Allied Health Sciences, Grand Valley State University, 515 Michigan St NE - Suite 200, Grand Rapids, MI, 49503, USA; College of Health Professions, Central Michigan University, Health Professions Building 1222, Mount Pleasant, MI, 48859, USA.
Allied Health Sciences, Grand Valley State University, 515 Michigan St NE - Suite 200, Grand Rapids, MI, 49503, USA.
Complement Ther Clin Pract. 2018 Nov;33:107-117. doi: 10.1016/j.ctcp.2018.09.003. Epub 2018 Sep 15.
To determine if Kava Kava is an effective treatment for combating symptoms of anxiety despite warnings of hepatotoxicity from the Centers for Disease Control and Prevention (CDC).
Databases PubMed, CINAHL, and PsycINFO were utilized to obtain clinical trials on Kava Kava and its effects on anxiety. A total of 11 articles met inclusion/exclusion criteria: 2 for Kava Kava vs. another anti-anxiety medication, 2 detailing additional adverse events, and 7 for Kava Kava vs. placebo. Mantel-Haenszel fixed-effects model was used to analyze the data, with responder rates being pooled to compute weighted risk ratios.
Kava Kava was shown to be more effective than placebo in 3 of the 7 trials. A final risk ratio of 1.50 (95% CI: 1.12, 2.01) from responder rates was calculated in favor of the intervention from 5 clinical trials (n = 330). Adverse events were shown to be the same as placebo (P = 0.574), and laboratory values analyzing hepatotoxicity were no different when compared to baseline except in two studies.
Kava Kava appears to be a short-term treatment for anxiety, but not a replacement for prolonged anti-anxiety use. Although not witnessed in this review, liver toxicity is especially possible if taken longer than 8 weeks.
尽管疾病预防控制中心 (CDC) 警告称卡瓦具有肝毒性，但仍要确定卡瓦是否能有效治疗焦虑症状。
利用 PubMed、CINAHL 和 PsycINFO 数据库获取关于卡瓦及其对焦虑影响的临床试验。共有 11 篇文章符合纳入/排除标准：2 篇为卡瓦与另一种抗焦虑药物的比较，2 篇详细介绍了其他不良事件，7 篇为卡瓦与安慰剂的比较。采用 Mantel-Haenszel 固定效应模型分析数据，汇总应答率以计算加权风险比。
在 7 项试验中的 3 项中，卡瓦比安慰剂更有效。来自 5 项临床试验（n=330）的应答率最终计算出的干预风险比为 1.50（95%CI：1.12, 2.01）。不良事件与安慰剂相同（P=0.574），与基线相比，除了两项研究外，分析肝毒性的实验室值没有差异。
卡瓦似乎是一种短期治疗焦虑的方法，但不能替代长期使用抗焦虑药物。虽然在本综述中未观察到，但如果服用时间超过 8 周，肝毒性尤其可能发生。
