses. We used "Hegde's g," an effect size estimator which is equivalent to a standardized mean difference corrected for small sample bias. The PROSPERO registration number is CRD42020131300. Twenty-three publications reported on 29 different comparisons. One study had to be excluded because no data could be extracted, leaving 28 comparisons. Eighteen comparisons used placebo, nine comparisons an active control, and in one case was compared to no treatment. The metaanalysis of the placebo-controlled trials yielded an overall effect size of Hedge's g = 0.18 (95% confidence interval -0.007/0.373; = 0.059). Active comparator trials yielded a highly heterogeneous significant effect size of g = 0.26. This is mainly due to the large effect size of nonrandomized studies, which converges against zero in the randomized trials. Homeopathic has a small effect size over and against placebo in preventing excessive hematoma and other sequelae of surgeries. The effect is comparable to that of anti-inflammatory substances.
顺势疗法在外科手术中用于预防或治疗疼痛减轻及手术的其他后遗症。我们的目的是进行一项临床试验的荟萃分析，以评估顺势疗法减轻术后炎症反应的疗效。我们按照预先定义的方案，对所有关于顺势疗法在外科手术中应用的研究进行了系统评价和荟萃分析。我们纳入了所有将顺势疗法与安慰剂或其他活性对照进行比较的随机和非随机研究，并计算了两项定量荟萃分析及适当的敏感性分析。我们使用了“Hedge's g”，这是一种效应量估计值，等同于校正了小样本偏差的标准化均数差。PROSPERO注册号为CRD42020131300。23篇出版物报道了29项不同的比较。由于无法提取数据，一项研究不得不被排除，剩下28项比较。18项比较使用了安慰剂，9项比较使用了活性对照，还有一项将顺势疗法与不治疗进行了比较。安慰剂对照试验的荟萃分析得出总体效应量为Hedge's g = 0.18（95%置信区间为-0.007/0.373；P = 0.059）。活性对照试验得出高度异质性的显著效应量g = 0.26。这主要是由于非随机研究的效应量较大，而在随机试验中该效应量趋近于零。顺势疗法在预防手术过度血肿及其他后遗症方面相对于安慰剂有较小的效应量。其效果与抗炎物质相当。
