Little C, Parsons T
Institute of Health & Community Studies, Bournemouth University, Bournemouth House, Bournemouth University, 17 Christchurch Road, Bournemouth, Dorset, UK, BH1 3LG.
Cochrane Database Syst Rev. 2001(1):CD002948. doi: 10.1002/14651858.CD002948.
The increasing popularity of the use of complementary and alternative interventions or treatments appears to be particularly evident amongst people with chronic disease. In the treatment of rheumatoid arthritis, one therapy that has been identified as having potential benefit, is herbal medicine (phytotherapy).
To assess the effectiveness of herbal therapies in the treatment of rheumatoid arthritis.
We developed a search strategy using terms to include all forms of arthritis combined with herbal medicine. We searched the following electronic databases from 1966 to 2000: MEDLINE, EMBASE, CISCOM, AMED, CINAHL, Cochrane Controlled Trials Register (CCTR), Cochrane Musculoskeletal specialized register, Dissertation Abstracts, BIDS ISI and the Cochrane Complementary Medicine Fields Specialized Register. This was supplemented by searching the reference lists from retrieved trials.
All randomized trials of herbal interventions in rheumatoid arthritis, compared to placebo. Two reviewers independently read and selected each potential study according to the criteria published in an a priori protocol. Papers of any language were included.
Data were extracted independently by the same two reviewers and an assessment of methodological quality was conducted.
Eleven studies met the inclusion criteria. Seven of the studies compared gamma-linolenic acid (GLA) to placebo although three of these were not suitable for data pooling. The remaining studies considered four different herbal interventions and were assessed individually. All of the GLA studies found some improvement in clinical outcomes but methodology and study quality was variable, making it difficult to draw conclusive results. However, the better quality studies suggest potential relief of pain, morning stiffness and joint tenderness. With the exception of one intervention (Tripterygium wilfordii hook F), no serious side effects were reported.
REVIEWER'S CONCLUSIONS: There appears to be some potential benefit for the use of GLA in rheumatoid arthritis although further studies are required to establish optimum dosage and duration of treatment. The single studies are inconclusive.
补充和替代干预措施或疗法的使用日益普遍，这在慢性病患者中似乎尤为明显。在类风湿关节炎的治疗中，一种被认为具有潜在益处的疗法是草药医学（植物疗法）。
评估草药疗法治疗类风湿关节炎的有效性。
我们制定了一种检索策略，使用的检索词包括所有形式的关节炎与草药医学的组合。我们检索了1966年至2000年的以下电子数据库：医学索引数据库（MEDLINE）、荷兰医学文摘数据库（EMBASE）、补充医学信息与咨询服务中心数据库（CISCOM）、联合与补充医学数据库（AMED）、护理学与健康领域数据库（CINAHL）、考克兰对照试验注册库（CCTR）、考克兰肌肉骨骼系统专业注册库、论文摘要数据库、BIDS科学信息数据库（ISI）以及考克兰补充医学领域专业注册库。通过检索所检索到的试验的参考文献列表对其进行补充。
所有关于草药干预治疗类风湿关节炎的随机试验，与安慰剂进行比较。两名评审员根据事先制定的方案中公布的标准独立阅读并选择每项潜在研究。纳入任何语言的论文。
由相同的两名评审员独立提取数据，并对方法学质量进行评估。
11项研究符合纳入标准。其中7项研究将γ-亚麻酸（GLA）与安慰剂进行比较，不过其中3项不适合进行数据合并。其余研究考虑了4种不同的草药干预措施，并分别进行了评估。所有关于GLA的研究都发现临床结果有一定改善，但方法学和研究质量各不相同，难以得出确凿结果。然而，质量较好的研究表明可能缓解疼痛、晨僵和关节压痛。除了一种干预措施（雷公藤）外，未报告严重副作用。
使用GLA治疗类风湿关节炎似乎有一些潜在益处，不过需要进一步研究来确定最佳剂量和治疗持续时间。单项研究尚无定论。
