Herbal interventions for chronic asthma in adults and children

 

Abstract

Background

Herb and plant based preparations are a popular treatment for asthma, although there remain concerns as to their efficacy and safety. In Western societies, motivations for using such treatments may be both positive and negative, with their perceived safety and dissatisfaction with conventional medicine among them. In China such treatments are more commonly used and many compounds considered 'conventional' are derived from herbs or plants.

Objectives

To assess the efficacy and safety of herb and plant extracts in the management of chronic asthma.

Search methods

The Cochrane Airways Group Trials Register, CENTRAL, MEDLINE, EMBASE and AMED were searched with pre-defined terms. Searches are current as of February 2007.

Selection criteria

Randomised placebo controlled trials of any herb or plant extract were eligible. Study participants had to have a primary diagnosis of asthma. Studies in both adults and children were eligible for the review.

Data collection and analysis

Two reviewers assessed studies for suitability. Data were extracted and double-checked.

Main results

Twenty-seven studies (29 experimental groups) met the review entry criteria, randomising a total of 1925 participants. The studies identified assessed the effects of 21 different herbal preparations. Study quality varied considerably, and the sample sizes were often small. For primary outcomes (exacerbations, steroids use and lung function measurements): Two out of six studies reporting change in FEV1 were positive, with very few data available on the frequency of exacerbations. One study which did report these data was negative. Health-related quality of life was only measured in one trial.

Authors' conclusions

The evidence base for the effects of herbal treatments is hampered by the variety of treatments assessed, poor reporting quality of the studies and lack of available data. The data that are available from the studies provide only a small insight into the long-term efficacy and harm profiles of these treatments. The absence of common endpoint measurements limits the validity of our findings further. Positive findings in this review warrant additional well-designed trials in this area.

 

Plain language summary

Herbal interventions for chronic asthma in adults and children

Chronic asthma is a inflammatory disease of the airways characterised by wheeze and breathlessness. Drug therapy is usually used to control symptoms but complementary medicine is often used, including herbal treatments, and the efficacy and safety of such treatments is not clear. We reviewed evidence from 27 trials covering 21 different herbal treatments in both adults and children from both in-patient and out-patient settings. In general, the reporting of trials was poor. The outcomes measured by the trials varied considerably which made it difficult to compare the results of studies that did look at the same treatment. On the basis of the available evidence it is not possible to show whether any of these herbal treatments can improve asthma symptoms. Further trials of high quality are needed to assess the use of herbal treatments in asthma.

 

摘要

背景

針對患有慢性氣喘的成人及幼童施以草藥進行介入性治療

雖然現在仍對草藥與植物性製劑的有效性及安全性存有一些疑慮，但是草藥和植物為基礎的製備物常用於氣喘的治療。在西方社會，會利用這些植物性治療物進行治療有其正面動機與負面的動機，其中可能是因為這些使用者感受到植物性治療物的安全性並對於現行藥物治療的成效感到不滿意所致。在中國，這類治療物的使用更為普遍，而且有許多常見的複合物被認為是出自草藥或植物。

目標

本研究即希望評估將草藥和植物萃取物使用於慢性氣喘治療的有效性和安全性。

搜尋策略

本研究係利用預先訂定的關鍵字針對Cochrane Airways Group Trials Register、CENTRAL、MEDLINE、EMBASE和AMED等資料庫進行檢索，檢索至2007年2月。

選擇標準

本研究納入了含有任何藥草和植物萃取物並有安慰劑的隨機性對照試驗。研究的受試者必須要具有原發性氣喘的診斷。以幼童和成人進行的試驗都可以納入本研究中。

資料收集與分析

本研究係由兩位審閱者評估試驗的適當性。由試驗中摘錄的數據需經彼此雙重確認。

主要結論

27個試驗(涵蓋29個實驗組)符合納入條件，總共隨機選取了1925位受試者。這些已確認的研究評估21種藥草製劑的功效。研究品質的差異大且參與的樣本數較少。對主要成果(症狀惡化比例、類固醇的使用和肺部功能檢測)來說，在6個試驗中有2個試驗發現FEV1有正向的改變，但很少資料可說明症狀惡化的頻率。僅一個試驗發現負面的結果。僅一個試驗評估健康有關的生活品質。

作者結論

藥草治療療效的證據基礎會因所評估的治療，研究報告品質不佳與缺乏可用的資料而異。由試驗中取出的可用數據僅提供些微這些治療的長期效益和危害的狀況。缺乏常見的成果評量進一步限制我們結果的效度。這篇研究中的正面發現支持需在這個領域中進行更多設計良好的試驗之想法。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

利用藥草治療患有慢性氣喘的幼童及成人。 慢性氣喘是一種呼吸道出現喘氣或是呼吸不順症狀的發炎性疾病。藥物治療通常可以控制其症狀，但仍常會選用包括藥草的輔助性醫療方法，但目前仍不清楚藥草治療的安全性和有效性。我們檢閱27篇涵蓋住出院的成人或孩童氣喘病患進行的21個不同藥草測試的試驗。整體來說，這些試驗品質不佳。其檢測的成果不一，不易比較各試驗間的結果。根據現有的證據來看，不易釐清哪一藥草製劑可改善氣喘症狀。因此有必要藉更多高品質的試驗來評估利用這些藥草治療氣喘的功效。。