School of Health and Human Sciences, Southern Cross University, Lismore, NSW, 2480, Australia.
School of Medicine, University of Tasmania, Hobart, TAS, 7001, Australia.
Phytother Res. 2018 Aug;32(8):1488-1500. doi: 10.1002/ptr.6099. Epub 2018 Apr 30.
Herbal products are popular among women during the perinatal period. St John's wort (SJW), Hypericum perforatum, is a common remedy for mild depression, a problem prevalent in this population. Although the safety of herbal products must be investigated, ethical issues constrain intervention studies in humans. Hence, animal studies often inform clinical decisions. The objective of this study is to systematically review rodent studies assessing the safety of SJW during the perinatal period. A literature search to November 10, 2017, identified 10 rodent studies that met a priori inclusion criteria. Study quality was evaluated according to both the Systematic Review Centre for Laboratory animal Experimentation tool for assessing bias and recommendations for appropriate reporting of herbal medicine research. Significant methodological limitations were found in each of the studies reviewed. These limitations include the lack of botanical verification and omission of extract characterization, inadequate explanation of dosage rationale, and absence of bias limiting protocols. Critical appraisal with contemporary tools indicates that each of the reviewed studies lacks appropriate rigour, rendering the results unreliable. Despite this, these papers are used in the rationale for recommending or contraindicating SJW during pregnancy and lactation.
草药产品在围产期妇女中很受欢迎。贯叶金丝桃（SJW），金丝桃属植物，是治疗轻度抑郁症的常用药物，而该人群中普遍存在这种问题。尽管必须对草药产品的安全性进行调查，但伦理问题限制了对人类的干预研究。因此，动物研究经常为临床决策提供信息。本研究的目的是系统地回顾评估围产期 SJW 安全性的啮齿动物研究。截至 2017 年 11 月 10 日的文献检索确定了 10 项符合预先设定纳入标准的啮齿动物研究。研究质量根据系统评价中心对实验室动物实验的工具进行评估，并对草药药物研究的适当报告提出建议。在审查的每一项研究中都发现了显著的方法学局限性。这些局限性包括缺乏植物学验证和提取物特征描述的遗漏、剂量合理性解释不足以及缺乏限制偏倚的方案。使用现代工具进行批判性评估表明，审查的每一项研究都缺乏适当的严谨性，从而导致结果不可靠。尽管如此，这些论文仍被用于在妊娠和哺乳期推荐或禁止 SJW 的理由中。
