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首页> 外文期刊>The journal of clinical psychiatry >Adverse Effects of St. John's Wort: A Systematic Review.
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Adverse Effects of St. John's Wort: A Systematic Review.

机译：圣约翰草的不良影响：系统评价。

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OBJECTIVE: To obtain an overview of the available clinical evidence on safety and tolerability of hypericum extracts, we reviewed (1) dropout rates and adverse effects in double-blind randomized trials comparing hypericum extracts and placebo or synthetic standard antidepressants; (2) dropout rates and adverse effects in large-scale observational studies; and (3) adverse effects reported in published cases and to public drug surveillance agencies. METHOD: Data on dropout rates and adverse effects were extracted from double-blind randomized trials of hypericum monopreparations collected for a Cochrane review (last search July 2003) and from a PubMed search (text word hypericum; search dates 1998-January 2003). Similar data were extracted from uncontrolled observational studies including at least 100 patients identified through a PubMed search (search term hypericum NOT animal, last update May 2003), contacts with manufacturers, and screening of review articles. Case reports and case series on adverse events associated with hypericum products were identified through a MEDLINE search (1966-November 2002; search term: hypericum AND [adverse effects OR interaction]) and a PubMed search (February 2003) and were collected from 5 public drug surveillance agencies (data through May 2001). All database searches were conducted as English and non-English language searches. RESULTS: Data from 35 double-blind randomized trials showed that dropout and adverse effects rates in patients receiving hypericum extracts were similar to placebo, lower than with older antidepressants, and slightly lower than with selective serotonin reuptake inhibitors. Dropout rates due to adverse effects in 17 observational studies including 35,562 patients ranged from 0% to 5.7%; interactions or serious adverse effects were not reported in any study. Published cases and cases reported to drug surveillance agencies suggest that interactions with a variety of drugs (particularly cyclosporine in transplant patients) are the most relevant adverse effects of hypericum extracts. CONCLUSIONS: The available evidence suggests that hypericum extracts are well tolerated and safe if taken under control of a physician who is aware of potentially relevant risks in specific circumstances.
机译：目的：为了获得有关贯叶连翘提取物安全性和耐受性的可用临床证据的概述，我们综述了（1）在双盲随机试验中比较贯叶连翘提取物和安慰剂或合成标准抗抑郁药的退出率和不良反应; （2）大规模观察研究中的辍学率和不良反应; （3）在已公布的案件中以及向公共毒品监督机构报告的不良影响。方法：关于辍学率和不良反应的数据是从针对Cochrane评价（2003年7月的最新搜索）和PubMed搜索（文本hypericum;搜索日期1998年1月至2003年1月）收集的金丝桃单一制剂双盲随机试验中提取的。从不受控制的观察性研究中提取了类似的数据，包括通过PubMed搜索（搜索词hypericum NOT animal，最新更新，2003年5月），与制造商的联系以及评论文章的筛选确定的至少100名患者。通过MEDLINE搜索（1966年11月至2002年11月;搜索词：贯叶连翘与[不良影响或相互作用]）和PubMed搜索（2003年2月）确定了与贯叶连翘产品相关的不良事件的病例报告和病例系列，并从5个公众中收集毒品监视机构（截至2001年5月的数据）。所有数据库搜索均以英语和非英语语言进行。结果：来自35个双盲随机试验的数据表明，接受贯叶连翘提取物治疗的患者的辍学率和不良反应率与安慰剂相似，低于老年抗抑郁药，且略低于选择性5-羟色胺再摄取抑制剂。在17项观察性研究中，包括35,562例患者的不良反应引起的辍学率从0％到5.7％;交互作用或严重不良反应未在任何研究中报道。已发表的病例和向药物监督机构报告的病例表明，与多种药物的相互作用（尤其是移植患者中的环孢素）是金丝桃提取物最相关的不良反应。结论：现有证据表明，金丝桃提取物在医生的控制下具有良好的耐受性和安全性，医生了解在特定情况下可能存在的相关风险。

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