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顺势疗法与传统疗法治疗急性上呼吸道感染:复发率与抗生素处方的真实世界队列研究

Homeopathic and Conventional Treatments for Acute Upper Respiratory Tract Infections: Real-World Cohort Study on Recurrence and Antibiotic Prescriptions.

作者信息

Banik Norbert, De Jaegere Sabine, Niederle Sabine, Reineke Thorsten

机构信息

Consultant Health Services Research and Epidemiolgogy, Munich, Germany.

Deutsche Homöopathie-Union, Karlsruhe, Germany.

出版信息

Complement Med Res. 2025;32(1):13-25. doi: 10.1159/000543183. Epub 2025 Jan 8.

Abstract

INTRODUCTION

The study evaluated the recurrence of acute upper respiratory tract infections (aURTIs) and the number of antibiotic prescriptions within a 12-month follow-up period in patients prescribed with either homeopathic medicines or medicines from one of four conventional medication classes for aURTI therapy.

METHODS

This explorative cohort study used real-world electronic healthcare data from the Disease Analyzer database (IQVIA). Included were patients of all ages from Germany with an index diagnosis of aURTI between 2010 and 2018, who had prescriptions for either homeopathic, conventional cough and cold, nasal, or throat medicines or nonopioid analgesics on the day of diagnosis or within 6 days afterwards. aURTI recurrence was assessed by multivariable logistic regression, the number of antibiotic prescriptions by multivariable negative binomial regression.

RESULTS

From 3,628,295 patients with aURTI diagnosis initially identified in the database in the relevant time interval, a total of 610,118 patients, fulfilling the in- and not violating the exclusion criteria, were retained for analysis. In the multivariate analyses on all patients, prescriptions of nasal medicines were associated with a significant, slightly higher (OR: 1.18, CI: 1.10-1.26, p < 0.001) risk of aURTI recurrence compared to homeopathic medicines within 12 months. Prescriptions of cough and cold (OR: 0.92, CI: 0.86-0.97, statistically significant, p = 0.005) as well as throat medicines (OR: 0.93, CI: 0.86-1.01, p = 0.086) and nonopioid analgesics (OR: 0.95, CI: 0.89-1.02, p = 0.181) were associated with slightly lower risk of aURTI recurrence compared to homeopathic medicines. In the analysis of the age-dependent subgroups, there were some deviations from the overall population in terms of statistical significance; however, the directions of the effect estimates were unchanged. Almost all results of negative binomial regression analyses assessing differences in the frequency of antibiotic prescriptions during follow-up, both in all patients and in the age-dependent subgroups, were statistically significant in favor of homeopathic medicines.

CONCLUSION

The study demonstrated that follow-up recurrence and antibiotic prescriptions in patients with uncomplicated aURTI are at least comparable between patients treated with homeopathic and conventional medicines in real-world practice. Despite some methodological limitations inherent to the database used, the results of this study indicate that homeopathic medicines present a valuable therapeutic option for managing aURTI.

INTRODUCTION

The study evaluated the recurrence of acute upper respiratory tract infections (aURTIs) and the number of antibiotic prescriptions within a 12-month follow-up period in patients prescribed with either homeopathic medicines or medicines from one of four conventional medication classes for aURTI therapy.

METHODS

This explorative cohort study used real-world electronic healthcare data from the Disease Analyzer database (IQVIA). Included were patients of all ages from Germany with an index diagnosis of aURTI between 2010 and 2018, who had prescriptions for either homeopathic, conventional cough and cold, nasal, or throat medicines or nonopioid analgesics on the day of diagnosis or within 6 days afterwards. aURTI recurrence was assessed by multivariable logistic regression, the number of antibiotic prescriptions by multivariable negative binomial regression.

RESULTS

From 3,628,295 patients with aURTI diagnosis initially identified in the database in the relevant time interval, a total of 610,118 patients, fulfilling the in- and not violating the exclusion criteria, were retained for analysis. In the multivariate analyses on all patients, prescriptions of nasal medicines were associated with a significant, slightly higher (OR: 1.18, CI: 1.10-1.26, p < 0.001) risk of aURTI recurrence compared to homeopathic medicines within 12 months. Prescriptions of cough and cold (OR: 0.92, CI: 0.86-0.97, statistically significant, p = 0.005) as well as throat medicines (OR: 0.93, CI: 0.86-1.01, p = 0.086) and nonopioid analgesics (OR: 0.95, CI: 0.89-1.02, p = 0.181) were associated with slightly lower risk of aURTI recurrence compared to homeopathic medicines. In the analysis of the age-dependent subgroups, there were some deviations from the overall population in terms of statistical significance; however, the directions of the effect estimates were unchanged. Almost all results of negative binomial regression analyses assessing differences in the frequency of antibiotic prescriptions during follow-up, both in all patients and in the age-dependent subgroups, were statistically significant in favor of homeopathic medicines.

CONCLUSION

The study demonstrated that follow-up recurrence and antibiotic prescriptions in patients with uncomplicated aURTI are at least comparable between patients treated with homeopathic and conventional medicines in real-world practice. Despite some methodological limitations inherent to the database used, the results of this study indicate that homeopathic medicines present a valuable therapeutic option for managing aURTI.

摘要

引言

本研究评估了接受顺势疗法药物或四种传统药物类别之一用于治疗急性上呼吸道感染(aURTIs)的患者在12个月随访期内急性上呼吸道感染的复发情况以及抗生素处方数量。

方法

这项探索性队列研究使用了来自疾病分析数据库(IQVIA)的真实世界电子医疗数据。纳入的是2010年至2018年间在德国被诊断为aURTI的所有年龄段患者,这些患者在诊断当天或之后6天内开具了顺势疗法药物、传统止咳感冒药、鼻腔用药、咽喉用药或非阿片类镇痛药的处方。通过多变量逻辑回归评估aURTI复发情况,通过多变量负二项回归评估抗生素处方数量。

结果

在相关时间间隔内最初在数据库中确定的3,628,295例aURTI诊断患者中,共有610,118例患者符合纳入标准且未违反排除标准,被保留用于分析。在对所有患者的多变量分析中,与顺势疗法药物相比,鼻腔用药处方在12个月内aURTI复发风险显著略高(比值比:1.18,置信区间:1.10 - 1.26,p < 0.001)。止咳感冒药(比值比:0.92,置信区间:0.86 - 0.97,具有统计学意义,p = 0.005)、咽喉用药(比值比:0.93,置信区间:0.86 - 1.01,p = 0.086)和非阿片类镇痛药(比值比:0.95,置信区间:0.89 - 1.02,p = 0.181)与顺势疗法药物相比,aURTI复发风险略低。在按年龄分组的亚组分析中,在统计学意义方面与总体人群存在一些偏差;然而,效应估计的方向没有变化。几乎所有评估随访期间抗生素处方频率差异的负二项回归分析结果,在所有患者和按年龄分组的亚组中,在统计学上都显著有利于顺势疗法药物。

结论

该研究表明,在现实世界实践中,接受顺势疗法和传统药物治疗的单纯性aURTI患者的随访复发情况和抗生素处方至少具有可比性。尽管所使用的数据库存在一些固有的方法学局限性,但本研究结果表明,顺势疗法药物是治疗aURTI的一种有价值的治疗选择。

引言

本研究评估了接受顺势疗法药物或四种传统药物类别之一用于治疗急性上呼吸道感染(aURTIs)的患者在12个月随访期内急性上呼吸道感染的复发情况以及抗生素处方数量。

方法

这项探索性队列研究使用了来自疾病分析数据库(IQVIA)的真实世界电子医疗数据。纳入的是2010年至2018年间在德国被诊断为aURTI的所有年龄段患者,这些患者在诊断当天或之后6天内开具了顺势疗法药物、传统止咳感冒药、鼻腔用药、咽喉用药或非阿片类镇痛药的处方。通过多变量逻辑回归评估aURTI复发情况,通过多变量负二项回归评估抗生素处方数量。

结果

在相关时间间隔内最初在数据库中确定的3,628,295例aURTI诊断患者中,共有610,118例患者符合纳入标准且未违反排除标准,被保留用于分析。在对所有患者的多变量分析中,与顺势疗法药物相比,鼻腔用药处方在12个月内aURTI复发风险显著略高(比值比:1.18,置信区间:1.10 - 1.26,p < 0.001)。止咳感冒药(比值比:0.92,置信区间:0.86 - 0.97,具有统计学意义,p = 0.005)、咽喉用药(比值比:0.93,置信区间:0.86 - 1.01,p = 0.086)和非阿片类镇痛药(比值比:0.95,置信区间:0.89 - 1.02,p = 0.181)与顺势疗法药物相比,aURTI复发风险略低。在按年龄分组的亚组分析中,在统计学意义方面与总体人群存在一些偏差;然而,效应估计的方向没有变化。几乎所有评估随访期间抗生素处方频率差异的负二项回归分析结果,在所有患者和按年龄分组的亚组中,在统计学上都显著有利于顺势疗法药物。

结论

该研究表明,在现实世界实践中,接受顺势疗法和传统药物治疗的单纯性aURTI患者的随访复发情况和抗生素处方至少具有可比性。尽管所使用的数据库存在一些固有的方法学局限性,但本研究结果表明,顺势疗法药物是治疗aURTI的一种有价值的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f938/11892463/e8fe07fd6583/cmr-2025-0032-0001-543183_F01.jpg

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