Passalacqua Giovanni, Bousquet Philippe J, Carlsen Kai-Hakon, Kemp James, Lockey Richard F, Niggemann Bodo, Pawankar Ruby, Price David, Bousquet Jean
Allergy and Respiratory Diseases, University of Genoa, Italy.
J Allergy Clin Immunol. 2006 May;117(5):1054-62. doi: 10.1016/j.jaci.2005.12.1308.
Complementary-alternative medicines are extensively used in the treatment of allergic rhinitis and asthma, but evidence-based recommendations are lacking. To provide evidence-based recommendations, the literature was searched by using MedLine and the Cochrane Library to March 2005 (Key words: Asthma [OR] Rhinitis, [AND] Complementary [OR] Alternative Medicine, [OR] Herbal, [OR] Acupuncture, [OR] Homeopathy, [OR] Alternative Treatment). Randomized trials, preferably double-blind and published in English, were selected. The articles were evaluated by a panel of experts. Quality of reporting was assessed by using the scale validated by Jadad. The methodology of clinical trials with complementary-alternative medicine was frequently inadequate. Meta-analyses provided no clear evidence for the efficacy of acupuncture in rhinitis and asthma. Some positive results were described with homeopathy in good-quality trials in rhinitis, but a number of negative studies were also found. Therefore it is not possible to provide evidence-based recommendations for homeopathy in the treatment of allergic rhinitis, and further trials are needed. A limited number of studies of herbal remedies showed some efficacy in rhinitis and asthma, but the studies were too few to make recommendations. There are also unresolved safety concerns. Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence.
补充替代医学被广泛用于治疗过敏性鼻炎和哮喘，但缺乏基于证据的推荐意见。为了提供基于证据的推荐意见，我们利用MedLine和考克兰图书馆检索到2005年3月的文献（关键词：哮喘[或]鼻炎，[且]补充[或]替代医学，[或]草药，[或]针灸，[或]顺势疗法，[或]替代疗法）。我们选择了随机试验，最好是双盲试验且以英文发表的。文章由一组专家进行评估。报告质量采用Jadad验证的量表进行评估。补充替代医学临床试验的方法学常常不够完善。荟萃分析没有为针灸治疗鼻炎和哮喘的疗效提供明确证据。在高质量的鼻炎试验中，顺势疗法有一些阳性结果描述，但也发现了一些阴性研究。因此，不可能为顺势疗法治疗过敏性鼻炎提供基于证据的推荐意见，还需要进一步试验。少数关于草药疗法的研究显示其在鼻炎和哮喘治疗中有一定疗效，但研究数量太少，无法给出推荐意见。同时，安全性问题也尚未解决。目前可得的证据并不支持补充替代疗法对鼻炎和哮喘的治疗效果。
