Borrelli Francesca, Ernst Edzard
Department of Experimental Pharmacology, University of Naples Federico II, Via D. Montesano 49, 80131 Naples, Italy.
Eur J Clin Pharmacol. 2002 Jul;58(4):235-41. doi: 10.1007/s00228-002-0457-2. Epub 2002 Jun 7.
Cimicifuga racemosa has long been advocated as an alternative to hormone-replacement therapy. However, recent experimental studies and a clinical trial have raised some questions on its utility. The aim of this systematic review is principally to summarise the trial evidence regarding the efficacy of C. racemosa in the treatment of menopausal symptoms. In addition, we also explore the evidence relating to the mechanism of action of this herbal medicine.
Searches of seven computerised databases were performed to identify all randomised clinical trials (RCTs) on C. racemosa as well as animal and in vitro experiments. No language restrictions were imposed. Data were extracted by both authors according to predefined criteria and are summarised in narrative form.
Four RCTs of C. racemosa as a treatment of menopausal symptoms were included. They yielded no compelling evidence for the efficacy of C. racemosa on menopausal symptoms. The small beneficial effects observed in some studies could be explained by a central activity, and an oestrogenic activity cannot be completely excluded.
In spite of plausible mechanisms of action of C. racemosa, its clinical efficacy for the treatment of menopausal symptoms has not been convincingly demonstrated through rigorous clinical trials. Additional rigorous RCTs and biochemical and chemical investigations are warranted.
总状升麻长期以来一直被提倡作为激素替代疗法的替代品。然而，最近的实验研究和一项临床试验对其效用提出了一些疑问。本系统评价的目的主要是总结关于总状升麻治疗更年期症状疗效的试验证据。此外，我们还探讨了与这种草药作用机制相关的证据。
检索了七个计算机化数据库，以识别所有关于总状升麻的随机临床试验（RCT）以及动物和体外实验。没有语言限制。两位作者根据预定义的标准提取数据，并以叙述形式进行总结。
纳入了四项将总状升麻作为更年期症状治疗方法的RCT。它们没有提供令人信服的证据证明总状升麻对更年期症状有效。在一些研究中观察到的微小有益效果可以用中枢活性来解释，并且不能完全排除雌激素活性。
尽管总状升麻有合理的作用机制，但其治疗更年期症状的临床疗效尚未通过严格的临床试验得到令人信服的证明。需要进行更多严格的RCT以及生化和化学研究。
