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Homeopathie bij hooikoorts

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Binnen de conventionele geneeskunde is hooikoorts is te behandelen met geneesmiddelen zoals antihistaminica die allergische reacties onderdrukken en/of door desensibilisatie, waarbij het afweersysteem met het inspuiten of innemen van het allergeen minder gevoelig wordt gemaakt. Als alternatief kan homeopathie overwogen worden.

Er zijn verschillende gerandomiseerde, dubbelblinde studies met positieve uitkomsten gedaan met het homeopathisch middel Galphimia glauca.[1][2]

Daarnaast zijn er verscheidene kwalitatief goede gerandomiseerde, dubbelblinde studies verricht waarbij een homeopathische verdunning van allergenen zoals pollen of huisstofmijt werd gebruikt, om de allergie effectief te verminderen.[3][4][5][6]

In 1991 melden Nederlandse epidemiologen over homeopatische studies al:

Overall, of the 105 trials with interpretable results, 81 trials indicated positive results whereas in 24 trials no positive effects of homoeopathy were found. 

In het BMJ artikel (2000) was de bespreking van de bevindingen boeiend, en we citeren:

We found that homoeopathy and placebo had different effects. Compared with placebo, homoeopathy provoked a clear, significant, and clinically relevant improvement in nasal inspiratory peak flow, similar to that found with topical steroids.

However, the subjective improvement was less clear. Although the objective measure consistently improved in all five centres, the subjective results were better than placebo in only four of the five centres and overall there was no difference between the groups. If the objective results are valid the discrepancy in the subjective measurements may be partly due to under recruitment compounded by aggravations and possible initial placebo responses during the run-in period in both groups, perhaps reflecting the positive expectations of the participants.

Patients with rhinitis are keen to enter studies in their quest for better symptom control.24 Subjective improvement began before the end of the placebo run-in phase in both groups, and this lessened the chance of distinguishing between the groups.

A larger sample size may have shown a subjective difference between the groups.More initial aggravations occurred in patients who received homoeopathy, and this may have further complicated the subjective results.

The pattern of temporary worsening followed by improvement, seen in this trial and observed in clinical homoeopathy for over 200 years, is not typical of placebo. 

Maar het hele probleem is niet eenvoudig, we moeten ook dit citaat hier geven uit 2007: [7]

Five large meta-analyses of homoeopathy trials have been done. All have had the same result: after excluding methodologically inadequate trials and accounting for publication bias, homoeopathy produced no statistically significant benefit over placebo. And yet homoeopathy can still be clinically useful. 

During the cholera epidemic in the 19th century, death rates at the London Homoeopathic Hospital were three times lower than those at the Middlesex Hospital.

The reason for homoeopathy’s success in this epidemic is even more interesting than the placebo effect. At the time, nobody could treat cholera, and while medical treatments such as blood-letting were actively harmful, the homoeopaths’ treatments were at least inert.

Similarly, modern medicine can offer little for conditions such as many types of back pain, stress at work, medically unexplained fatigue, and most common colds.

Going through a theatre of medical treatment, and trying every drug in the book, will only elicit side-effects. An inert pill in these circumstances seems a sensible option.

However, just as homoeopathy has unexpected benefits, so it can have unexpected side-effects. The very act of prescribing a pill carries its own risks: medicalisation, reinforcement of counterproductive illness behaviours, and promotion of the idea that a pill is an appropriate response to a social problem, or a modest viral illness……

Referentie

[1] Wiesenauer M, Häussler S, Gaus W. | [Pollinosis therapy with Galphimia glauca]. | Fortschr Med. | 1983 May 5;101(17):811-4.

[2] Wiesenauer M, Gaus W. | Double-blind trial comparing the effectiveness of the homeopathic preparation Galphimia potentiation D6, Galphimia dilution 10(-6) and placebo on pollinosis. | Arzneimittelforschung. | 1985;35(11):1745-7.

[3] Reilly DT, Taylor MA, McSharry C, Aitchison T. | Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hayfever as model. | Lancet. | 1986 Oct 18;2(8512):881-6.

[4] Reilly D, Taylor MA, Beattie NG, Campbell JH, McSharry C, Aitchison TC, Carter R, Stevenson RD. | Is evidence for homoeopathy reproducible? | Lancet. | 1994 Dec 10;344(8937):1601-6.

[5] Taylor MA, Reilly D, Llewellyn-Jones RH, McSharry C, Aitchison TC. | Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series. | BMJ. | 2000 Aug 19-26;321(7259):471-6.

[6] Kim LS, Riedlinger JE, Baldwin CM, Hilli L, Khalsa SV, Messer SA, Waters RF. | Treatment of seasonal allergic rhinitis using homeopathic preparation of common allergens in the southwest region of the US: a randomized, controlled clinical trial. | Ann Pharmacother. | 2005 Apr;39(4):617-24. Epub 2005 Mar 1.

[7] Goldacre B. | Benefits and risks of homoeopathy. | Lancet. | 2007 Nov 17;370(9600):1672-3.

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