Homeopathic treatment in acute gout

285 Pages·2013·3.03 MB·English

by  Cara, Raakhi.

Homoeopathic Treatment in Acute Gout
A research report submitted to the faculty of Health Sciences,
Technikon Witwatersrand, Johannesburg, in partial fulfillment of the requirements
for the degree of Masters of Technology: Homoeopathy
by
Raakhi Cara
(Student number: 9614149)
Prof. M. Tikly
Supervisor
Dr. E. M. Solomon
Co-Supervisor
Johannesburg, 2003
DECLARATION
I declare that this research report is my own, unaided work. It is being submitted
for the Degree of Masters of Technology at the Technikon Witwatersrand,
Johannesburg. It has not been submitted before any degree or examination in any
other Technikon, or University.
su,
(Signature of candidate)
(cid:9)13fhn day of l'''Ec'"9' E2 a c
'° 3
ii
Dedicated to my loving,
husband Nilesh, and my parents, Pravin and Luxmi,
for enabling me to pursue my dreams
Ill
ACKNOWLEDGEMENTS
I would like to express my sincere gratitude to the following individuals for their
assistance in the completion of this dissertation.
Supervisor: Prof. M. Tikly (FRCP, PhD)
Co-Supervisor: Dr. E.M. Solomon (HD. ND.DO . (Lind), BA (Unisa)
Statistician: Lasath Pundyadeera
Technikon Witwatersrand for financial assistance
All the volunteers that participated in this trial
Dr. Bradshaw, Dr. Eden, Dr. Hardy and Dr Pellow from Weleda Pharmacy for
their guidance
iv
ABSTRACT
This research was conducted to determine the effect of homoeopathic treatment
on acute gout patients. Putterman (1994) conducted a research study on the effect
of the homoeopathic remedy Colchicum autumnale in gout, and found partial
improvement in the clinical picture of gout. No research has been conducted in
South Africa on the efficacy of homoeopathic medicines in acute gout patients.
This study focused on the homoeopathic Law of Similars, where a single most
similar homoeopathic remedy was chosen according to the unique characteristic
symptoms displayed by each participant suffering with acute gout.
This was a qualitative study that used ten subjects who presented within five days
of acute gout and participated in the fifteen-day study period. Participants that
complied with the American College of Rheumatology (formerly American
Rheumatism Association, ACR) criteria for gout were selected. Serum uric acid
tests were taken on day 0 and day 6 to assess hyperuricemia. On day 0 a thorough
case history and examination was taken followed by administration of the
indicated remedy. Treatment efficacy was evaluated on day 1, 3 and 6, based on
daily subjective impression of participant involvement, objective analysis and
comparative analysis of serum uric acid. Re-examination for relapses or rebound
attacks followed on day 15.
In a study using allopathic remedies in acute gout, resolution of all acute gout
symptoms occurred at an average of 8 days using indomethacin and 7 days using
triamcinolone (Alloway et. al., 1993). In this study using homoeopathic
similimum treatment, resolution of all acute gout symptoms occurred at an
average of 6 days. One episode of a rebound gout attack occurred and serum uric
acid decreased in 80% of patients. Homoeopathic similimum prescribing is an
effective alternative treatment for acute gout. Although more research is required,
the preliminary findings of this study suggest that the correct homoeopathic
similimum treatment is an effective treatment for the symptoms of acute gout.
TABLE OF CONTENTS(cid:9) Page no.
TITLE PAGE (cid:9) i
DECLARATION (cid:9) ii
DEDICATION (cid:9) iii
ACKNOWLEDGEMENTS (cid:9) iv
I (cid:9)
ABSTRACT(cid:9) v
TABLE OF CONTENTS (cid:9) vi
APPENDICES(cid:9) xii
LIST OF TABLES (cid:9) xiii
LIST OF GRAPHS (cid:9) xv
LIST OF ABBREVIATIONS (cid:9) xvi
CHAPTER ONE: INTRODUCTION(cid:9) 1
1.1 General Introduction (cid:9) 1
I (cid:9) 1.2 Aim of study (cid:9) 1
CHAPTER TWO: LITERATURE REVIEW (cid:9) 2
2.1 Gout (cid:9) 2
2.2 Four stages of gout (cid:9) 2
2.2.1 Asymptomatic hyperuricemia (cid:9) 2
2.2.2 Acute gout (cid:9) 3
2.2.3 Recurrent attacks (cid:9) 4
I (cid:9) 2.2.4 Intercritical stage (cid:9) 4
2.2.5 Chronic stage (cid:9) 5
2.3 Hyperuricemia (cid:9) 6
2.3.1 Underexcretion of urate (cid:9) 7
2.3.2 Overproduction of urate (cid:9) 8
2.4 Pathogenesis (cid:9) 9
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2.5 Prognosis (cid:9) 10
2.6 Diagnosis (cid:9) 10
2.7 Risk factors (cid:9) 11
2.8 Epidemiology (cid:9) 12
2.9 Randomized studies on acute gout (cid:9) 12
2.10 Management of gout (cid:9) 13
2.10.1 Termination of the acute painful attack (cid:9) 13
2.10.2 Prevention of recurrences (cid:9) 13
2.10.3 Preventing urate deposition (cid:9) 13
2.10.4 Diet (cid:9) 13
2.10.5 Complications of allopathic treatment (cid:9) 14
2.10.6 Alternative approach (cid:9) 15
2.11 Homoeopathy (cid:9) 15
2.11.1 Preparation of homoeopathic remedies and potentization (cid:9) 16
2.11.2 Proving (cid:9) 17
2.11.3 Materia medica (cid:9) 17
2.11.4 Single remedy (cid:9) 18
2.11.5 Determination of homoeopathic remedies in acute cases (cid:9) 18
2.11.6 Repertorization (cid:9) 19
2.11.7 Responses that indicate cure (cid:9) 20
2.11.8 Aggravation (cid:9) 21
CHAPTER THREE: METHODOLOGY (cid:9) 22
3.1 Sample selection (cid:9) 22
3.2 Trial period (cid:9) 22
3.3 Homoeopathic repertorization and treatment (cid:9) 23
3.4 Medication (cid:9) 23
3.5 Subjective and objective assessment (cid:9) 23
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3.6 Questionnaires (cid:9) 24
3.7 Analysis of urate (cid:9) 25
3.8 Data interpretation and statistical analysis (cid:9) 25
CHAPTER FOUR: CASE STUDIES (cid:9) 27
4.1 Patient A (cid:9) 27
4.1.1 Homoeopathic treatment (cid:9) 28
4.1.2 Follow up cases (cid:9) 29
4.1.3 Discussion (cid:9) 30
4.1.4 Subjective improvement as a percentage (cid:9) 31
4.1.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 31
4.1.6 Change in SUA on day 0 and day 6 (cid:9) 31
4.2 Patient B (cid:9) 32
4.2.1 Homoeopathic treatment (cid:9) 33
4.2.2 Follow up cases (cid:9) 34
4.2.3 Discussion (cid:9) 35
4.2.4 Subjective improvement as a percentage (cid:9) 36
4.2.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 36
4.2.6 Change in SUA on day 0 and day 6 (cid:9) 36
4.3 Patient C (cid:9) 37
4.3.1 Homoeopathic treatment (cid:9) 38
4.3.2 Follow up cases (cid:9) 39
4.3.3 Discussion (cid:9) 40
4.3.4 Subjective improvement as a percentage (cid:9) 41
4.3.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 41
4.3.6 Change in SUA on day 0 and day 6 (cid:9) 41
4.4 Patient D (cid:9) 42
4.4.1 Homoeopathic treatment (cid:9) 42
4.4.2 Follow up cases (cid:9) 43
4.4.3 Discussion (cid:9) 44
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4.4.4 Subjective improvement as a percentage (cid:9) 45
4.4.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 45
4.4.6 Change in SUA on day 0 and day 6 (cid:9) 45
4.5 Patient E (cid:9) 46
4.5.1 Homoeopathic treatment (cid:9) 47
4.5.2 Follow up cases (cid:9) 48
4.5.3 Discussion (cid:9) 49
4.5.4 Subjective improvement as a percentage (cid:9) 50
4.5.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 50
4.5.6 Change in SUA on day 0 and day 6 (cid:9) 50
4.6 Patient F (cid:9) 51
4.6.1 Homoeopathic treatment (cid:9) 52
4.6.2 Follow up cases (cid:9) 52
4.6.3 Discussion (cid:9) 53
4.6.4 Subjective improvement as a percentage (cid:9) 54
4.6.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 54
4.6.6 Change in SUA on day 0 and day 6 (cid:9) 54
4.7 Patient G (cid:9) 55
4.7.1 Homoeopathic treatment (cid:9) 56
4.7.2 Follow up cases (cid:9) 57
4.7.3 Discussion (cid:9) 58
4.7.4 Subjective improvement as a percentage (cid:9) 58
4.7.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 58
4.7.6 Change in SUA on day 0 and day 6 (cid:9) 58
4.8 Patient H (cid:9) 59
4.8.1 Homoeopathic treatment (cid:9) 60
4.8.2 Follow up cases (cid:9) 61
4.8.3 Discussion (cid:9) 61
4.8.4 Subjective improvement as a percentage (cid:9) 62
4.8.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 62
4.8.6 Change in SUA on day 0 and day 6 (cid:9) 62
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4.9 Patient I (cid:9) 63
4.9.1 Homoeopathic treatment (cid:9) 64
4.9.2 Follow up cases (cid:9) 64
4.9.3 Discussion (cid:9) 65
4.9.4 Subjective improvement as a percentage (cid:9) 66
4.9.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 66
4.9.6 Change in SUA on day 0 and day 6 (cid:9) 66
4.10 Patient J (cid:9) 67
4.10.1 Homoeopathic treatment (cid:9) 68
4.10.2 Follow up cases (cid:9) 68
4.10.3 Discussion (cid:9) 69
4.10.4 Subjective improvement as a percentage (cid:9) 70
4.10.5 Objective improvement on day 0, 1, 3, 6 and 15 (cid:9) 70
4.10.6 Change in SUA on day 0 and day 6 (cid:9) 70
CHAPTER FIVE: QUANTITATIVE ANALYSIS(cid:9) 71
5.1 Demographics (cid:9) 71
5.2 Clinical baseline data (cid:9) 72
5.3 Response to therapy (cid:9) 73
5.4 Compliance of patients (cid:9) 74
CHAPTER SIX: QUALITATIVE ANALYSIS(cid:9) 90
6.1 The correlation with other studies of acute gout (cid:9) 90
6.1.1 Diagnosis (cid:9) 90
6.1.2 Gender (cid:9) 90
6.1.3 Family history (cid:9) 91
6.1.4 Age related symptoms (cid:9) 91
6.1.5 Obesity (cid:9) 91
6.1.6 Alcohol abuse (cid:9) 91