Kronenberg Fredi, Fugh-Berman Adriane
Rosenthal Center for Complementary and Alternative Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, Box 75, New York, NY 10032, USA.
Ann Intern Med. 2002 Nov 19;137(10):805-13. doi: 10.7326/0003-4819-137-10-200211190-00009.
Women commonly use soy products, herbs, and other complementary and alternative medicine (CAM) therapies for menopausal symptoms. Randomized, controlled trials have evaluated the efficacy and short-term safety of these therapies.
To review randomized, controlled trials of CAM therapies for menopausal symptoms in order to better inform practice and guide future research.
Searches of MEDLINE for articles published from January 1966 through March 2002, of the Alternative and Complementary Database (AMED) of the British Library for articles published from January 1985 through December 2000, and of the authors' own extensive files. Search terms were hot flash/flush, menopause, and climacteric, combined with phytoestrogens, alternative medicine, herbal medicine, traditional medicine, Traditional Chinese Medicine (TCM ), Ayurveda, naturopathy, chiropractic, osteopathy, massage, yoga, relaxation therapy, homeopathy, aromatherapy, and therapeutic touch.
29 randomized, controlled clinical trials of CAM therapies for hot flashes and other menopausal symptoms were identified; of these, 12 dealt with soy or soy extracts, 10 with herbs, and 7 with other CAM therapies.
Each author extracted information from half of the studies on the number of patients, study design, outcome measures, and results; the other author then checked these results.
Soy seems to have modest benefit for hot flashes, but studies are not conclusive. Isoflavone preparations seem to be less effective than soy foods. Black cohosh may be effective for menopausal symptoms, especially hot flashes, but the lack of adequate long-term safety data (mainly on estrogenic stimulation of the breast or endometrium) precludes recommending long-term use. Single clinical trials have found that dong quai, evening primrose oil, a Chinese herb mixture, vitamin E, and acupuncture do not affect hot flashes; two trials have shown that red clover has no benefit for treating hot flashes.
Black cohosh and foods that contain phytoestrogens show promise for the treatment of menopausal symptoms. Clinical trials do not support the use of other herbs or CAM therapies. Long-term safety data on individual isoflavones or isoflavone concentrates are not available.
女性常用大豆制品、草药及其他补充和替代医学（CAM）疗法来缓解更年期症状。随机对照试验已对这些疗法的疗效和短期安全性进行了评估。
回顾CAM疗法治疗更年期症状的随机对照试验，以便为临床实践提供更好的信息并指导未来研究。
检索MEDLINE数据库中1966年1月至2002年3月发表的文章、大英图书馆的替代和补充数据库（AMED）中1985年1月至2000年12月发表的文章以及作者自己的大量文献资料。检索词为潮热/潮红、更年期、绝经期，并与植物雌激素、替代医学、草药医学、传统医学、中医（TCM）、阿育吠陀医学、自然疗法、脊椎按摩疗法、整骨疗法、按摩、瑜伽、放松疗法、顺势疗法、芳香疗法和治疗性触摸相结合。
确定了29项关于CAM疗法治疗潮热及其他更年期症状的随机对照临床试验；其中，12项涉及大豆或大豆提取物，10项涉及草药，7项涉及其他CAM疗法。
每位作者从一半的研究中提取关于患者数量、研究设计、结局指标和结果的信息；另一位作者随后检查这些结果。
大豆似乎对潮热有一定益处，但研究结果并不确凿。异黄酮制剂似乎不如大豆食品有效。黑升麻可能对更年期症状有效，尤其是潮热，但缺乏足够的长期安全性数据（主要是关于对乳腺或子宫内膜的雌激素刺激），因此不建议长期使用。单项临床试验发现，当归、月见草油、一种中药混合物、维生素E和针灸对潮热没有影响；两项试验表明，红三叶草对治疗潮热没有益处。
黑升麻和含有植物雌激素的食物在治疗更年期症状方面显示出前景。临床试验不支持使用其他草药或CAM疗法。目前尚无关于单个异黄酮或异黄酮浓缩物的长期安全性数据。
