順勢療法討論區 Homeopathy Discuss!

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Speaker ~ Dr JENNIFER JACOBS

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admin 發表於 2015-6-5 20:35:53 | 顯示全部樓層 |閱讀模式
DAY 1 – 5 June 2015 ( 1400-1520 )
Clinical Researchand SafetyProf Jennifer Jacobs
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https://goo.gl/ub1H5S



Prof Jennifer Jacobs,
USA. Homeopathic treatment ofrespiratory illnesses in children: Results from two randomised trials
來自美國。兒童呼吸系統疾病的順勢療法治療:兩個隨機試驗的結果

  
Background
  
背景
  
Clinical Assistant Professor, University of  Washington
  
華盛頓大學臨床助理教授
  
  
Dr Jennifer Jacobs is a family practice physician  specializing in homeopathic medicine. She is also a clinical assistant  professor in epidemiology at the University of Washington School of Public  Health and Community Medicine. Dr Jacobs is a former President of the  American Institute of Homeopathy, and served on the advisory board of the NIH  Office of Alternative Medicine.
  
Dr. Jennifer Jacobs是一位執業家庭醫生,專科於順勢療法。她也是華盛頓大學公共衛生和社會醫學學院的一位流行病學臨床助理教授。Dr. Jacobs是美國順勢療法學院前任院長,並擔任美國國立衛生研究院另類醫學辦公室的顧問委員會成員。
  
Research area
  
研究範圍
Mathie  RT, Roniger H, Van Wassenhoven M, Frye J, Jacobs J, Oberbaum M, Bordet MF,  Nayak C, Chaufferin G, Ives JA, Dantas F, Fisher P. Method for appraising  model validity of randomised controlled trials of homeopathic treatment:  multi-rater concordance study. BMC Med Res Methodol. 2012 Apr 17;12:49. doi:  10.1186/1471-2288-12-49.
  
用於評價順勢療法治療的隨機對照試驗的有效性模式:多方位的一致性研究
  
  
BACKGROUND:
  
背景:
  
A method for assessing the model validity of randomised controlled  trials of homeopathy is needed. To date, only conventional standards for  assessing intrinsic bias (internal validity) of trials have been invoked,  with little recognition of the special characteristics of homeopathy.
  
必需要有一種方法用於評估順勢隨機對照試驗的有效性模型。迄今為止,只有常規標準以評估主流試驗的內在偏差(內部有效度),很少針對到順勢療法特點而作評估。
  
  
We aimed to identify relevant judgmental domains to use in assessing  the model validity of homeopathic treatment (MVHT). We define MVHT as the  extent to which a homeopathic intervention and the main measure of its  outcome, as implemented in a randomised controlled trial (RCT), reflect  'state-of-the-art' homeopathic practice.
  
我們的目的,是確定用作評估順勢療法有效性模式(MVHT)的相關判斷領域。我們把MVHT定義為順勢療法干預的程度、及其結果的主要測量,建議用於隨機對照試驗(RCT)之中,反映順勢療法實踐的藝術性。
  
  
METHODS:
  
方法:
  
Using an iterative process, an international group of experts  developed a set of six judgmental domains, with associated descriptive  criteria.
  
一個國際專家小組通過一個反複的過程,開發了一共六項的判斷領域,當中包括了相關的描述性標準。
  
  
The domains address:
  
六個領域分別為:
  
(I)                  the rationale  for the choice of the particular homeopathic intervention;
  
選擇特定順勢療法干預形式的合理性;
  
(II)                the homeopathic  principles reflected in the intervention;
  
在干預中能否體現順勢療法的原理;
  
(III)              the extent of  homeopathic practitioner input;
  
順勢療法醫生介入的程度;
  
(IV)              the nature of  the main outcome measure;
  
主要醫療成果測量方法的性質;
  
(V)                the capability  of the main outcome measure to detect change;
  
主要醫療成果之測量方法充份反映變化的能力;
  
(VI)              the length of  follow-up to the endpoint of the study. Six papers reporting RCTs of  homeopathy of varying design were randomly selected from the literature. A  standard form was used to record each assessor's independent response per  domain, using the optional verdicts 'Yes', 'Unclear', 'No'. Concordance among  the eight verdicts per domain, across all six papers, was evaluated using the  kappa (κ) statistic.
  
跟進至研究完結的長度。隨機從文獻中選出六篇論文提供了順勢療法隨機對照試驗的不同設計。以一個標準的表格,來記錄每一個評估員對每個領域的獨立反應,使用可選的裁決「是」、「不清楚」和「否」。評估各個領域中八個判決之間的一致性,在所有六篇論文,以卡帕(κ)作統計。
  
  
RESULTS:
  
結果:
  
The six judgmental domains enabled MVHT to be assessed with 'fair' to  'almost perfect' concordance in each case. For the six RCTs examined, the  method allowed MVHT to be classified overall as 'acceptable' in three,  'unclear' in two, and 'inadequate' in one.
  
在那六個判斷性領域中,每一個都使MVHT在各種情況下,能夠被評估為「合理」至「幾乎完美」。對於六個隨機對照試驗研究,這方法允許MVHT作整體判斷,有3個為「可接受」,2個是「不清楚」,一個是「不足」。
  

Taylor JA, Jacobs J.Homeopathic ear drops as an adjunct to  standard therapy in children with acute otitis media. Homeopathy. 2011  Jul;100(3):109-15. doi: 10.1016/j.homp.2011.03.002.  順勢療法滴耳療劑作為小兒急性中耳炎的輔助療法  
  OBJECTIVE:  
目的:
  
To assess the effectiveness of a homeopathic ear drop for treatment of  otalgia in children with acute otitis media (AOM).
  
為了評估順勢療法滴耳劑於治療急性中耳炎(AOM)兒童耳痛的有效性。
  
  METHODS:    
方法:
  
Children with AOM were enrolled in the study at the time of diagnosis  and randomized to receive either standard therapy alone or standard therapy  plus a homeopathic ear drop solution that was to be used on as needed basis  for up to 5 days. Parents of children in both treatment groups rated the  severity of 5 AOM symptoms twice daily for 5 days in a symptom diary. A  symptom score was computed for each assessment with lower scores denoting  less severe symptoms. Parents of children randomized to receive ear drops  also recorded information regarding symptoms being treated and response to  treatment.
  
患有AOM的兒童經診斷後被納入於研究當中,然後隨機分組,一組只接受標準主流治療,另一組則於標準主流治療上加入順勢療法療劑滴耳,為期長達5天。兩個治療組別兒童的家長,每天兩次在症狀日記上對5項AOM症狀的嚴重程度作評分,為期5天。每個評估個案都計算出的一個症狀評分,分數越低表示症狀越不嚴重。兒童父母會隨機被分派滴耳劑,並為接受治療的症狀和對治療的反應的有關資料作記錄。
  
  RESULTS:    
結果:
  
A total of 119 eligible children were enrolled in the study; symptom  diaries were received from 94 (79%). Symptom scores tended to be lower in the  group of children receiving ear drops than in those receiving standard  therapy alone; these differences were significant at the second and third  assessments (P = 0.04 and P = 0.003, respectively). In addition, the rate of  symptom improvement was faster in children in the ear drop group compared  with children in standard therapy alone group (P = 0.002). The most common  reason for administration of ear drops was ear pain, recorded for 93 doses;  improvement was noted after 78.4% of doses for this indication. There were no  significant side effects related to use of the ear drops.
  
這研究總共有119名合資格子女參加;當中收回94份症狀日記(79%)。接受滴耳劑的兒童組別比僅接受標準治療的兒童組別,傾向有較低的症狀評分;這些差異在第二和第三評估(分別為P  = 0.04和P =0.003)更為顯著。此外,滴耳組別兒童相比單一標準主流治療組別兒童有較快的症狀改善率(P=0.002)。施用滴耳劑的最常見原因為是耳朵痛, 有93劑服用記錄;以此跡象使用滴劑的有78.4%使用後錄得有改善。而在使用滴耳劑組別中並沒有顯著的副作用。
  
  CONCLUSIONS:    
結論:
  
This study suggests that homeopathic ear drops were moderately  effective in treating otalgia in children with AOM and may be most effective  in the early period after a diagnosis of AOM. Pediatricians and other primary  health care providers should consider homeopathic ear drops a useful adjunct  to standard therapy.
  
這項研究表明,順勢療法滴耳療劑在小兒急性中耳炎的耳痛治療中是有效的,在診斷為AOM後的初期可能是最有效的。兒科醫生及其他基層醫療提供者應該考慮以順勢療法滴耳療劑作為一種有用的輔助療法。
  


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