黑升麻对乳腺癌幸存者的更年期症状没有什么益处

(ASCO摘要第1593号)

纽约，纽约——2001年5月——哥伦比亚大学研究人员领导的一项研究发现，一种广泛用于治疗更年期症状的草药——黑升麻，对乳腺癌幸存者的更年期症状几乎没有影响。这项研究是首次对一种治疗乳腺癌患者潮热的草药进行随机临床试验。黑升麻是印第安人的传统疗法。这项研究也增加了对“替代医学”的系统研究，这种有争议的治疗方法在现代西方医学实践中没有得到很好的确立。“这项研究真正表明，有必要对替代药物进行随机试验，就像对其他药物进行调查一样，”该研究的作者之一、公共卫生学博士维克多·r·格兰(Victor R. Grann)说。Dr. Grann是哥伦比亚大学内科和外科医学院赫伯特·欧文综合癌症中心医学和公共卫生的临床副教授。这项研究结果将于5月13日在旧金山举行的美国临床肿瘤学会年会上公布，并发表在5月15日的《临床肿瘤学杂志》上。研究人员认为，鉴于越来越多的患者转向这些疗法，研究结果对帮助患者正确看待替代疗法很重要。特别是癌症患者和幸存者经常使用替代疗法。一些替代药物已在对照临床试验中被证明是有效和安全的。 Most have not. “Because so many people, including patients with life-threatening diseases and those taking other medications, use complementary and alternative medicine, the research community has a responsibility to assess their efficacy and safety in these patient populations,” report the authors. “The largest segment of the cancer survivor community consists of breast cancer patients,” the authors added. “Nearly two-thirds of such patients report experiencing hot flashes.” The lead author is Judith S. Jacobson, Dr.P.H., M.B.A., assistant professor of clinical public health in the Mailman School of Public Health, and at Columbia’s Herbert Irving Comprehensive Cancer Center. The study assessed menopause symptoms in 85 breast cancer survivors. Half took black cohosh pills; half received a placebo, or inactive pill. For most symptoms, the outcomes were not statistically different between the groups. Both reported an average of about 27 percent fewer hot flashes, one of the most uncomfortable and common symptoms of menopause. This suggested the improvements were due to a placebo effect, in which patients often feel better simply because they are being treated. But excessive sweating, one of the seven menopausal symptoms studied improved with the herbal preparation. This was excessive sweating. “This finding may be due to chance, but unlike, for example, nervousness or headaches, sweating is directly related to the perception of heat and is also what many women find most unpleasant about hot flashes,” the authors said. The other menopausal symptoms studied were heart palpitations, headaches, poor sleep, depression, and irritability or nervousness. The researchers also found that the black cohosh pills are generally safe. Researchers are interested in therapies for menopause symptoms among breast cancer survivors because estrogen replacement may theoretically increase their risk of a cancer recurrence. Another common breast cancer treatment, Tamoxifen, also can trigger menopause-like symptoms. Black cohosh, whose scientific name is Cimicifuga racemosa, is native to the eastern United States and Canada. Native Americans have used it for menstrual, menopausal, and other conditions. Europeans also have used it for more than 50 years, particularly in Germany, where it is produced in precise pill formulations and regulators have issued favorable reports on its effectiveness. One limitation of the Columbia study was that it lasted only two months, the authors said; the researchers feared participants might drop out if they did not experience a benefit within that period. “It is possible that when used for a longer period of time, black cohosh may show greater efficacy relative to placebo, although our data show no strong indication of such a trend,” the authors said. Also, the study did not assess black cohosh’s use among healthy women. Such a study is under way at Columbia’s Rosenthal Center for Complimentary and Alternative Medicine. The just-finished study was supported by the American Cancer Society; the Sindab African American Breast Cancer Project; the Avon Foundation Breast Cancer Research and Care Program; the Breast Cancer Alliance; and a manufacturer of black cohosh pills, which supplied those used for the study.

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