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Integrative oder alternative Kinder- und Jugendmedizin?

Spagat zwischen Innovation und Scharlatanerie

Integrative or alternative pediatric medicine?

Balancing act between innovation and charlatanry

  • Leitthema
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Bei alternativer Medizin und Komplementärmedizin handelt es sich um Sammelbezeichnungen für Therapien, die als Alternative oder Ergänzung zur Schulmedizin angewendet werden. Eine wirklich alternative Medizin ist generell bei relevanten Erkrankungen extrem problematisch, wenn etablierte Therapiekonzepte vorhanden sind. Daher handelt es sich in der Kinderheilkunde um eine ergänzende Behandlung – also um Komplementärmedizin. Mit dem Begriff integrative Medizin wird eine Kombination aus bester evidenzbasierter Schulmedizin und komplementärmedizinischen Verfahren bezeichnet. In der allgemeinen Bevölkerung und in der Kinderheilkunde nimmt die Nutzung von Komplementärmedizin seit Jahren zu. Asiatische Therapieverfahren wie Akupunktur, Traditionelle Chinesische Medizin oder das Spektrum der Mind-Body-Medizin gewinnen international immer mehr an Bedeutung, und in Deutschland verankerte Therapieverfahren wie Naturheilkunde, Phytotherapie, anthroposophische Medizin und Homöopathie werden häufig auch in der Kinderheilkunde in Anspruch genommen und auf erfahrungsheilkundlicher Basis angewendet. Die eingesetzten Medikamente einiger komplementärmedizinischer Richtungen werden im Arzneimittelgesetz (AMG) als „besondere Therapierichtungen“ bezeichnet und durch das Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) nach eigenen Kriterien zugelassen bzw. registriert. Obwohl im deutschen AMG eine Methodenvielfalt verankert ist, gibt es viel zu wenige wissenschaftliche Daten. Ziel des Beitrags ist die Darstellung der Komplementärmedizin in der Kinderheilkunde mit einem Plädoyer für mehr qualitativ gute Forschung in diesem Bereich, damit die Chancen innovativer Verfahren der Komplementärmedizin im Sinne einer integrativen Medizin genutzt und die Risiken minimiert werden können.

Abstract

Alternative medicine and complementary medicine are collective terms for therapies that are used as alternatives or supplements to conventional medicine. A truly alternative medicine is generally extremely problematic for relevant diseases if established treatment concepts are available. As a rule the treatment in pediatrics therefore always has to be a supplementary treatment, i.e. complementary medicine. The term integrative medicine refers to a combination of the best evidence-based conventional medicine and complementary medicine procedures. In the general population and in pediatrics the use of complementary medicine has been increasing for many years. Asian therapeutic procedures, such as acupuncture, traditional Chinese medicine or the spectrum of mind-body medicine are becoming more and more important internationally and therapeutic methods anchored in Germany, such as naturopathy, phytotherapy, anthroposophic medicine and homeopathy are also frequently used in pediatrics and applied on an experiential basis. The drugs used in some complementary medical systems are referred to in the German Medicines Act (AMG) as “particular therapeutic systems” and approved by the Federal Institute for Drugs and Medical Devices (BfAM) according to its own criteria. Although a variety of methods are anchored in the German AMG, there are far too little scientific data. The aim of this article is to present complementary medicine in pediatrics with a plea for more high-quality research in this field so that the opportunities offered by innovative procedures of complementary medicine can be exploited in the sense of integrative medicine and the risks minimized.

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Literatur

  1. Titel PVHM (2018) Heiler, Gurus, Scharlatane – der seltsame Boom der Alternativmedizin; Die Macht der Heiler. Spiegel (18.08.2018). https://magazin.spiegel.de/SP/2018/34/158957335/index.html

  2. Laengler A, Spix C, Seifert G, Gottschling S, Graf N, Kaatsch P (2008) Complementary and alternative treatment methods in children with cancer: a population-based retrospective survey on the prevalence of use in Germany. Eur J Cancer 44(15):2233–2240

    Article  PubMed  Google Scholar 

  3. Langler A, Spix C, Edelhauser F, Kameda G, Kaatsch P, Seifert G (2011) Use of homeopathy in pediatric oncology in Germany. eCAM 2011:867151

    PubMed  Google Scholar 

  4. Langler A, Zuzak TJ (2013) Complementary and alternative medicine in paediatrics in daily practice—a European perspective. Complementary Ther Med 21(Suppl 1):26–33

    Article  Google Scholar 

  5. Seifert G, Henze G, Langler A (2011) Adverse events associated with the use of complementary and alternative medicine in children. Arch Dis Child 96(8):786–787

    Article  PubMed  Google Scholar 

  6. NCCIH National Center for Complementary and Integrative Health (NCCIH) https://nccih.nih.gov/

  7. Anderson MD Integrative medicine center https://www.mdanderson.org/patients-family/diagnosis-treatment/care-centers-clinics/integrative-medicine-center.html

  8. https://www.bfarm.de/DE/Arzneimittel/Arzneimittelzulassung/Zulassungsarten/BesondereTherapierichtungen/_node.html.

  9. Esparham A, Misra S, Sibinga E et al (2018) Pediatric Integrative Medicine: Vision for the. Futur children (basel Switzerland) 5(8). https://doi.org/10.3390/children5080111

    Article  Google Scholar 

  10. McClafferty H, Vohra S, Bailey M et al (2017) Pediatric integrative medicine. Pediatrics 140(3):pii:e20171961. https://doi.org/10.1542/peds.2017-1961

    Article  Google Scholar 

  11. Ramesh G, Gerstbacher D, Arruda J, Golianu B, Mark J, Yeh AM (2018) Pediatric integrative medicine in academia: Stanford children’s experience. Children (Basel) 5:12

    Google Scholar 

  12. Vohra S, Zorzela L, Kemper K, Vlieger A, Pintov S (2019) Setting a research agenda for pediatric complementary and integrative medicine: a consensus approach. Complement Ther Med 42:27–32

    Article  PubMed  Google Scholar 

  13. Weydert JA, Brown ML, McClafferty H (2018) Integrative medicine in pediatrics. Adv Pediatr 65(1):19–39

    Article  PubMed  Google Scholar 

  14. https://www.imconsortium.org.

  15. Laengler A, Spix C, Edelhauser F et al (2010) Anthroposophic medicine in paediatric oncology in Germany: results of a population-based retrospective parental survey. Pediatr Blood Cancer 55(6):1111–1117

    Article  PubMed  Google Scholar 

  16. Kienle GS, Glockmann A, Grugel R, Hamre HJ, Kiene H (2011) Clinical research on anthroposophic medicine:update of a health technology assessment report and status quo. Forsch Komplementmed 18(5):269–282

    PubMed  Google Scholar 

  17. Baars EW, Koster EB, Verhoef J (2017) The contribution of Anthroposophic medicine to self-management: an exploration of concepts, evidence, and patient perspectives. Complementary Med Res 24(4):225–231

    Article  Google Scholar 

  18. Troger W, Galun D, Reif M, Schumann A, Stankovic N, Milicevic M (2014) Quality of life of patients with advanced pancreatic cancer during treatment with mistletoe: a randomized controlled trial. Dtsch Arztebl Int 111(29–30):493–502

    PubMed  PubMed Central  Google Scholar 

  19. Troger W, Galun D, Reif M, Schumann A, Stankovic N, Milicevic M (2013) Viscum album [L.] extract therapy in patients with locally advanced or metastatic pancreatic cancer: a randomised clinical trial on overall survival. Eur J Cancer 49(18):3788–3797

    Article  PubMed  CAS  Google Scholar 

  20. Mathie RT, Van Wassenhoven M, Jacobs J et al (2016) Model validity and risk of bias in randomised placebo-controlled trials of individualised homeopathic treatment. Complement Ther Med 25:120–125

    Article  PubMed  Google Scholar 

  21. Mathie RT, Ramparsad N, Legg LA et al (2017) Randomised, double-blind, placebo-controlled trials of non-individualised homeopathic treatment: systematic review and meta-analysis. Syst Rev 6(1):63

    Article  PubMed  PubMed Central  Google Scholar 

  22. Mathie RT, Lloyd SM, Legg LA et al (2014) Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis. Syst Rev 3:142

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hahn RG (2013) Homeopathy: meta-analyses of pooled clinical data. Forsch Komplementmed 20(5):376–381

    Article  PubMed  Google Scholar 

  24. Shang A, Huwiler-Muntener K, Nartey L et al (2005) Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet 366(9487):726–732

    Article  PubMed  Google Scholar 

  25. Anheyer D, Lauche R, Schumann D, Dobos G, Cramer H (2017) Herbal medicines in children with attention deficit hyperactivity disorder (ADHD): A systematic review. Complement Ther Med 30:14–23

    Article  PubMed  Google Scholar 

  26. Anheyer D, Frawley J, Koch AK et al (2017) Herbal medicines for gastrointestinal disorders in children and adolescents: a systematic review. Pediatrics 139(6):pii:e20170062. https://doi.org/10.1542/peds.2017-0062

    Article  Google Scholar 

  27. Anheyer D, Cramer H, Lauche R, Saha FJ, Dobos G (2018) Herbal medicine in children with respiratory tract infection: systematic review and meta-analysis. Acad Pediatr 18(1):8–19

    Article  PubMed  Google Scholar 

  28. Locher C, Pforr C (2014) The legacy of Sebastian Kneipp: linking wellness, naturopathic, and allopathic medicine. J Altern Complement Med 20(7):521–526

    Article  PubMed  Google Scholar 

  29. Eckert M, Anheyer M (2018) Applied pediatric integrative medicine: what we can learn from the ancient teachings of Sebastian Kneipp in a kindergarten setting. Children (Basel) 5(8). https://doi.org/10.3390/children5080102

    Article  PubMed Central  Google Scholar 

  30. Zou L, Zhang Y, Yang L et al (2019) Are mindful exercises safe and beneficial for treating chronic lower back pain? A systematic review and meta-analysis of randomized controlled trials. J Clin Med 8(5). https://doi.org/10.3390/jcm8050628

    Article  PubMed  Google Scholar 

  31. Hendriks T (2018) The effects of Sahaja Yoga meditation on mental health: a systematic review. J Complementary Integr Med 15(3). https://doi.org/10.1515/jcim-2016-0163

    Article  Google Scholar 

  32. Cramer H, Lauche R, Anheyer D et al (2018) Yoga for anxiety: a systematic review and meta-analysis of randomized controlled trials. Depress Anxiety 35(9):830–843

    Article  PubMed  Google Scholar 

  33. Danhauer SC, Addington EL, Cohen L et al (2019) Yoga for symptom management in oncology: a review of the evidence base and future directions for research. Cancer. https://doi.org/10.1002/cncr.31979

    Article  PubMed  Google Scholar 

  34. Dobos GAP (2019) Mind-Body-Medizin. Urban & Fischer in Elsevier, München

    Google Scholar 

  35. Kanitz JL, Camus ME, Seifert G (2013) Keeping the balance—an overview of mind-body therapies in pediatric oncology. Complementary Ther Med 21(Suppl 1):20–25

    Article  Google Scholar 

  36. - (2016) Mind-body therapies in children and youth. Pediatr Electron Pages 138(3). https://doi.org/10.1542/peds.2016-1896

    Article  Google Scholar 

  37. Zuzak TJ, Bonkova J, Careddu D et al (2013) Use of complementary and alternative medicine by children in Europe: published data and expert perspectives. Complementary Ther Med 21(Suppl 1):34–47

    Article  Google Scholar 

  38. Zuzak TJ, Zuzak-Siegrist I, Simoes-Wust AP, Rist L, Staubli G (2009) Use of complementary and alternative medicine by patients presenting to a Paediatric Emergency Department. Eur J Pediatr 168(4):431–437

    Article  PubMed  Google Scholar 

  39. Birdee GS, Phillips RS, Davis RB, Gardiner P (2010) Factors associated with pediatric use of complementary and alternative medicine. Pediatrics 125(2):249–256

    Article  PubMed  Google Scholar 

  40. Black LI, Clarke TC, Barnes PM, Stussman BJ, Nahin RL (2015) Use of complementary health approaches among children aged 4–17 years in the United States: National Health Interview Survey, 2007–2012. Natl Health Stat Report 78:1–19

    Google Scholar 

  41. Langler A, Boeker R, Kameda G, Seifert G, Edelhauser F, Ostermann T (2013) Attitudes and beliefs of paediatric oncologists regarding complementary and alternative therapies. Complementary Ther Med 21(Suppl 1):10–19

    Article  Google Scholar 

  42. (2016): AAoP. Periodic survey #49 Complementary and Alternative Medicine (CAM) therapies in pediatric practices. 2016.

  43. Treister-Goltzman Y, Peleg R (2015) Trends in publications on complementary and alternative medicine in the medical literature. J Complementary Integr Med 12(2):111–115

    Article  Google Scholar 

  44. Veziari Y, Leach MJ, Kumar S (2017) Barriers to the conduct and application of research in complementary and alternative medicine: a systematic review. Bmc Complementary Altern Med 17(1):166

    Article  Google Scholar 

  45. National Center for Complementary and Integrative Health (2016) Time to talk campaign. https://nccih.nih.gov/news/multimedia/gallery/asktell.htm

    Google Scholar 

  46. Eckert M, Amarell C, Anheyer D, Cramer H, Dobos G (2018) Integrative pediatrics: successful implementation of integrative medicine in a German hospital setting-concept and realization. Children (Basel) 5(9). https://doi.org/10.3390/children5090122

    Article  PubMed Central  Google Scholar 

  47. Stritter W, Rutert B, Langler A, Eggert A, Holmberg C, Seifert G (2018) Integrative care for children with cancer. Project design for the development of an integrative care programme for use in paediatric oncology. Complement Ther Med 41:247–251

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Klinik für Pädiatrie mit Schwerpunkt Onkologie und Hämatologie, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    G. Seifert

  2. Faculty of Medicine, Department of Paediatrics, University of São Paulo, São Paulo, Estado de São Paulo, Brasilien

    G. Seifert

  3. Abteilung für Kinder- und Jugendmedizin, Gemeinschaftskrankenhaus, Herdecke, Deutschland

    T. Zuzak & A. Längler

  4. Department für pädiatrische Hämato-Onkologie, Kinderklinik III, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland

    T. Zuzak

  5. Fakultät für Gesundheit, Professur für Integrative Kinder- und Jugendmedizin, Institut für Integrative Medizin, Universität Witten/Herdecke, Witten, Deutschland

    A. Längler

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Correspondence to G. Seifert.

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Interessenkonflikt

G. Seifert erhielt finanzielle Mittel zur Durchführung von Symposien, Vortragshonorare und Reisekostenerstattungen von den Firmen: Dr. Willmar Schwabe GmbH & Co. KG, SALUS Pharma GmbH, Aurora Europe GmbH, Ligetis GmbH, Weleda AG, Helixor Heilmittel GmbH. A. Längler und T. Zuzak und geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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R. Kerbl, Leoben

W. Kaulfersch, Klagenfurt am Wörthersee

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Seifert, G., Zuzak, T. & Längler, A. Integrative oder alternative Kinder- und Jugendmedizin?. Monatsschr Kinderheilkd 167, 758–767 (2019). https://doi.org/10.1007/s00112-019-0737-x

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