Autohemotherapy

from Wikipedia, the free encyclopedia

The term autologous blood therapy or autologous blood treatment is understood to mean different methods which have in common that a certain amount of blood is first taken from the patient and then re-injected or infused, with some methods being treated in different ways beforehand. Proponents of autologous blood therapy see the various procedures as “unspecific stimulation therapies” or unspecific retuning therapies . These belong to the alternative medical procedures. The body's own blood should serve as a stimulus for foreign bodies. The origins of autologous blood therapy are experiments by the English doctor William Highmore in 1874 and by Novotny in 1912. The Swedish doctors Elfstrom and Grafstrom , who lived in the USA and who first administered autologous blood to their patients in cases of severe infections in 1898, are considered to be the founders of autologous blood therapy. The Berlin surgeon August Bier made autologous blood therapy a breakthrough in 1905. It is documented that treatment with autologous blood was a common medical treatment method in Germany from the beginning of the 20th century to around 1960 with a wide variety of indications. The introduction of the sulfonamides in 1932 led to the gradual decline in autologous blood therapy and was replaced by therapy with antibiotics . In addition to alternative practitioners, it is mainly still used by naturopathic doctors. According to a survey from 1997, around 75,000 doctors in Germany used their own blood. In 2000 it was the third most popular naturopathic procedure after acupuncture and homeopathy .

The autologous blood procedures are both the autologous blood donation (autotransfusion), as well as from various dialysis methods to distinguish severe.

In practice, unchanged autologous blood is most often used. Another common variant of autologous blood treatment includes the addition of ozone . As a rule, the autologous blood therapy is repeated several times.

The medical effectiveness of the method has not been scientifically proven due to the lack of randomized controlled studies , and in some indications it has even been refuted.

Different forms of autologous blood treatment

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Most autologous blood treatments take 0.5 to 5 ml of blood from the arm vein. The reinjection of the withdrawn blood takes place later intramuscularly , subcutaneously , intracutaneously or intravenously . In a special case (potentized autologous blood according to Imhäuser), a small amount of blood is given to the patient for oral intake.

  • The simplest variant is to inject the withdrawn blood back into it: the unchanged autologous blood therapy.
  • Autohemotherapy with defibrinated autologous blood: the blood is mechanically coagulated and the fibrin that has formed is removed before re-injection.
  • ozone autologous blood therapy: the blood is enriched with an ozone-oxygen mixture and returned.
  • Hematogenous oxidation therapy (HOT), blood washing according to Wehrli, photobiological treatment: 50–200 ml of blood are rendered incoagulable with sodium citrate and heparin . Oxygen and ozone are blown in and the foam is irradiated with a UV-C lamp and infused back. Several studies have failed to show the effectiveness of this non-refundable method.
  • With ultraviolet-activated autologous blood therapy (UVE) , the blood is also irradiated with UV-C light and mechanically moved before it is injected back .
  • Autologous blood therapy with the addition of homeopathic preparations.
  • Autologous blood therapy with the addition of immune stimulants such as Echinacea .
  • Autologous target cytokines (ATC) according to Nikolaus Klehr for the therapy of cancer .
  • Autologous blood nosode : Taking a drop of blood from the fingertip, homeopathic treatment of the blood and oral intake by the patient (mostly children here).
  • Reinjection of hemolyzed autologous blood: Here, the blood is brought to osmotic hemolysis by adding distilled water and then injected back.
  • Reinjection of mechanically hemolyzed autologous blood (cluster autologous blood): The blood is pumped several times through a mixing chamber (trade name Foamake), the cell membranes are mechanically destroyed.
  • Collection of venous blood, centrifugation and local injection (mostly in the area of ​​a diseased joint) as so-called " autologous platelet-rich plasma "

According to another classification, there is also talk of a small and a large autologous blood therapy.

In rare cases, small amounts of the parents' blood should also be used in children if they are very afraid of injections.

commitment

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The autologous blood treatment should strengthen the body's defenses and work against chronic infections , allergic diseases , neurodermatitis , asthma , warts , rheumatic diseases or circulatory disorders . Similar to regular cold showers or visits to the sauna , they should change the mind of the body and awaken its self-healing powers . According to these ideas, the blood injected into the muscles stimulates the immune system . However, this should not be directed against one's own blood, but, once activated, act more strongly against foreign intruders such as viruses or bacteria . In the case of other diseases, an alleged improvement in blood flow is more in the foreground.

Complications and side effects

As with autologous blood donation , there are no immunological problems with autologous blood therapy. The transmission of viruses and bacteria is also excluded. Basically (as with any invasive procedure) there is the possibility that the injection may lead to an infection if the sterility is insufficient .

Autohaemotherapy is contraindicated in people with coagulation disorders, as bruises and abscesses can occur (for example during chemotherapy ) . Further contraindications exist with simultaneous immunosuppressive therapy , pathological hyperfunction of the thyroid gland , severe liver and kidney damage.

After treatment, intolerance reactions can include nettle rash , dizziness, headache, fever and palpitations, and if autologous blood has been injected with additional substances, in severe cases an allergic shock .

Effect of autologous blood therapy

The autologous blood therapy is primarily empirical medicine. In the field of autologous blood therapy, research was mainly carried out in the first half of the 20th century. The claimed mode of action is not plausible from a scientific point of view. As part of the consultation of hematogenous oxidation therapy (HOT) (also: blood washing according to Wehrli, or: photobiological treatment) before the working committee "Medical Treatment" of the Federal Committee of Doctors and Health Insurance Funds in 2000, the examination of the scientific findings on HOT showed that Randomized controlled trials are possible and carried out for this therapy. However, the evaluated scientific documents could not prove a benefit of the HOT. The positive effects on the disease process described by the users could also not be scientifically proven. Here is placebo assumed -Effekten.

In the largest study to date on autologous blood injection to support the conservative treatment of complete medial Achilles tendon ruptures, no benefit compared to placebo could be demonstrated.

In a review from 2017 with 31 processed references from the Alpha Clinic in Zurich, which reports on the possible uses of various forms of autologous blood therapy in the field of traumatology, it is summarized as follows:

"Autohemotherapy has received a lot of attention recently and has been used for numerous indications. The mode of action of autohemotherapy aims to fill a defect and release local growth factors in order to initiate and maintain wound healing. As part of this mode of action, positive effects of autologous therapies have been found for the treatment of tendons, ligaments and cartilage damage. Research is currently being carried out into how these indications can be expanded through the targeted addition of cells or through supporting biomaterials. "

In 2013 the German Society for Dentistry, Oral and Maxillofacial Medicine (DGZMK), after evaluating 24 literature references, saw itself prompted to recommend that "the use of autologous blood and autologous blood products (...) in reconstructive surgery of the dental, The mouth and jaw area [has] a long, scientifically founded tradition ".

The IGeL monitor of the MDS (Medical Service of the Central Association of Health Insurance Funds) has evaluated the scientific literature specifically on autologous blood therapy for tendon irritation and rates this self-pay service as “tending to be negative”. There was no evidence of a benefit compared to a comparator therapy (corticoids, anesthetic). Possible harmful effects can therefore not be justified.

Legal position

In the context of the specification of § 28 TFG, a dispute has recently been triggered as to whether the Transfusion Act applies to the various variants of autologous blood therapy .

costs

Autologous blood therapy is an individual health service (IGeL). The GOÄ provides for number 284 for autologous blood therapy. Expect around 7 to 20 euros per injection (according to GOÄ = fee schedule for doctors). A treatment cycle can cost up to around 500 euros. The costs of autologous blood therapy are only covered by a few statutory health insurance companies as a statutory benefit in accordance with Section 11 (6) SGB V adopted. This should be seen under the aspect of strengthening competition among health insurers on the benefit side.

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  1. ↑ Krebs, Praxis der Eigenbluttherapie, 5th edition 2008.
  2. ↑ Schürer-Waldheim, F .: About the mode of action of autologous blood treatment . In: German journal for surgery . Springer, April 1933, ISSN  1435-2451 , p. 352-362 .
  3. ^ Höveler, Victor: Eigenbluttherapie: A primer for practice . 7th edition. Haug, Heidelberg 1998, ISBN 3-7760-1701-5 , p. 14 .
  4. ↑ Gündling PW: The importance of autologous blood therapy for acute respiratory infections . In: EHK . Haug, 2009, p. 14-20 , doi : 10.1055 / s-0029-1213489 .
  5. ↑ Harald Krebs: autologous blood therapy . In: Volker Schmiedel, Matthias Augustin (Ed.): Guide to Naturopathy . 7th edition. Urban & Fischer / Elsevier, 2017, ISBN 978-3-437-55143-7 , pp. 207 .
  6. ↑ Gedeon: Autologous Blood Therapy and Other Autologous Procedures - A Textbook for Medical Practice . Ed .: Wolfgang Gedeon. Karl F. Haug Verlag, Heidelberg 2000, ISBN 3-8304-7021-5 , p. 16 .
  7. ↑ a b Jobst D et al .: Do intramuscular administration of autologous blood help in chronic recurrent infections of the respiratory tract? - Fallen in the path of a randomized trial . In: Z Allg Med . No. 81 , 2005, pp. 258-263 .
  8. ↑ a b c d Helmut Sauer: autologous blood therapy, oxygen and ozone therapy . In: Karin Kraft, Rainer Stange (Ed.): Textbook Naturopathic Treatment . Stuttgart 2010, ISBN 978-3-8304-5333-8 , pp. 468-484 .
  9. ↑ Bühring M et al .: Autologous blood treatment in practice. First results of a survey . In: Z Allg Med . 1997, p. 73 .
  10. ↑ a b Injections of autologous blood are no more effective than placebo injections in the case of rupture of the Achilles tendon . In: Ludwig WD, Schuler J (ed.): The drug letter . tape 54 , no. 1 . Westkreuz Verlag, Berlin, p. 07a .
  11. ↑ a b Pschyrembel, Naturopathy and alternative healing methods, 4th edition 2011, page 119.
  12. ^ Stiftung Warentest (Hg): The other medicine. Benefits and risks of gentle healing methods, Berlin 2nd edition 1992, p. 223
  13. ↑ Gedeon: Autologous Blood Therapy and Other Autologous Procedures - A Textbook for Medical Practice . Ed .: Wolfgang Gedeon. Karl F. Haug Verlag, Heidelberg 2000, ISBN 3-8304-7021-5 , p. 35 .
  14. ^ Haferkamp, ​​Hans: The autologous blood treatment . Hippocrates, Stuttgart 1951.
  15. ↑ Haematogenous oxidation therapy (HOT) - Summary Report of the Working Committee "Medical treatment" of the Federal Committee of Physicians and Health Insurers on the deliberations under §135 paragraph 1 SGB V. ( Memento of 29 September 2007 at the Internet Archive ) IKK.de, March 30 2001.
  16. ↑ Keene, DJ, et al .: Platelet rich plasma in Achilles Tendon Healing (PATH-2 Trial) . In: British Medical Journal . tape 367 , 2019, pp. l6132 .
  17. ↑ a b Erggelet Ch. Et al: Evidence in autologous blood therapies: PRP, ACP, ACS . In: Swiss Journal for Sports Medicine & Sports Traumatology . Vol. 65 (2), 2017, pp. 21-25 .
  18. ↑ Schliephake H: Scientific report of the DGZMK: Recommendation for the use of autologous blood and autologous blood products in dentistry, oral medicine and maxillofacial medicine . In: German Dental Journal . No. 68 (5) , 2013, pp. 313 f .
  19. ↑ IGeL-Monitor, evaluation of autologous blood therapy for tendinopathy . Retrieved October 11, 2018.
  20. ↑ Spickhoff, Medical Law, 3rd edition 2018, Section 28 TFG, no. 3.
  21. ↑ Strengthening the immune system through treatment of autologous blood, der general practitioner, 01/2016, p. 37.
  22. ↑ Autologous blood therapy finds more followers ( Memento from October 19, 2009 in the Internet Archive ) Lifeline.de, November 21, 2002.
  23. ↑ Service area: Naturopathic Treatment / Alternative Medicine (PDF file; 261 kB) Rechtskrankenkassen.de, September 9, 2012.
  24. ↑ Tintner: § 11 Types of Services / 2.7 Statutory Services (Paragraph 6). In: Sommer, SGB V Komm.Haufe Online, accessed on January 26, 2019 .