Nartey Linda, Huwiler-Müntener Karin, Shang Aijing, Liewald Katharina, Jüni Peter, Egger Matthias
Department of Social and Preventive Medicine, University of Bern, Berne, Switzerland.
J Clin Epidemiol. 2007 Aug;60(8):787-94. doi: 10.1016/j.jclinepi.2006.11.018. Epub 2007 Mar 26.
Herbal medicine (phytotherapy) is widely used, but the evidence for its effectiveness is a matter of ongoing debate. We compared the quality and results of trials of Western phytotherapy and conventional medicine.
A random sample of placebo-controlled trials of Western phytotherapy was identified in a comprehensive literature search (19 electronic databases). Conventional medicine trials matched for condition and type of outcome were selected from the Cochrane Central Controlled Trials Register (issue 1, 2003). Data were extracted in duplicate. Trials described as double-blind, with adequate generation of allocation sequence and adequate concealment of allocation were assumed to be of higher methodological quality.
Eighty-nine herbal medicine and 89 matched conventional medicine trials were analyzed. Studies of Western herbalism were smaller, less likely to be published in English, and less likely to be indexed in MEDLINE than their counterparts from conventional medicine. Nineteen (21%) herbal and four (5%) conventional medicine trials were of higher quality. In both groups, smaller trials showed more beneficial treatment effects than larger trials.
Our findings challenge the widely held belief that the quality of the evidence on the effectiveness of herbal medicine is generally inferior to the evidence available for conventional medicine.
草药疗法（植物疗法）应用广泛，但其有效性证据仍存在争议。我们比较了西方植物疗法与传统医学试验的质量和结果。
通过全面的文献检索（19个电子数据库），随机抽取西方植物疗法的安慰剂对照试验样本。从Cochrane中心对照试验注册库（2003年第1期）中选取与疾病情况和结局类型匹配的传统医学试验。数据进行了双人提取。描述为双盲、分配序列产生充分且分配隐藏充分的试验被认为具有较高的方法学质量。
分析了89项草药医学试验和89项匹配的传统医学试验。西方草药医学研究规模较小，用英文发表的可能性较低，且被MEDLINE收录的可能性低于传统医学研究。19项（21%）草药医学试验和4项（5%）传统医学试验质量较高。在两组中，规模较小的试验显示出比规模较大的试验更有益的治疗效果。
我们的研究结果挑战了一种广泛持有的观点，即草药医学有效性证据的质量通常低于传统医学的证据。
