Pratte Morgan A, Nanavati Kaushal B, Young Virginia, Morley Christopher P
1 Department of Family Medicine, SUNY Upstate Medical University , Syracuse, NY.
J Altern Complement Med. 2014 Dec;20(12):901-8. doi: 10.1089/acm.2014.0177.
To assess existing reported human trials of Withania somnifera (WS; common name, ashwagandha) for the treatment of anxiety.
Systematic review of the literature, with searches conducted in PubMed, SCOPUS, CINAHL, and Google Scholar by a medical librarian. Additionally, the reference lists of studies identified in these databases were searched by a research assistant, and queries were conducted in the AYUSH Research Portal. Search terms included "ashwagandha," "Withania somnifera," and terms related to anxiety and stress. Inclusion criteria were human randomized controlled trials with a treatment arm that included WS as a remedy for anxiety or stress. The study team members applied inclusion criteria while screening the records by abstract review.
Treatment with any regimen of WS.
Number and results of studies identified in the review.
Sixty-two abstracts were screened; five human trials met inclusion criteria. Three studies compared several dosage levels of WS extract with placebos using versions of the Hamilton Anxiety Scale, with two demonstrating significant benefit of WS versus placebo, and the third demonstrating beneficial effects that approached but did not achieve significance (p=0.05). A fourth study compared naturopathic care with WS versus psychotherapy by using Beck Anxiety Inventory (BAI) scores as an outcome; BAI scores decreased by 56.5% in the WS group and decreased 30.5% for psychotherapy (p<0.0001). A fifth study measured changes in Perceived Stress Scale (PSS) scores in WS group versus placebo; there was a 44.0% reduction in PSS scores in the WS group and a 5.5% reduction in the placebo group (p<0.0001). All studies exhibited unclear or high risk of bias, and heterogenous design and reporting prevented the possibility of meta-analysis.
All five studies concluded that WS intervention resulted in greater score improvements (significantly in most cases) than placebo in outcomes on anxiety or stress scales. Current evidence should be received with caution because of an assortment of study methods and cases of potential bias.
评估已报道的关于南非醉茄（WS；俗名，印度人参）治疗焦虑症的人体试验。
文献系统综述，由医学图书馆员在PubMed、SCOPUS、CINAHL和谷歌学术进行检索。此外，研究助理检索了这些数据库中所识别研究的参考文献列表，并在阿育吠陀研究门户网站进行了查询。检索词包括“印度人参”“南非醉茄”以及与焦虑和压力相关的词汇。纳入标准为有治疗组将WS作为焦虑或压力治疗手段的人体随机对照试验。研究团队成员在通过摘要审查筛选记录时应用纳入标准。
采用任何南非醉茄治疗方案。
综述中识别出的研究数量及结果。
筛选了62篇摘要；5项人体试验符合纳入标准。3项研究使用汉密尔顿焦虑量表的不同版本，将几种剂量水平的南非醉茄提取物与安慰剂进行比较，其中2项显示南非醉茄相对于安慰剂有显著益处，第3项显示有益效果接近但未达到显著水平（p = 0.05）。第4项研究通过使用贝克焦虑量表（BAI）评分作为结局指标，比较了自然疗法联合南非醉茄与心理治疗；BAI评分在南非醉茄组下降了56.5%，在心理治疗组下降了30.5%（p < 0.0001）。第5项研究测量了南非醉茄组与安慰剂组的感知压力量表（PSS）评分变化；南非醉茄组的PSS评分降低了44.0%，安慰剂组降低了5.5%（p < 0.0001）。所有研究均显示存在不明确或高偏倚风险，且设计和报告的异质性使得进行荟萃分析成为不可能。
所有5项研究均得出结论，在焦虑或压力量表结局方面，南非醉茄干预比安慰剂导致更大的评分改善（大多数情况下具有显著意义）。由于研究方法多样以及存在潜在偏倚的情况，当前证据应谨慎对待。
