Pittler M H, Ernst E
Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, United Kingdom.
J Clin Psychopharmacol. 2000 Feb;20(1):84-9. doi: 10.1097/00004714-200002000-00014.
Synthetic anxiolytic drugs are effective for treating anxiety, but they are burdened with adverse effects. Constraints on resources and time often render therapies such as psychologic interventions impracticable. Thus, an effective oral medication with few adverse effects would be a welcome addition to the therapeutic repertoire. This systematic review and meta-analysis was aimed at assessing the evidence for or against the efficacy of kava extract as a symptomatic treatment for anxiety. Systematic literature searches were performed in the computerized databases MEDLINE, EMBASE, BIOSIS, AMED, CISCOM, and the Cochrane Library (all from their respective inception to June 1998). The search terms used were kava, kawa, kavain, Piper methysticum, and Rauschpfeffer (German term for Piper methysticum). Experts on the subject were contacted to provide further information. There were no restrictions regarding the language of publication. Double-blind, randomized, placebo-controlled trials of oral kava extract for the treatment of anxiety were included. All publications were blinded before assessment by a person not involved in the study. Data were extracted in a standardized, predefined fashion independently by the two reviewers. The methodologic quality of all trials was assessed. Superiority of kava extract over placebo was suggested by all seven reviewed trials. The meta-analysis of three trials suggests a significant difference in the reduction of the total score on the Hamilton Rating Scale for Anxiety in favor of kava extract (weighted mean difference, 9.69; 95% confidence interval, 3.54-15.83). These data imply that kava extract is superior to placebo as a symptomatic treatment for anxiety. Therefore, kava extract is an herbal treatment option for anxiety that is worthy of consideration.
合成抗焦虑药物对治疗焦虑有效，但存在不良反应。资源和时间的限制常常使心理干预等疗法难以实施。因此，一种不良反应少的有效口服药物将是治疗方案中的一个受欢迎的补充。本系统评价和荟萃分析旨在评估支持或反对卡瓦提取物作为焦虑症对症治疗有效性的证据。在MEDLINE、EMBASE、BIOSIS、AMED、CISCOM和Cochrane图书馆等计算机数据库中进行了系统的文献检索（均从各自创建至1998年6月）。使用的检索词为卡瓦、卡哇、卡瓦因、胡椒科植物卡瓦胡椒以及Rauschpfeffer（德语中卡瓦胡椒的名称）。联系了该领域的专家以获取更多信息。对出版物的语言没有限制。纳入了口服卡瓦提取物治疗焦虑症的双盲、随机、安慰剂对照试验。所有出版物在由未参与该研究的人员进行评估之前均进行了盲法处理。两位审阅者以标准化、预先定义的方式独立提取数据。评估了所有试验的方法学质量。所有七项纳入综述的试验均表明卡瓦提取物优于安慰剂。三项试验的荟萃分析表明，汉密尔顿焦虑量表总分降低方面存在显著差异，支持卡瓦提取物（加权平均差为9.69；95%置信区间为3.54 - 15.83）。这些数据表明，作为焦虑症的对症治疗，卡瓦提取物优于安慰剂。因此，卡瓦提取物是一种值得考虑的焦虑症草药治疗选择。
