Griffiths Peter
Primary and Intermediate Care, Florence Nightingale School of Nursing and Midwifery, King's College London.
Br J Community Nurs. 2003 Dec;8(12):557-61. doi: 10.12968/bjcn.2003.8.12.11853.
There has long been an interest in the use of cranberry, usually as a juice, to prevent and treat urinary tract infections (UTI). This mini-review examined the evidence available using a simple search on an internet-based resource designed to make evidence readily available to practitioners in the South Eastern NHS regions of the UK. The resource, known as KA24, provides access to a range of databases and full text of journal articles. The first stage of the review identified two existing Cochrane Reviews, one examining cranberry as a treatment, the other as prevention. Both concluded that there was insufficient evidence to recommend the use of cranberry in treating UTIs, although some weak research did offer support for cranberry juice in preventing UTIs. A search for further evidence not included in the Cochrane review identified several new reviews and two randomized controlled trials (RCTs) of cranberry as prevention. The reviews were not systematic and came to contradictory conclusions. They were based on a selective reading of the evidence base and gave no criteria for determining the inclusion or validity of studies. One of the RCTs was available for full scrutiny and was appraised as a valid study. Both RCTs found that cranberry (as juice or capsule) significantly reduced the rate of UTI in sexually active women. There is evidence to support the use of cranberry to prevent UTI in some populations but none to support its use as a treatment.
长期以来,人们一直对使用蔓越莓(通常是作为果汁)来预防和治疗尿路感染(UTI)很感兴趣。这篇小型综述通过在一个基于互联网的资源上进行简单搜索来审查现有证据,该资源旨在让英国国民健康服务(NHS)东南部地区的从业者能够轻松获取证据。这个名为KA24的资源提供了一系列数据库和期刊文章的全文访问权限。综述的第一阶段确定了两项现有的Cochrane系统评价,一项研究蔓越莓作为治疗方法,另一项研究其作为预防手段。两项评价均得出结论,没有足够的证据推荐使用蔓越莓治疗尿路感染,尽管一些薄弱的研究确实为蔓越莓汁预防尿路感染提供了支持。对Cochrane系统评价中未包含的进一步证据进行搜索,发现了几项新的综述以及两项关于蔓越莓预防作用的随机对照试验(RCT)。这些综述并不系统,得出了相互矛盾的结论。它们基于对证据库的选择性阅读,且没有给出确定研究纳入或有效性的标准。其中一项RCT可供全面审查,并被评估为一项有效的研究。两项RCT均发现,蔓越莓(作为果汁或胶囊)能显著降低性活跃女性的尿路感染发生率。有证据支持在某些人群中使用蔓越莓预防尿路感染,但没有证据支持将其用于治疗。