Steurer-Stey Claudia, Russi Erich W, Steurer Johann
Department of Internal Medicine, Medical Policlinic, University Hospital Zürich, Switzerland.
Swiss Med Wkly. 2002 Jun 29;132(25-26):338-44. doi: 10.4414/smw.2002.09972.
An increasing number of patients with asthma are attracted by complementary and alternative medicine (CAM). Therefore, it is of importance that scientific evidence about the efficacy of this type of therapy is regarded.
We searched the electronic databases Medline, Embase and the Cochrane Library for controlled trials and systematic reviews to evaluate the evidence of the most popular alternative therapies, i.e. acupuncture, homeopathy, breathing techniques, herbal and nutritional therapies.
Claims that acupuncture is effective for the treatment of asthma are not based on well-performed clinical trials. The role of homeopathy in the treatment of asthma needs further evaluation. Breathing techniques, e.g. improved control of breathing by yoga, may contribute to the control of asthma symptoms, but due to the small number of controlled trials and due to the small number of patients it is not possible to make firm judgments. Herbal remedies cannot be recommended based on the available evidence. Recommendations for a diet high in vitamin C and marine fatty acids are not harmful, but evidence for clinically meaningful effects are scant.
Up to now evidence is lacking that alternative forms of medicine are more effective than placebo in asthma. However, lack of evidence does not always mean that treatment is ineffective, but it could mean that effectiveness has not been adequately investigated. High quality research as in conventional therapy should be fostered in complementary medicine.
越来越多的哮喘患者被补充和替代医学(CAM)所吸引。因此,重视这类疗法疗效的科学证据很重要。
我们检索了电子数据库Medline、Embase和Cochrane图书馆,以查找对照试验和系统评价,以评估最流行的替代疗法的证据,即针灸、顺势疗法、呼吸技术、草药和营养疗法。
声称针灸对哮喘治疗有效的说法并非基于良好的临床试验。顺势疗法在哮喘治疗中的作用需要进一步评估。呼吸技术,如通过瑜伽改善呼吸控制,可能有助于控制哮喘症状,但由于对照试验数量少且患者数量少,无法做出确凿的判断。根据现有证据,不能推荐草药疗法。关于高维生素C和海洋脂肪酸饮食的建议并无危害,但缺乏有临床意义效果的证据。
到目前为止,缺乏证据表明替代医学形式在哮喘治疗中比安慰剂更有效。然而,缺乏证据并不总是意味着治疗无效,但可能意味着疗效尚未得到充分研究。补充医学应促进开展与传统疗法一样高质量的研究。