Homeopathic treatment of migraine in adults: A randomized trial

Migraine is a disabling neurological disorder that substantially impairs quality of life. Although individualized homoeopathic medicines (IHMs) are widely used, robust evidence remains limited. This randomized, double-blind, placebo-controlled trial evaluated IHMs selected using Boenninghausen’s Characteristics and Repertory (BCR) guided by Boenninghausen’s hexameter in 99 adults with migraine (IHMs: n = 66; placebo: n = 33) over three months. The primary outcome was migraine-related disability (MIDAS), while secondary outcomes included RAND SF-36, MYMOP-2, headache frequency, pain intensity, and rescue analgesic use. Compared with placebo, IHMs produced statistically significant and clinically meaningful improvements across all outcomes, with reduced disability, headache burden, symptom severity, and analgesic use, alongside improved quality of life. Among the 24 prescribed remedies, Nux vomica, Sepia, and Cinchona officinalis were most frequently used, while Magnesium carbonicum and Natrum carbonicum showed the most consistent benefit. Bang’s Blinding Index and Berger–Exner testing confirmed successful blinding and allocation concealment. The systematic application of Boenninghausen’s hexameter provided a structured framework for individualized case analysis and repertorization using BCR. Overall, IHMs selected through this approach were superior to placebo in improving migraine outcomes, warranting confirmation in larger multicentric trials with longer follow-up.偏头痛是一种致残性神经系统疾病，会严重损害患者的生活质量。尽管个体化顺势疗法药物（individualized homoeopathic medicines, IHMs）应用广泛，但相关可靠证据依然有限。本项随机双盲安慰剂对照试验，以博宁豪森六步诊疗法为指导，采用博宁豪森特征与症状对照表（Boenninghausen’s Characteristics and Repertory, BCR）筛选个体化顺势疗法药物，共纳入99名成年偏头痛患者（顺势疗法药物组：n=66；安慰剂组：n=33），随访时长为3个月。本试验的主要结局指标为偏头痛相关残疾量表（MIDAS），次要结局指标包括RAND健康调查简表36项（RAND SF-36）、偏头痛疗效评价量表2（MYMOP-2）、头痛发作频率、疼痛强度以及急救镇痛药使用情况。与安慰剂组相比，个体化顺势疗法药物组在所有结局指标上均展现出具有统计学意义且临床价值显著的改善，具体表现为残疾程度降低、头痛负担减轻、症状严重程度下降以及镇痛药使用减少，同时患者生活质量得到提升。在24种开具的治疗药物中，马钱子（Nux vomica）、乌贼墨制剂（Sepia）以及金鸡纳皮（Cinchona officinalis）的使用频率最高；而碳酸镁制剂（Magnesium carbonicum）与碳酸钠制剂（Natrum carbonicum）则展现出最为稳定的治疗获益。邦氏盲法指数（Bang’s Blinding Index）与伯杰-埃克斯纳检验（Berger–Exner testing）证实本试验成功实现了盲法及分配隐藏。博宁豪森六步诊疗法的系统化应用，为基于博宁豪森特征与症状对照表的个体化病例分析及症状对照筛选提供了结构化框架。总体而言，通过该方法筛选出的个体化顺势疗法药物在改善偏头痛结局方面优于安慰剂，该结论有待在更大规模的多中心试验及更长随访周期中进一步验证。