Pittler M H, Schmidt K, Ernst E
Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exter EX2 4NT, UK.
Obes Rev. 2005 May;6(2):93-111. doi: 10.1111/j.1467-789X.2005.00169.x.
Herbal weight-loss supplements are marketed with claims of effectiveness. Our earlier systematic review identified data from double-blind, randomized controlled trials for a number of herbal supplements. The aim of this systematic review was to assess all clinical evidence of adverse events of herbal food supplements for body weight reduction for which effectiveness data from rigorous clinical trials exist. We assessed Ephedra sinica, Garcinia cambogia, Paullinia cupana, guar gum, Plantago psyllium, Ilex paraguariensis and Pausinystalia yohimbe. Literature searches were conducted on Medline, Embase, Amed and The Cochrane Library. Data were also requested from the spontaneous reporting scheme of the World Health Organization. We hand-searched relevant medical journals and our own files. There were no restrictions regarding the language of publication. The results show that adverse events including hepatic injury and death have been reported with the use of some herbal food supplements. For herbal ephedra and ephedrine-containing food supplements an increased risk of psychiatric, autonomic or gastrointestinal adverse events and heart palpitations has been reported. In conclusion, adverse events are reported for a number of herbal food supplements, which are used for reducing body weight. Although the quality of the data does not justify definitive attribution of causality in most cases, the reported risks are sufficient to shift the risk-benefit balance against the use of most of the reviewed herbal weight-loss supplements. Exceptions are Garcinia cambogia and yerba mate, which merit further investigation.
草药减肥补充剂在市场上宣称具有功效。我们早期的系统评价确定了一些草药补充剂的双盲、随机对照试验数据。本系统评价的目的是评估存在严格临床试验有效性数据的用于减轻体重的草药食品补充剂不良事件的所有临床证据。我们评估了麻黄、藤黄果、瓜拉那、瓜尔胶、洋车前子、巴拉圭冬青和育亨宾。在Medline、Embase、Amed和考克兰图书馆进行了文献检索。还向世界卫生组织的自发报告系统索取了数据。我们手工检索了相关医学期刊和我们自己的档案。对出版物的语言没有限制。结果表明，使用某些草药食品补充剂已报告了包括肝损伤和死亡在内的不良事件。对于草药麻黄和含麻黄碱的食品补充剂，已报告精神、自主神经或胃肠道不良事件以及心悸的风险增加。总之，有多种用于减轻体重的草药食品补充剂报告了不良事件。虽然在大多数情况下数据质量不足以明确因果关系，但报告的风险足以改变风险效益平衡，反对使用大多数经审查的草药减肥补充剂。藤黄果和马黛茶是例外，值得进一步研究。
