順勢療法

維基百科,自由的百科全書
前往: 導覽搜尋
山姆·赫尼曼

順勢療法英語homeopathy),又稱同類療法,一種替代療法,是德國醫師山姆·赫尼曼在藥物實驗金雞納樹皮時,所發現的一種治療理論。順勢療法根據他發表的「同類治同類」理論, 此理論指如某物質能在健康的人身上,引起病人患某病時的病症,將此物質稀釋震盪處理後就能治療該病[1],舉例來,說洋蔥會令人打噴嚏流眼淚,稀釋震盪後的洋蔥則可治療類似打噴嚏流眼淚的過敏性鼻炎。雖然有人稱順勢療法是一門偽科學[2][3],其療效並不比安慰劑[4]。但近年來卻有越來越多的醫學文獻被發表證實其對人體的療效,近幾年已發表的順勢療法科學文獻,且順勢療法藥物在近幾年每年銷售的成長速度上,也高於傳統的化學西藥,越來越多的歐洲國家將其列為國家健保給付的一種民眾醫療方式。

簡介[編輯]

赫尼曼相信人生病的主因為一種他名為「病蔭」的現象,能以順勢療法的「療劑」對付。療劑的製作,乃反覆以水或酒精稀釋一特定物質,然後於彈性物體上給予強力沖擊 。稀釋通常持續到原物質的分子消失無蹤的程度[5]。 順勢療師以參考書選取療劑,並以病者的徵狀,人格物質,生理心理狀況及生活史作補充考慮[6]

順勢療法缺乏生物學上之根據[7]且其理論早己被推翻。[8] ,此療法所假定的行為機制無論在科學上[9][10] 或是在物論學上[11]均不可能。雖然有臨床試驗得出正面結果[12][13]系統化綜述揭示原因僅為機率,研究方法之缺憾, 及報告偏倚。總括而言,並沒有支持其功效[9][14][15][16]存在之證據。 儘管證據顯示其沒有作用,持續運用順勢療法遭批評為不道德行為:因為這會使病人減少使用真正有效之藥物,所受之痛苦因而增加[17]世界衛生組織對使用順勢療法治療嚴重疾病,如人類免疫缺陷病毒瘧疾,發出警告[18]。 亦因其子烏虛有的療效,順勢療法被有些衛道科學及醫學界初認為是「一派胡言」[19] 「招搖撞騙」[20][21][22],或「騙術」[23]。但世衛組織也曾發表順勢療法的書刊報告,文中皆以drug(藥物)來稱順勢療法,並詳述世界各國對順勢療法的醫藥管理方式,堪稱是目前對順勢療法最中立的報告,WHO順勢療法報告

英國下議院 科學及技術委員會表示:「我等看來,系統化綜述及巨量分析己經一槌定音地顯示,順勢療法的效果並不比安慰劑強。政府亦與我們所見相同。」[24] 儘管科學尚無法解釋順勢療法如何在人體上產生作用,英國政府健保局NHS仍持續地給付順勢療法,數家醫院至今也持續提供順勢醫療門診服務,也是不爭的事實。

順勢療法之稀釋[編輯]

順勢療法普遍使用「三級指數強度」。 赫尼曼發明出「百分位等級」或稱 "C 等級",每個等級單位代表將某物質稀釋一百倍。(另外亦有以小數為單為的強度指數 (以 "X" 或 "D"指示),療劑以十倍為單位被稀釋[25])。2C等級代表某物質先被稀釋一百倍,然後將稀釋溶液稀釋再稀釋一百倍,得出稀釋一萬倍的溶液[26] 。6C等級即重覆此過程六次,得出稀釋度為100−6=10−12(一萬億分之一,或 1/1,000,000,000,000)。更高的等級亦按照此方法行。於順勢療法中,溶液愈稀釋其強度愈高,物質愈稀釋其作為療劑的效用愈大[27] 。最終溶液經常被稀釋到與溶劑 (純水,糖水或酒精)無分別的程度[5][28][29]

赫尼曼提倡於大部分情況下使用30C稀釋強度(即稀釋度達1060).[30] 在赫尼曼的時代,療劑能無限稀釋是不無道理的假設,因原子或分子,作為化學物質的最小單位的既念才剛現世。稀釋濃度超過12C後,溶液中基本上不存在任何分子

此瓶含有D6級的山金車,即此溶液的稀釋度為百萬分之一(10-6).

。批評及支持者均嘗試以各種比喻形容其稀釋情況[31],據報赫尼曼曾笑指對付流行疫症的合適方法,是將一瓶毒物稀釋到日內瓦湖,然後重覆六十次[32][33] 。另一個批評者的例子中,一個12C強度的溶液,相當於「一抺鹽倒進南北大西洋"[32][33] 。此例子於數學上大致正確[34] 。三分之一滴物質稀釋到地體上所有的水體會得出約為13C的溶劑[35][31][36]。其中一種熱門流行性感冒療劑,是鴨肝的200C稀釋物,以 oscillococcinum為名上市。整個可觀察宇宙大概只有 1080 個原子, 以一個原子作溶質,整個宇宙作溶劑,可得到約40C的溶液。 Oscillococcinum 需要用 10320多個宇宙,來製做出該強度的療劑[37] 。這些宣稱能達到的稀釋程度,乃順勢療法最具爭議,最不合理的環節[38]。但oscillococcinum在歐盟許多國家以及加拿大,美國,皆是以順勢療法藥品合法地可宣稱治療流感於市場上銷售。並有數篇已發表於醫學期刊的文獻支持其對流感病患的療效。

參考文獻[編輯]

  1. ^ Hahnemann, Samuel. The Homœopathic Medical Doctrine, or "Organon of the Healing Art". Dublin: W.F. Wakeman. 1833: iii, 48–49. "Observation, reflection, and experience have unfolded to me that the best and true method of cure is founded on the principle, similia similibus curentur. To cure in a mild, prompt, safe, and durable manner, it is necessary to choose in each case a medicine that will excite an affection similar (ὅμοιος πάθος) to that against which it is employed."  Translator: Charles H. Devrient, Esq.
  2. ^ Tuomela R. Chapter 4: Science, Protoscience, and Pseudoscience. In Pitt JC, Marcello P. Rational Changes in Science: Essays on Scientific Reasoning. Boston Studies in the Philosophy of Science 98 (Springer). 1987: 83–101. doi:10.1007/978-94-009-3779-6_4. ISBN 978-94-010-8181-8. 
  3. ^ Smith K. Homeopathy is Unscientific and Unethical. Bioethics. 2012, 26 (9): 508–512. doi:10.1111/j.1467-8519.2011.01956.x. 
  4. ^ Shang A, Huwiler-Müntener K, Nartey L, et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet. 2005, 366 (9487): 726–32. doi:10.1016/S0140-6736(05)67177-2. PMID 16125589. 
  5. ^ 5.0 5.1 Dynamization and Dilution, Complementary and Alternative Medicine, Creighton University Department of Pharmacology [2009-03-24]原出處存檔於2002-08-26) 
  6. ^ Hahnemann S, The Organon of the Healing Art. 5th. 1833: aphorisms 5 and 217, ISBN 0-87983-228-2 
  7. ^ Ernst, Edzard. Homeopathy: A Critique of Current Clinical Research. Skeptical Inquirer. December 2012, 36 (6). 
  8. ^ Atwood, Kimball. Homeopathy and Evidence-Based Medicine: Back to the Future – Part II. Science Based Medicine. January 11, 2008 [September 18, 2013]. 
  9. ^ 9.0 9.1 Shang, Aijing; Huwiler-Müntener, Karin; Nartey, Linda; Jüni, Peter; Dörig, Stephan; Sterne, Jonathan AC; Pewsner, Daniel; Egger, Matthias, Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy, The Lancet. 2005, 366 (9487): 726–732, doi:10.1016/S0140-6736(05)67177-2, PMID 16125589 
  10. ^ UK Parliamentary Committee Science and Technology Committee - "Evidence Check 2: Homeopathy"
  11. ^ Grimes D R, Proposed mechanisms for homeopathy are physically impossible, FACT. 2012, 17 (3): 149, doi:10.1111/j.2042-7166.2012.01162.x 
  12. ^ Cucherat, M; Haugh, MC; Gooch, M; Boissel, JP, Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group, European journal of clinical pharmacology. 2000, 56 (1): 27–33, PMID 10853874 
  13. ^ Caulfield, Timothy; Debow, Suzanne, A systematic review of how homeopathy is represented in conventional and CAM peer reviewed journals, BMC Complementary and Alternative Medicine. 2005, 5: 12, doi:10.1186/1472-6882-5-12, PMID 15955254 
  14. ^ Kleijnen, J; Knipschild, P; Ter Riet, G, Clinical trials of homoeopathy, BMJ. 1991, 302 (6772): 316–23, doi:10.1136/bmj.302.6772.316, PMID 1825800 
  15. ^ Linde, K; Clausius, N; Ramirez, G; Melchart, D; Eitel, F; Hedges, L; Jonas, W, Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials, The Lancet. 1997, 350 (9081): 834–43, doi:10.1016/S0140-6736(97)02293-9, PMID 9310601 
  16. ^ Linde, K; Scholz, M; Ramirez, G; Clausius, N; Melchart, D; Jonas, WB, Impact of Study Quality on Outcome in Placebo-Controlled Trials of Homeopathy, Journal of Clinical Epidemiology. 1999, 52 (7): 631–6, doi:10.1016/S0895-4356(99)00048-7, PMID 10391656 
  17. ^ Shaw, D. M. Homeopathy is where the harm is: Five unethical effects of funding unscientific 'remedies'. Journal of Medical Ethics. 2010, 36 (3): 130–131. doi:10.1136/jme.2009.034959. PMID 20211989. 
  18. ^ Mashta, O. WHO warns against using homoeopathy to treat serious diseases. BMJ. 24 August 2009, 339 (aug24 2): b3447–b3447. doi:10.1136/bmj.b3447. 
  19. ^ Homeopathy is nonsense, says new chief scientist. Daily Telegraph. 18 Apr 2013 [September 9, 2013]. 
  20. ^ Baran GR, Kiana MF, Samuel SP. Chapter 2: Science, Pseudoscience, and Not Science: How Do They Differ?. Healthcare and Biomedical Technology in the 21st Century (Springer). 2014: 19–57. doi:10.1007/978-1-4614-8541-4_2. ISBN 978-1-4614-8540-7. "within the traditional medical community it is considered to be quackery" 
  21. ^ Paul S. Boyer. The Oxford Companion to United States History. [January 15, 2013]. ISBN 9780195082098. "After 1847, when regular doctors organized the American Medical Association (AMA), that body led the war on "quackery," especially targeting dissenting medical groups such as homeopaths, who prescribed infinitesimally small doses of medicine. Ironically, even as the AMA attacked all homeopathy as quackery, educated homeopathic physicians were expelling untrained "quacks" from their ranks." 
  22. ^ James Randi. An encyclopedia of claims, frauds, and hoaxes of the occult and supernatural. St. Martin's Press. 1995 [January 15, 2013]. ISBN 9780312109745. 
  23. ^ Supported by science?: What Canadian naturopaths advertise to the public. [January 15, 2013]. "Within the non-CAM scientific community, homeopathy has long been viewed as a sham" 
  24. ^ Evidence Check 2: Homeopathy - Science and Technology Committee, House of Commons of the United Kingdom Science and Technology Committee. 22 February 2010 [2014-04-05] 
  25. ^ http://www.ritecare.com/homeopathic/guide_potency.asp
  26. ^ 於標準化學中,這代表原物質濃度為0.01%
  27. ^ Glossary of Homeopathic Terms, Creighton University Department of Pharmacology [2009-02-15] 
  28. ^ Smith T, Homeopathic Medicine, Healing Arts Press. 1989:  14–15 
  29. ^ Similia similibus curentur (Like cures like), Creighton University Department of Pharmacology [2007-08-20] 
  30. ^ Hahnemann S, The Organon of the Healing Art. 6th. 1921: aphorism 128, ISBN 0-87983-228-2 
  31. ^ 31.0 31.1 有關順勢療法稀釋療劑於數學上的討論,見順勢療法-稀釋
  32. ^ 32.0 32.1 Bambridge AD, Homeopathy investigated, Kent, England: Diasozo Trust. 1989, ISBN 0-948171-20-0 
  33. ^ 33.0 33.1 Andrews P, Homeopathy and Hinduism, The Watchman Expositor. Watchman Fellowship. 1990, 7 (3) 
  34. ^ A 12C solution produced using sodium chloride (also called natrum muriaticum in homeopathy) is the equivalent of dissolving 0.36 mL of table salt, weighing about 0.77 g, into a volume of water the size of the Atlantic Ocean, since the volume of the Atlantic Ocean and its adjacent seas is 3.55×108 km3 or 3.55×1020 L : Emery KO, Uchupi E, The geology of the Atlantic Ocean, Springer. 1984, ISBN 0-387-96032-5 
  35. ^ 地體水體總體積約為1.36×109 km3: Earth's water distribution, Water Science for Schools, United States Geological Survey. 28 August 2006, ISBN 0-07-825402-7 
  36. ^ Gleick PH, Water resources, In Schneider SH., Encyclopedia of climate and weather, 2, New York: Oxford University Press. 1996:  817–823 
  37. ^ Robert L. Park, Superstition: Belief in the Age of Science, Princeton University Press. 2008:  145–146, ISBN 0-691-13355-7 
  38. ^ Fisher, P, The Memory of Water: a scientific heresy?, Homeopathy. 2007, 96 (3): 141–2, doi:10.1016/j.homp.2007.05.008, PMID 17678808