Huntley Alyson L, Ernst Edzard
Department of Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, England.
Menopause. 2003 Sep-Oct;10(5):465-76. doi: 10.1097/01.GME.0000058147.24036.B0.
Many women have turned to complementary and alternative medicines for relief from their menopausal symptoms. The prevalence of herbal medicinal product use among menopausal women highlights the need for investigation into these interventions. The aim of this study was to evaluate the benefit of herbal medicinal products for the treatment of menopausal symptoms by performing a systematic review of randomized clinical trials.
Literature searches of four computerized databases were done to identify randomized clinical trials of herbal medicinal products for the treatment of menopausal symptoms. Manufacturers of herbal products were contacted, and our own files were also searched. There were no restrictions on the language of publication. Trials were considered if the outcome measures related to the physical or psychological impact of menopause, whether by compendium scores, questionnaires, or women's symptom diaries, excluding studies describing artificially induced menopause. This review was not concerned with biochemical or pathological data.
Eighteen randomized clinical trials that fit our criteria were identified. These studies investigated black cohosh (n = 4), red clover (n = 4), kava (n = 3), dong quai (n = 1), evening primrose oil (n = 1), ginseng (n = 1), and combination products (n = 4). Trial quality was generally good, with 16 of 18 studies scoring 3 or more (maximum 5) on the Jadad Scale.
There is no convincing evidence for any herbal medical product in the treatment of menopausal symptoms. However, the evidence for black cohosh is promising, albeit limited by the poor methodology of the trials. The studies involving red clover suggest it may be of benefit for more severe menopausal symptoms. There is some evidence for the use of kava, but safety concerns mean this herbal product is not a therapeutic option at present. The evidence is inconclusive for the other herbal medicinal products reviewed.
许多女性转向补充和替代医学以缓解更年期症状。更年期女性使用草药产品的普遍性凸显了对这些干预措施进行调查的必要性。本研究的目的是通过对随机临床试验进行系统评价，评估草药产品治疗更年期症状的益处。
对四个计算机化数据库进行文献检索，以确定草药产品治疗更年期症状的随机临床试验。联系了草药产品制造商，并检索了我们自己的档案。对出版物的语言没有限制。如果结局指标与更年期的身体或心理影响相关，无论是通过简编评分、问卷还是女性症状日记，则考虑纳入试验，不包括描述人工诱导更年期的研究。本评价不涉及生化或病理数据。
确定了18项符合我们标准的随机临床试验。这些研究调查了黑升麻（n = 4）、红三叶草（n = 4）、卡瓦（n = 3）、当归（n = 1）、月见草油（n = 1）、人参（n = 1）和复方产品（n = 4）。试验质量总体良好，18项研究中有16项在雅达量表上得分为3分或更高（满分5分）。
没有令人信服的证据表明任何草药产品可用于治疗更年期症状。然而，黑升麻的证据很有前景，尽管受试验方法不佳的限制。涉及红三叶草的研究表明，它可能对更严重的更年期症状有益。有一些证据支持使用卡瓦，但安全问题意味着这种草药产品目前不是一种治疗选择。对于所审查的其他草药产品，证据尚无定论。
