經前症候群的替代療法大多數未通過實證

有些治療具有潛力但仍需更多研究

  問卷調查顯示,有近乎四成的美國民眾使用至少一種的替代療法,而大多數為告知其醫師,他們大多患有長期慢性病,如經前症候群(premenstrual syndrome (PMS))。在七月份American Journal of Obstetrics & Gynecology期刊上的一則回顧中,研究人員對二十七種補充及替代治療經前症候群的療法進行評估,結果發現,這些治療並沒有任何值得注意的療效。主筆者Clare Stevinson, MSc,特別提出叮嚀:在考慮使用經前症候群替代療法時,要特別小心,因為許多研究顯示大多數的替代療法仍未達到嚴格的科學標準。

Alternative Therapies for PMS Largely Untested

Some Treatments Show Promise but Require More Research

By L.A. McKeown
WebMD Medical News

Reviewed by Aman Shah, MD

Aug. 10, 2001 -- Surveys suggest that about 40% of Americans use at least one alternative therapy, and the majority do not inform their doctors. Many of them are people with chronic conditions, such as premenstrual syndrome (PMS). In a review published in the July issue of the American Journal of Obstetrics & Gynecology, researchers evaluated 27 studies on various complementary and alternative therapies in the treatment of PMS and found that there is no compelling evidence that any of these therapies are effective.

Lead author Clare Stevinson, MSc, of the University of Exeter in England, urges caution when considering alternative treatments for PMS because most studies of alternative therapies don't meet high scientific standards.

The studies that Stevinson and her colleague, Edzard Ernst, FRCP, examined looked at herbs (7 studies looking at herbals such as evening primrose oil, chaste tree, and gingko) and dietary supplements (13 studies looking at vitamins A, B6, and E, magnesium, and carbohydrate and protein supplements) as well as homeopathy, chiropractic, relaxation, massage, and reflexology (1 study each).

Herbal treatments in particular are quite popular, and the researchers identified several randomized, controlled trials that examined individual herbals.

"There's really basically no evidence to support whether [herbs] work or not," says Stevinson. "Most of the ones used in PMS are pretty low-risk generally, although people can have allergic reactions to any type of herb."

A good reason to do thorough research on herbs is that it may take awhile before specific problems become apparent. For example, St. John's wort -- often used for depression -- was considered relatively safe. But it wasn't until it started to be widely used that it was shown to interfere with some prescription medications.

The researchers also found little evidence to support homeopathy or supplements such as vitamin E or magnesium. But Stevinson points out that studies in which carbohydrate intake is increased are worthy of further investigation because carbohydrate cravings are a common symptom of PMS.

Other treatments that appear promising but don't have enough science behind them include massage and reflexology. These two, as well as yoga, exercise, therapeutic touch, and meditation, pose less risk of harm than oral supplements, she says.

"We don't know if they are likely to be more effective. ... But they generally aren't going to do any harm, and there is some preliminary evidence that they might be worth trying," she tells WebMD.

But there are caveats to trying untested therapies, even if there is little risk of harm.

"If they don't work, then the consumer might be wasting their time," says Richard Nahin, PhD, director of extramural research, training, and review at the National Center for Complementary and Alternative Medicine in Bethesda, Md. "There can be low risk, but if there is low benefit, then what is the advantage to using it?" He also points out that in addition to time, some therapies may waste your money, too.

"All we can do as a federal government agency is try to provide the best information available and let the public make an educated decision. What decision they make is certainly up to them, and in some cases folks may feel it's worth spending X amount of dollars if there is low risk and just taking a chance that it may work on them," says Nahin. "I think that's the strategy that a lot of people use."

"The literature doesn't suggest that anything has jumped out as being particularly efficacious for PMS, although a lot of things are being studied," he says. "[But] there isn't much in the conventional realm either that is useful for PMS, and that's why a lot of people have turned to alternative or complementary medicine."

 

© 2001 WebMD Corporation. All rights reserved.

    
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