The efficacy of homoeopathic Ilex paraguensis in the treatment of nocturnal enuresis in children between five and eighteen years, residing in children's homes

Abstract

The purpose of this study was to evaluate the efficacy of lIex paraguensis 6x in the treatment of nocturnal enuresis. It was part of a group research project, which intended to explore the effectiveness of a homoeopathic complex (Cantharis vesicatoria 12ch, Equisetum hymenale 12ch, Sarsaparilla 12ch, Staphysagria 12ch, Uva ursi 12ch); as well as the homoeopathic simillimum in the treatment of the above-mentioned disorder. The research focuses on children between the ages of five and eighteen living in various children's homes in Durban. The incidence of nocturnal enuresis in these institutions is high and poses a real problem to both the institutions and the affected children. Nocturnal enuresis is categorised into primary and secondary enuresis. Primary nocturnal enuresis is defined as the failure to achieve dryness consistently and accounts for more than 90 percent of all cases of enuresis (Ullom-Minnich, 1996: 2259). Secondary enuresis refers to the return of incontinence after an extended period of dryness (Ullom-Minnoch, 1996: 2259). For the purpose of this study this distinction was largely ignored as homoeopathic treatment is not reliant on a detailed diagnosis for it's efficacy. The children were however screened for chronic urinary tract infections as well as other neurological and systemic causes e.g. diabetes mellitus. Each child received a full physical examination as well as a detailed homoeopathic case taking. The aim of the above was to exclude any clear aetiologies as well as to establish the homoeopathic simillimum. The sample comprised twenty-six children, five received placebo, and twenty-one received llex paraguensis. This study was part of a larger group research, which comprised of sixty-eight children divided into four groups. Three trial groups of fifteen, sixteen and twenty-one children each, and one placebo group of sixteen children i.e. the placebo group was shared. An observation period of two weeks with the completion of enuresis diaries was used as a baseline for statistical analysis. The following two weeks formed the treatment period with each child receiving a single powder each evening before bed. The remaining four weeks formed the post treatment observation period. Upon completion of the trial, placebo group children were offered free treatment and those who wished to continue with treatment were referred to the Homoeopathic Day Clinic. Results were analysed using descriptive and non-parametric statistical procedures. The average number of wet nights was used and the results analysed both within and across the groups. The Mann-Whitney U test was applied to the inter group comparison and the Wilcoxon's Signed Rank test was applied to the intra group comparison. No statistically significant improvement was noted in either the placebo or treatment group. There was also no statistically significant difference between the two groups. This indicated an absence of response to homoeopathic treatment with lIex paraguensis. This study failed to demonstrate any clinical improvement in symptoms of nocturnal enuresis. Possible wider psychodynamic improvements or clinical improvements over a longer time period were not measured in this study. Further research could be aimed to assess these areas, before final conclusions can be made about the efficacy of homeopathic lIex paraguensis in the management of nocturnal enuresis.