Sarris Jerome, Kavanagh David J
School of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital, Queensland, Brisbane, Australia.
J Altern Complement Med. 2009 Aug;15(8):827-36. doi: 10.1089/acm.2009.0066.
Mood and anxiety disorders pose significant health burdens on the community. Kava and St. John's wort (SJW) are the most commonly used herbal medicines in the treatment of anxiety and depressive disorders, respectively.
The objective of this study was to conduct a comprehensive review of kava and SJW, to review any evidence of efficacy, mode of action, pharmacokinetics, safety and use in major depressive disorder, bipolar disorder, seasonal affective disorder (SAD), generalized anxiety disorder, social phobia (SP), panic disorder (PD), obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).
A systematic review was conducted using the electronic databases MEDLINE, CINAHL, and The Cochrane Library during late 2008. The search criteria involved mood and anxiety disorder search terms in combination with kava, Piper methysticum, kavalactones, St. John's wort, Hypericum perforatum, hypericin, and hyperforin. Additional search criteria for safety, pharmacodynamics, and pharmacokinetics were employed. A subsequent forward search was conducted of the papers using Web of Science cited reference search.
Current evidence supports the use of SJW in treating mild-moderate depression, and for kava in treatment of generalized anxiety. In respect to the other disorders, only weak preliminary evidence exists for use of SJW in SAD. Currently there is no published human trial on use of kava in affective disorders, or in OCD, PTSD, PD, or SP. These disorders constitute potential applications that warrant exploration.
Current evidence for herbal medicines in the treatment of depression and anxiety only supports the use of Hypericum perforatum for depression, and Piper methysticum for generalized anxiety.
情绪和焦虑障碍给社会带来了沉重的健康负担。卡瓦胡椒和圣约翰草分别是治疗焦虑症和抑郁症最常用的草药。
本研究旨在对卡瓦胡椒和圣约翰草进行全面综述，以回顾其在重度抑郁症、双相情感障碍、季节性情感障碍（SAD）、广泛性焦虑症、社交恐惧症（SP）、惊恐障碍（PD）、强迫症（OCD）和创伤后应激障碍（PTSD）中的疗效、作用方式、药代动力学、安全性及应用的相关证据。
2008年末，利用电子数据库MEDLINE、CINAHL和考克兰图书馆进行了系统综述。检索标准包括情绪和焦虑障碍检索词与卡瓦胡椒、卡瓦根、卡瓦内酯、圣约翰草、贯叶连翘、金丝桃素和贯叶连翘素的组合。还采用了安全性、药效学和药代动力学的额外检索标准。随后使用科学网的被引参考文献检索对论文进行了向前检索。
现有证据支持圣约翰草用于治疗轻中度抑郁症，卡瓦胡椒用于治疗广泛性焦虑症。对于其他疾病，仅有薄弱的初步证据支持圣约翰草用于治疗季节性情感障碍。目前尚无关于卡瓦胡椒用于情感障碍、强迫症、创伤后应激障碍、惊恐障碍或社交恐惧症的人体试验发表。这些疾病构成了值得探索的潜在应用领域。
目前草药治疗抑郁症和焦虑症的证据仅支持贯叶连翘用于治疗抑郁症，卡瓦胡椒用于治疗广泛性焦虑症。
