Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Phytother Res. 2022 Nov;36(11):4115-4124. doi: 10.1002/ptr.7598. Epub 2022 Aug 25.
Clinical trial studies revealed conflicting results on the effect of Ashwagandha extract on anxiety and stress. Therefore, we aimed to evaluate the effect of Ashwagandha supplementation on anxiety as well as stress. A systematic search was performed in PubMed/Medline, Scopus, and Google Scholar from inception until December 2021. We included randomized clinical trials (RCTs) that investigate the effect of Ashwagandha extract on anxiety and stress. The overall effect size was pooled by random-effects model and the standardized mean difference (SMD) and 95% confidence interval (CIs) for outcomes were applied. Overall, 12 eligible papers with a total sample size of 1,002 participants and age range between 25 and 48 years were included in the current systematic review and meta-analysis. We found that Ashwagandha supplementation significantly reduced anxiety (SMD: -1.55, 95% CI: -2.37, -0.74; p = .005; I = 93.8%) and stress level (SMD: -1.75; 95% CI: -2.29, -1.22; p = .005; I = 83.1%) compared to the placebo. Additionally, the non-linear dose-response analysis indicated a favorable effect of Ashwagandha supplementation on anxiety until 12,000 mg/d and stress at dose of 300-600 mg/d. Finally, we identified that the certainty of the evidence was low for both outcomes. The current systematic review and dose-response meta-analysis of RCTs revealed a beneficial effect in both stress and anxiety following Ashwagandha supplementation. However, further high-quality studies are needed to firmly establish the clinical efficacy of the plant.
临床试验研究结果显示，关于 Ashwagandha 提取物对焦虑和压力的影响存在相互矛盾的结果。因此，我们旨在评估 Ashwagandha 补充剂对焦虑和压力的影响。我们在 PubMed/Medline、Scopus 和 Google Scholar 中进行了系统搜索，检索时间从建库开始至 2021 年 12 月。我们纳入了研究 Ashwagandha 提取物对焦虑和压力影响的随机临床试验（RCT）。采用随机效应模型汇总总体效应量，应用标准化均数差（SMD）和 95%置信区间（CI）评估结局。总体上，纳入了 12 项符合条件的研究，共有 1002 名参与者，年龄在 25 至 48 岁之间，这些研究被纳入本次系统评价和荟萃分析。我们发现，与安慰剂相比，Ashwagandha 补充剂显著降低了焦虑（SMD：-1.55，95%CI：-2.37，-0.74；p =.005；I² = 93.8%）和压力水平（SMD：-1.75；95%CI：-2.29，-1.22；p =.005；I² = 83.1%）。此外，非线性剂量-反应分析表明，Ashwagandha 补充剂在 12000mg/d 剂量下对焦虑具有有利影响，在 300-600mg/d 剂量下对压力具有有利影响。最后，我们发现这两个结局的证据确定性都较低。本 RCT 的系统评价和剂量-反应荟萃分析显示，Ashwagandha 补充剂可改善焦虑和压力。然而，需要进一步开展高质量研究来明确该植物的临床疗效。
