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24Drs好健康報:減少熱潮紅 黑升麻無效！？

好健康熱頭條 ─ 黑升麻對熱潮紅無效  Black Cohosh a Bust for Hot Flashes 
好健康小單字 – 荷爾蒙補充療法(Hormone Replacement Therapy，HRT) 
  好健康熱頭條 ─ 黑升麻對熱潮紅無效 
 
 
數百萬名婦女曾經服用黑升麻來減少熱潮紅與其他更年期相關症狀，但是這篇有史以來對草藥補充品最嚴謹的研究顯示，沒有證據證明黑升麻有效。

這篇聯邦政府贊助的試驗是比較黑升麻與其他草藥補充品、傳統荷爾蒙療法、和不做治療對於更年期症狀的效果。

結果顯示，荷爾蒙療法是唯一能明顯減少熱潮紅、盜汗、與其他相關症狀的方法；研究結果刊載在內科醫學年鑑(Annals of Internal Medicine)上。

研究人員Katherine M. Newton博士向WebMD表示，他們發現，黑升麻沒有效將會讓許多婦女失望，以荷爾蒙療法這種明顯有效的方式替代是不錯的選擇。

【尋找替代方法】
大多數婦女在接近更年期時會有熱潮紅等相關症狀，通常會在45歲至55歲之間發生。

用雌激素或雌激素加上黃體激素的荷爾蒙療法對於減少熱潮紅非常有效，但基於安全顧慮，有數萬名婦女要放棄這種療法。

那些顧慮顯然在上個週末出現美國婦女乳癌急遽下降的新聞後得到認同，雖然下降的原因還不清楚，但是許多專家推測，它與2002年發表女性健康倡導研究後荷爾蒙使用量降低有關，這個研究發現使用者乳癌和心臟問題都有增加。

許多有症狀的婦女在停止服用荷爾蒙後改用黑升麻和其他草藥補充品，但是為評估這些產品有效性而設計良好的臨床試驗卻很少。

【研究更年期症狀的治療方法】
Newton博士和西雅圖衛生保健系統的團體醫療保險合作醫院的同事們徵召了351位更年期婦女和剛停經的婦女參與研究，這些婦女在參加試驗時的年齡為45歲至55歲之間，所有人每天都至少有兩種更年期相關的症狀。

所有參與者在不知道自己是哪種治療方法的情況下，於一年之中用以下五種療法的其中一種治療：
* 只用黑升麻(每天160毫克)
* 綜合多種草藥補充品，包括每天200毫克黑升麻、加上苜蓿、硼、當歸、人參、和其他草藥補充品。
* 綜合多種草藥補充品，不包括黑升麻，但有建議增加攝取大豆成分的食物。
* 傳統的荷爾蒙療法
* 對照組

研究人員發現，除了荷爾蒙療法之外，其他治療對於婦女每天的熱潮紅次數減少沒有顯著差異，服用草藥補充品的婦女比對照組平均減少半次熱潮紅，但這數量並不認為有意義，經過比較，使用荷爾蒙療法的婦女每天約減少四次熱潮紅。

【你可以做些什麼？】
因此，不想要用荷爾蒙療法的婦女可以怎麼避免熱紅潮呢？有些證據顯示，某些抗憂鬱劑有幫助，Newton博士表示，生活方式能產生很大的差異，包含：
* 多穿幾層衣服，以便於感到熱潮紅時可以脫掉。
* 身邊放些冰水或電扇。
* 在涼快的臥室睡覺。
* 避免刺激物，包括辛辣的食物、酒精、或熱的飲料。

全國老化協會的Sherry Sherman博士表示，感覺自己需要荷爾蒙療法的婦女，應該在最短的必要時間內服用最低的有效劑量。

她向WebMD表示，也許荷爾蒙療法對某些婦女較為危險，他們很樂意去辨別哪些人服用雌激素是安全的；不過，在這篇最新研究中，並未評估那些最近常被媒體關注的慣用組合荷爾蒙。

最近有位女演員兼作家Suzanne Somers在兜售生物特性相同的荷爾蒙，它是比傳統荷爾蒙療法更安全的替代選擇；但是Sherman博士表示，如果這種荷爾蒙像傳統的荷爾蒙療法一樣有效的話，他們大概具有同樣的風險。

Sherman博士是全國老化協會的老化生殖荷爾蒙研究主任，她表示，只因為你有服藥卻不知道風險，並不代表那些風險不存在。
  
  
  
  Black Cohosh a Bust for Hot Flashes 
 
 
Millions of women have taken black cohosh to reduce hot flashes and other menopause-related symptoms, but the most rigorous study of the herbal supplement ever conducted shows no evidence that it works.

The federally funded trial was designed to compare black cohosh to other herbal supplements, traditional hormone therapy, and placebo treatment for menopausal symptoms.

Hormone therapy was the only treatment that clearly reduced hot flashes, night sweats, and other related symptoms.

The study appears in the Dec. 19 issue of the journal Annals of Internal Medicine.

"Our finding that black cohosh did not work will be disappointing news to many women," researcher Katherine M. Newton, PhD, tells WebMD. "It would be nice to find a clearly effective alternative to hormone therapy."

Looking for Alternatives
Most women experience hot flashes and related symptoms around the time of menopause, which typically occurs between ages 45 and 55.

Hormone therapy involving estrogen or estrogen plus progestin is very effective for reducing hot flashes, but concerns about safety have caused millions of women to abandon the treatment.

Those concerns appeared to be bolstered late last week with the news of a dramatic drop in breast cancers among American women.

Although the reason for the drop is not yet clear, many experts speculate that it is related to the decline in hormone use following the 2002 publication of the Women's Health Initiative study, which found an increase in both breast cancers and heart problems among users.

Many symptomatic women turned to black cohosh and other herbal supplements when they stopped taking hormones, but few well-designed clinical trials have been done evaluating the effectiveness of these products.

Studying Treatments for Menopause Symptoms
In an effort to address this, Newton and colleagues with the Seattle-based health care system Group Health Cooperative recruited 351 menopausal and newly postmenopausal women for their study.

The women were between the ages of 45 and 55 when they entered the trial, and all were experiencing at least two menopause-related symptoms a day.

Without knowing which treatment they were getting, all of the women took one of five therapies for a year. The treatments were:
• Black cohosh alone (160 milligrams daily)
• A combination herbal supplement that included 200 milligrams of black cohosh daily, plus alfalfa, boron, dong quai, ginseng, and other herbal ingredients
• A combination herbal supplement that did not include black cohosh but did include recommendations to increase the consumption of soy-based foods
• Traditional hormone therapy
• Placebo

The researchers found no significant difference in the number of daily hot flashes experienced by women on any of the treatments, with the exception of hormone therapy.

Women taking herbal supplements had an average of half a hot flash a day less than women taking placebo -- an amount not considered significant. By comparison, the women on hormone therapy had about four fewer hot flashes a day.

What Can You Do?
So what can women who don't want to take hormone therapy do to avoid hot flashes? There is some evidence that certain antidepressants help some. And lifestyle measures can make a big difference, Newton says. These include:
• Dressing in layers so that you can take off clothing when you feel a hot flash coming on.
• Keeping ice water or a fan nearby.
• Sleeping in a cool bedroom.
• Avoiding triggers, which may include spicy food, alcohol, or hot beverages.

Women who feel they need hormone therapy should take it in the lowest effective dosage for the shortest time necessary, says Sherry Sherman, PhD, of the National Institute on Aging (NIA).

"It may be that hormone therapy is more risky for some women than for others," she tells WebMD. "We would love to be able to identify those women who can safely take estrogen and those who shouldn't."

Those custom compounded hormones that have been the subject of much recent media attention were not evaluated in the new study.

Bioidentical hormones are being touted by some, including actress and author Suzanne Somers, as being safer alternatives to traditional hormone therapy.

But Sherman says if the hormones are as effective as traditional hormones, they probably carry the same risks.

Sherman is director of clinical aging and reproductive hormone research at NIA.

"Just because you take a drug and don't know the risks doesn't mean those risks don't exist," she says.

SOURCES: Newton, K.M. Annals of Internal Medicine, Dec. 19, 2006; vol 145: pp 869-879. Katherine M. Newton, PhD, associate director of research, Group Health Center for Health Studies, Seattle. Sherry Sherman, PhD, director, clinical aging and reproductive hormone research, National Institute on Aging, National Institutes of Health, Bethesda, Md.
WebMD Medical News
by Salynn Boyles
Reviewed By Louise Chang
  
  
  
  好健康小單字 – 荷爾蒙補充療法(Hormone Replacement Therapy，HRT)
 
 
HRT，稱為荷爾蒙補充療法或是荷爾蒙替代療法，是指針對更年期或停經期婦女，給予適當的女性荷爾蒙【雌激素，雌素酮（Estrone, E1）、雌素二醇（Estradiol, E2）以及雌素三醇（Estriol, E3）】及黃體素【天然黃體素(C17類)以及合成的黃體素(C19及C21類)】補充，以緩解不適症狀，或預防一些中老年疾病的發生及惡化；除了一些絕對禁忌症外，絕大多數的婦女均可以使用。
 
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