Abstract:
Background: The risk for lower extremity amputation (LEA) in patients with diabetic foot ulcer is high, and high
recurrence rates of foot ulcers pose a risk that the amputations will be repeated. While the incidence rates of
diabetic foot ulcers are often poorly documented, such as is the case in India, the heavy strain of the disease
on health care budgets can easily
be felt the world over. The high cost of the treatment of foot ulcers causes
many patients to neglect needed care, resulting in amputations. The present observational study of diabetic
foot ulcer was undertaken for the purpose of deriving a group of useful homeopathic medicines for the treatment
of this condition, hopefully revealing a cost effective means of reducing the incidence of foot amputations.
Method: A prospective observational study was conducted by the Central Council for Research in
Homoeopathy at its Drug Standardization Extension Unit, Hyderabad, from October 2005 to September
2009. One hundred and fifty-six (156) patients with diabetic foot ulcer in the age group of above
thirty years from both sexes were screened and eighty-one patients were enrolled as per the pre-set
inclusion and exclusion criteria. Out of eighty-one cases enrolled only sixty-three cases completed
the follow up. The remainder of the cases were excluded. Homeopathic medicines prescribed to
the enrolled patients were limited to a group of fifteen pre-defined trial medicines. The improvement
of the cases was assessed basing upon the diabetic foot ulcer assessment score, before and after
treatment, on a prescribed format devised by the council (Table 1) and by periodic
photographs.
Results: The difference in the mean of the ulcer assessment score was found to be statistically significant
(P=0.000, <0.05) after the treatment with trial medicines. In only one case, the ulcer assessment score showed
no significant improvement from the baseline. Silicea (n=22), Sulphur (n=11), Lycopodium (n=10), Arsenic
album (n=8), Phosphorus (n=8) were found to be the most useful among the fifteen pre-identified trial medicines.
Conclusion: This was an observational study with positive results; however, it is difficult to attribute the positive
results to homeopathic therapy alone as the dressing of the ulcer and ancillary measures of themselves
often eventuate in ulcer resolution.
Further RCT corroboration is recommended for validation of the results.
