Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York City, NY, USA.
Information Systems/Medical Library, Memorial Sloan Kettering Cancer Center, New York City, NY, USA.
Phytother Res. 2018 May;32(5):865-891. doi: 10.1002/ptr.6033. Epub 2018 Feb 21.
Anxiety and depression are prevalent among cancer patients, with significant negative impact. Many patients prefer herbs for symptom relief to conventional medications which have limited efficacy/side effects. We identified single-herb medicines that may warrant further study in cancer patients. Our search included PubMed, Allied and Complementary Medicine, Embase, and Cochrane databases, selecting only single-herb randomized controlled trials between 1996 and 2016 in any population for data extraction, excluding herbs with known potential for interactions with cancer treatments. One hundred articles involving 38 botanicals met our criteria. Among herbs most studied (≥6 randomized controlled trials each), lavender, passionflower, and saffron produced benefits comparable to standard anxiolytics and antidepressants. Black cohosh, chamomile, and chasteberry are also promising. Anxiety or depressive symptoms were measured in all studies, but not always as primary endpoints. Overall, 45% of studies reported positive findings with fewer adverse effects compared with conventional medications. Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments. These may benefit cancer patients by minimizing medication load and accompanying side effects. However, well-designed larger clinical trials are needed before these herbs can be recommended and to further assess their psycho-oncologic relevance.
焦虑和抑郁在癌症患者中普遍存在,对他们造成严重的负面影响。许多患者喜欢使用草药来缓解症状,而不是选择传统药物,因为传统药物疗效有限且副作用明显。我们发现了一些可能具有进一步研究价值的单味草药,这些草药可以用于癌症患者。我们的检索范围包括 PubMed、辅助与补充医学数据库、Embase 和 Cochrane 数据库,检索时间限定在 1996 年至 2016 年,仅纳入评估单味草药治疗的随机对照试验,无论研究人群如何,排除已知与癌症治疗有相互作用的草药。共有 100 篇涉及 38 种植物的文章符合我们的纳入标准。在研究最多的草药(每种草药均有≥6 项随机对照试验)中,薰衣草、西番莲和藏红花在缓解焦虑和抑郁方面的效果与标准抗焦虑药和抗抑郁药相当。黑升麻、甘菊和贞节莓也有一定的疗效。所有研究均评估了焦虑或抑郁症状,但并非均将其作为主要终点。总体而言,45%的研究报告了阳性结果,与传统药物相比,其不良反应更少。基于现有数据,黑升麻、甘菊、贞节莓、薰衣草、西番莲和藏红花在缓解焦虑或抑郁方面可能有用,且具有良好的风险-效益比,优于标准治疗。这些草药可能通过减少药物负担和伴随的副作用,使癌症患者受益。然而,在推荐这些草药之前,还需要开展设计更完善、规模更大的临床试验,以进一步评估它们在心理肿瘤学方面的相关性。