Department of Neurology, Vanderbilt University School of Medicine, North A-0118, 1161 21st Ave South, Nashville, TN 37232-2551, USA.
Sleep Med Rev. 2012 Dec;16(6):509-18. doi: 10.1016/j.smrv.2012.01.003. Epub 2012 Mar 28.
Occidental medicine has a given definition for restless legs syndrome (RLS) and knowledge of RLS pathophysiology has led to the development of its therapeutic management. RLS has no cure. Many methods have been used for its treatment, among which traditional Chinese medicine (TCM) has been considered as a new approach. However, description and management of the disease symptoms can be found in Chinese ancient medical systems. The first mention of RLS may have been as early as the third century BC described as "leg uncomfortable". Nonetheless, the lack of a complete description encompassing all four modern cardinal features of RLS makes this uncertain. On the other hand, the first description of RLS encompassing three of the four major modern criteria occurs in the ancient book of Neike Zhaiyao (Internal summary), 1529 AD just about a century and a half prior to the description of RLS by Sir Thomas Willis in England. Here, we introduce the philosophical concepts of traditional Chinese medicine and the description, classification and understanding of RLS symptoms in traditional Chinese medicine. We have conducted an in-depth review of the literature reporting one part of TCM, Chinese herbal treatment efficacy for RLS, through both English and Chinese search engines. Eighty-five studies were included in the review and more than 40 formulas (including 176 different ingredients) were found in the literature. According to the literature, Chinese herbs have been demonstrated to be safe and hold great potential to be an effective treatment modality for RLS, but the evidence is limited by the quality of these studies. Of the eighty-five studies, only nine were clinical trials with a control group and only three of them were randomized. In cases where herbal preparations were compared to Western medications for RLS, the herbal preparations appear to be superior. However, uncertainty as to whether the diagnosis of RLS was made in accord with Western norms and the use of homemade non-validated rating scales create uncertainty as to the meaning of these results. High-quality randomized and double blinded clinical trials of Chinese herbs in treating RLS will be required in the future. This review highlights aspects of Chinese herbal treatment important to guide future research and clinical practice. To our knowledge, this is the first systematic English review of the role of Chinese herbs in the treatment of RLS.
西医对不宁腿综合征（RLS）有明确的定义，对 RLS 病理生理学的认识促进了其治疗管理的发展。RLS 目前无法治愈。有许多方法被用于其治疗，其中包括中医药。然而，中医对疾病症状的描述和管理可以在古代医学体系中找到。RLS 的最早记载可能早在公元前 3 世纪就有记载，被描述为“腿部不适”。尽管如此，由于缺乏一个完整的描述，涵盖 RLS 的所有四个现代主要特征，这一点尚不确定。另一方面，RLS 的最早描述包含四个现代主要标准中的三个，出现在公元 1529 年的古代著作《内科摘要》中，比英国的托马斯·威利斯爵士描述 RLS 早了大约一个半世纪。在这里，我们介绍了中医的哲学概念以及中医对 RLS 症状的描述、分类和理解。我们通过英文和中文搜索引擎对报告中医（中草药）治疗 RLS 疗效的文献进行了深入回顾。综述中包括 85 项研究，文献中发现了 40 多种配方（包括 176 种不同的成分）。根据文献，中草药已被证明是安全的，并具有成为 RLS 有效治疗方式的巨大潜力，但这些研究的质量限制了证据的有效性。在 85 项研究中，只有 9 项是有对照组的临床试验，其中只有 3 项是随机的。在中草药制剂与治疗 RLS 的西药进行比较的情况下，中草药制剂似乎更具优势。然而，由于不确定 RLS 的诊断是否符合西医标准，以及使用自制的非验证性评分量表，这些结果的意义存在不确定性。未来需要进行高质量的、随机的、双盲的治疗 RLS 的中草药临床试验。本综述强调了中医药治疗 RLS 的重要方面，为未来的研究和临床实践提供了指导。据我们所知，这是第一篇关于中草药治疗 RLS 作用的系统英文综述。
