Cheema Deepti, Coomarasamy Arri, El-Toukhy Tarek
Royal Worcestershire Hospital, Worcester, UK.
Arch Gynecol Obstet. 2007 Nov;276(5):463-9. doi: 10.1007/s00404-007-0390-9. Epub 2007 Jun 26.
Interest in non-hormonal therapies for the treatment of menopausal symptoms has increased since the publication of adverse effects of estrogen replacement therapy.
To provide information on the efficacy of non-hormonal therapies for menopausal vasomotor symptoms based on evidence from published randomised controlled studies.
The Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Alternative Therapies in Health and Medicine database (ATHMD) and Allied and Complementary Medicine database (AMED) were searched for randomised controlled trials in the English language reporting data on treatment of menopausal vasomotor symptoms. Trials including cancer breast patients were included.
Our search identified 58 randomised controlled trials of which 11 involved the use of clonidine, six for SSRIs, four for gabapentin, seven for black cohosh, seven for red clover, 18 for phytoestrogens, two for ginseng, one for evening primrose, one for dong quai and one for vitamin E. Most trials had methodological deficiencies.
There is evidence that clonidine, paroxetine, venlafaxine, gabapentin and black cohosh may be beneficial in the treatment of menopausal vasomotor symptoms in some women. Current evidence does not support the use of fluoxetine, red clover, phytoestrogens, Ginseng, evening primrose, dong quai and vitamin E. The side effects profile of these therapies should be considered.
自雌激素替代疗法的不良反应被公布以来，对治疗更年期症状的非激素疗法的关注度有所增加。
基于已发表的随机对照研究证据，提供关于非激素疗法治疗更年期血管舒缩症状疗效的信息。
检索Cochrane系统评价数据库（CDSR）、医学文献数据库（MEDLINE）、健康与医学替代疗法数据库（ATHMD）以及补充与替代医学数据库（AMED），查找以英文报道更年期血管舒缩症状治疗数据的随机对照试验。纳入包括乳腺癌患者的试验。
我们的检索共识别出58项随机对照试验，其中11项涉及可乐定的使用，6项涉及选择性5-羟色胺再摄取抑制剂（SSRI），4项涉及加巴喷丁，7项涉及黑升麻，7项涉及红三叶草，18项涉及植物雌激素，2项涉及人参，1项涉及月见草，1项涉及当归，1项涉及维生素E。大多数试验存在方法学缺陷。
有证据表明，可乐定、帕罗西汀、文拉法辛、加巴喷丁和黑升麻可能对某些女性的更年期血管舒缩症状治疗有益。目前的证据不支持使用氟西汀、红三叶草、植物雌激素、人参、月见草、当归和维生素E。应考虑这些疗法的副作用情况。
