بررسی اثر داروهای گیاهی و مکمل‌های غذایی بر ماستالژی: مروری سیستماتیک و متاآنالیز بر کارآزمایی‌های بالینی در ایران

نوع مقاله: مروری

نویسندگان

1 کارشناس ارشد مامایی، مرکز تحقیقات مراقبت‌های پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 کارشناس ارشد مامایی، مرکز تحقیقات مراقبت‌های پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران. دانشجوی دکتری تخصصی بهداشت باروری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

3 دکترای بهداشت باروری، دانشکده پرستاری و مامایی رازی، دانشگاه علوم پزشکی کرمان، کرمان، ایران.

چکیده

مقدمه: ماستالژی، یکی از شایع‌ترین علل مراجعه زنان به مراکز درمانی است که با توجه به اهمیت آن، تجویز صحیح دارو اهمیت دارد. با توجه به عوارض داروهای شیمیایی، تمایل بیماران به استفاده از طب مکمل افزایش یافته است. مطالعه مرور سیستماتیک و متاآنالیز حاضر با هدف ارزیابی و جمع‌بندی نتایج کارآزمایی­های بالینی انجام شده در مورد تأثیر داروهای گیاهی و مکمل‌های غذایی بر ماستالژی در ایران انجام شد.
روش‌کار: مطالعه حاضر به صورت مرور سیستماتیک و متاآنالیز اثر داروهای گیاهی و مکمل‌های غذایی بر ماستالژی است که جستجوی مقالات با استفاده از کلیدواژه‌های ماستالژی، طب مکمل، گیاهان دارویی و معادل انگلیسی آنها در مجلات فارسی و انگلیسی زبان نمایه شده در SID، Iranmedx، Scopus، Magiran، Irandoc، Pubmed و Google scholar در فاصله سال‌های 2019-2007 انجام شد. جهت ارزیابی کیفیت مقالات از مقیاس جداد استفاده شد. معیار ورود به مطالعه شامل: مطالعات کارآزمایی بالینی انجام شده در زمینه ماستالژی و معیار خروج، عدم دسترسی به متن کامل مقاله و وجود بیش از یک مداخله در هر گروه و نداشتن گروه کنترل بود.
یافته‌ها: در این مطالعه، 14 مقاله که دارای معیارهای ورود به مطالعه بودند، مورد بررسی قرار گرفتند که دارای ترکیبات آنتی‌اکسیدانی، فلاونوئیدی با خاصیت ضدالتهاب و ضددرد بوده و در تسکین ماستالژی تأثیر مطلوبی داشتند. اطلاعات به‌دست آمده، استفاده از ویتاگنوس و ویتامین E را جهت درمان ماستالژی مورد حمایت قرار می‌دهد. ضمن اینکه بذرکتان نیز نتایج مطلوبی را ارائه داد. نتایج متاآنالیز با سه مطالعه نشان داد که هیچ تفاوت معنی­داری بین گل مغربی و ویتامین E وجود ندارد (648/0=p).
نتیجه‌گیری: از بین تمام روش‌های ذکر شده، ویتاگنوس و ویتامین E دارای شواهد بیشتر برای استفاده در درمان ماستالژی می‌باشند. برای کاربردی شدن سایر روش‌ها، مطالعات بیشتر ضروری است.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of Herbal Medicines and Supplements on Mastalgia: A systematic review and meta-analysis of clinical trials in Iran

نویسندگان [English]

  • Sedigheh Sheidaei 1
  • Morvarid Irani 2
  • Masoumeh Ghazanfarpour 3
1 M.Sc. in Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
2 M.Sc. in Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. PhD Candidate of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
3 PhD in Reproductive Health, Razi School of Nursing and Midwifery, Kerman University of Medical Science, Kerman, Iran.
چکیده [English]

Introduction: Mastalgia is one of the most common causes of women referring to treatment centers that regarding its importance, proper administration of the drug is important. Due to the complications of chemical drugs, the patients' tendency to use complementary medicine has been increased. This systematic review and meta-analysis was conducted with aim to evaluate and summarize the results of clinical trials on the effects of herbal medicines and dietary supplements on mastalgia in Iran.
Methods: This systematic review and meta-analysis evaluated the effect of herbal medicines and supplements on Mastalgia by searching the articles using the keywords of mastalgia, complementary medicine, herbal medicine, their English in Persian and English journals indexed in SID, Iranmedx,  Irandoc, Magiran, Scopus,  Pubmed  and Google scholar from 2007 until 2019. The Jadad scale was used to evaluate the quality of the articles. The inclusion criteria were: the randomized controlled trials (RCTs) on mastalgia and exclusion criteria were: no access to the full text and the existence of more than one intervention in each group and lack of control group.
Results: In this study, 14 articles with inclusion criteria were evaluated which had antioxidant, flavonoid, anti-inflammatory and analgesic properties and had a good effect on mastalgia relief. The obtained data supports the use of Vitagnus and vitamin E for the treatment of mastalgia. In addition, cotton seed also provided good results. The results of the meta-analysis on three studies showed no significant difference between vitamin E and Evening Primrose (p = 0.648).
Conclusion: Among all the above mentioned methods, Vitagnus and Vitamin E have more evidence for use in the treatment of mastalgia. Further studies are needed to apply other methods.

کلیدواژه‌ها [English]

  • Breast pain
  • Complementary Medicine
  • Iran
  • Mastalgia
  • Medicinal Plants
  1. Parsay S, Olfati F, Nahidi S. Therapeutic effects of vitamin E on cyclic mastalgia. Breast J 2009; 15(5):510-4.
  2. Kılıç MÖ, Sen M, Içen D. The comparison of evening primrose oil, fructus agni casti, and reassurance in the treatment of mastalgia. Int J Surg Med 2016; 2(2):83-8.
  3. Shobeiri F, Oshvandi K, Nazari M. Clinical effectiveness of vitamin E and vitamin B6 for improving pain severity in cyclic mastalgia. Iran J Nurs Midwifery Res 2015; 20(6):723-7.
  4. Genç A, Çelebi MM, Çelik SU, Atman ED, Kocaay AF, Zergeroğlu AM, et al. The effects of exercise on mastalgia. Phys Sportsmed 2017; 45(1):17-21.
  5. Jaafarnejad F, Adibmoghaddam E, Emami SA, Saki A. Compare the effect of flaxseed, evening primrose oil and Vitamin E on duration of periodic breast pain. J Educ Health Promot. 2017; 6:85.
  6. Seraji A, Salehi A, Momeni H, Kerami A, Naeimi N. The effects of evening primrose and vitex agnus on pain scale of the women with cyclic mastalgia a clinical trial. Complement Med J Facul Nurs Midwifery 2014; 3(4):639-53.
  7. Sekhavat L, Zare Tarzejani T. The effect of vitex agnus-castus on mastalgia in women. Iran South Med J 2009; 11(2):147-52.
  8. Smith RL, Pruthi S, Fitzpatrick LA. Evaluation and management of breast pain. Mayo Clinic Proceedings. New York: Elsevier; 2004.
  9. Stevinson C, Ernst E. Complementary/alternative therapies for premenstrual syndrome: a systematic review of randomized controlled trials. Am J Obstet Gynecol 2001; 185(1):227-35.
  10. Canning S, Waterman M, Dye L. Dietary supplements and herbal remedies for premenstrual syndrome (PMS): a systematic research review of the evidence for their efficacy. J Reprod Infant Psychol 2006; 24(4):363-78.
  11. Whelan AM, Jurgens TM, Naylor H. Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review. Can J Clin Pharmacol 2009; 16(3):e407-29.
  12. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17(1):1-12.
  13. Zamani M, Arab M, Nasrollahi SH, Manikashani KH. The evaluation of fish oil (Omega-3 fatty acids) efficacy in treatment of primary dysmenorrhea in high school female students in Hamadan. J Gorgan Med Sci 2005; 7(1):39-42.
  14. Yaghmaei M, Moradi A, Hosseini R. A comparison of therapeutic effect between mefenamic acid and mefenamic acid plus fish oil in reduction of the sverity of pain in primary dysmenorrheal. J Guilan Univ Med Sci 2004; 13(49):68-73.
  15. Aydin Y, Atis A, Kaleli S, Uludağ S, Goker N. Cabergoline versus bromocriptine for symptomatic treatment of premenstrual mastalgia: a randomised, open-label study. Eur J Obstet Gynecol Reprod Biol 2010; 150(2):203-6.
  16. Kataria K, Dhar A, Srivastava A, Kumar S, Goyal A. A systematic review of current understanding and management of mastalgia. Indian J Surg 2014; 76(3):217-22.
  17. Dinç T, Coşkun F. Comparison of fructus agni casti and flurbiprofen in the treatment of cyclic mastalgia in premenopausal women. Ulus Cerrahi Derg 2014; 30(1):34-8.
  18. Chase C, Wells J, Eley S. Caffeine and breast pain: revisiting the connection. Nurs Womens Health 2011; 15(4):286-94.
  19. Olfati F, Parsai S, Kazemnejad A, Farhad M. Comparison of two-month and four-month effect of vitamin E on cyclic mastalgia. J Qazvin Univ Med Sci 2006; 10(2):60-4.
  20. Jafarnejad F, Hosseini SF, Mazloom SR, Hami M. Comparison of the effect of fish oil and vitamin E on duration of cyclic mastalgia. Evid Bas Care 2013; 3(1):69-76.
  21. Vaziri F, Zamani Lari M, Samsami Dehaghani A, Salehi M, Sadeghpour H, Akbarzadeh M, et al. Comparing the effects of dietary flaxseed and omega-3 Fatty acids supplement on cyclical mastalgia in Iranian women: a randomized clinical trial. Int J Fam Med 2014; 2014:174532.
  22. Ingram D, Hickling C, West L, Mahe L, Dunbar P. A double-blind randomized controlled trial of isoflavones in the treatment of cyclical mastalgia. Breast 2002; 11(2):170-4.
  23. Thompson LU, Chen JM, Li T, Strasser-Weippl K, Goss PE. Dietary flaxseed alters tumor biological markers in postmenopausal breast cancer. Clin Cancer Res 2005; 11(10):3828-35.
  24. Shahhosseini Z, Amin G, Salehi Sormaghi MH, Danesh MA, Abedian K. Clinical evaluation of anti-dysmenorrhea vitagnus. J Mazandaran Uni Med Sci 2006; 15(50):15-21.
  25. Salehi A, Momeni H, Seraji A. Comparison of the effects of Hypericum and Vitex agnus premenstrual syndrome compared with vitamin E: a randomized clinical trial. Complement Med J Facul Nurs Midwifery 2013; 3(1):395-405.
  26. Horrobin DF. The role of essential fatty acids and prostaglandins in the premenstrual syndrome. J Reprod Med 1983; 28(7):465-8.
  27. Ghasemnezhad A, Honermeier B. Yield, oil constituents, and protein content of evening primrose (Oenothera biennis L.) seeds depending on harvest time, harvest method and nitrogen application. Indust Crops Prod 2008; 28(1):17-23.
  28. Cornish S, Mehl-Madrona L. The role of vitamins and minerals in psychiatry. Integr Med Insights 2008; 3:33-42.
  29. Fathizadeh N, Takfallah L, Ehsanpour S, Namnabati M, Askari S. Effects of evening primrose oil and vitamin E on the severity of periodical breast pain. Iran J Nurs Midwifery Res 2009; 13(3):90-3.
  30. Fallah Huseini H, Mohtashami R, Sadeghi Z, Saeedi Y, Fallah Huseini A. A review on pharmacological effects of Nigella sativa L. seeds. J Med Plants 2011; 10(38):1-18.
  31. Nickavar B, Mojab F, Javidnia K, Amoli MA. Chemical composition of the fixed and volatile oils of Nigella sativa L. from Iran. Z Naturforsch C 2003; 58(9-10):629-31.
  32. Al-Ghamdi M. The anti-inflammatory, analgesic and antipyretic activity of Nigella sativa. J Ethnopharmacol 2001; 76(1):45-8.
  33. Gharaiy NR, Shahnazi M, Kia PY, Javadzadeh Y. The effect of cinnamon on cyclical breast pain. Iran Red Crescent Med J 2017; 19(6):e26442.
  34. Yeh HF, Luo CY, Lin CY, Cheng SS, Hsu YR, Chang ST. Methods for thermal stability enhancement of leaf essential oils and their main constituents from indigenous cinnamon (Cinnamomum osmophloeum). J Agric Food Chem 2013; 61(26):6293-8.
  35. Ramakrishnan R, Werbeck J, Khurana KK, Khan SA. Expression of interleukin‐6 and tumor necrosis factor α and histopathologic findings in painful and nonpainful breast tissue. Breast J 2003; 9(2):91-7.
  36. Mirabi P, Alamolhoda SH, Esmaeilzadeh S, Mojab F. Effect of medicinal herbs on primary dysmenorrhoea-a systematic review. Iran J Pharm Res 2014; 13(3):757-67.
  37. Salehi L, Salehi F. Comparative study of vitamin B6 versus placebo in premenstrual syndrome. Sci J Kurdistan Univ Med Sci 2007; 12(3):42-9.
  38. Bender DA. Non-nutritional uses of vitamin B6. Br J Nutr 1999; 81(1):7-20.
  39. Sharifi F, Simbar M, Mojab F, AlaviMajd H. A comparative study of the effects of Matricaria chamomillaextract and mefenamic acid on the severity of premenstrual syndrome symptoms. Arak Med Univ J 2013; 16(1):71-8.
  40. Jahanian M, Rakhshandeh H, Teimuri M. The effect of Chamomile extract on dysmenorrhea. Med J Mashhad Univ Med Sci 1999; 42(64):33-40.
  41. Jafarnejad F, Hosseini S, Mazloom S, Hami M. Comparison of the effect of fish oil and vitamin E on severity of cyclic mastalgia. Iran J Obstet Gynecol Infertil 2013; 15(39):9-15.
  42. Delfan B, Zarei F, Iravani S, Ebrahimzadeh F, Adineh A, Sepahvand R, et al. Vitamin E and Omega-3, 6 and 9 combinations versus Vitamin E in the treatment of mastodynia. Jundishapur J Nat Pharm Prod 2015; 10(2):e18659.
  43. Jafarnezhad F, Adib Moghaddam E, Ahmad Emami S, Saki A, Hami M, Mohammadzadeh Vatanchi A. Comparative effect of Flaxseed and Evening primrose oil with vitamin E on severity of Cyclic Mastalgia in women. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2016;19(22):8-16.
  44. Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Ahmadpour P, Javadzadeh Y. Effects of vitex agnus and flaxseed on cyclic mastalgia: a randomized controlled trial. Complement Ther Med 2016; 24:90-5.
  45. Alvandipour M, Tayebi P, Alizadeh NR, Khodabakhshi H. Comparison between effect of Evening Primrose oil and vitamin E in treatment of cyclic mastalgia. J Babol Univ Med Sci 2011; 13(2):7-11.
  46. Mirmolaei ST, Olfatbakhsh A, Fallahhosseini H, Kazemnejad E, Sotodeh A. The effect of vitagnus on cyclic breast pain in women of reproductive age. J Babol Univ Med Sci 2016; 18(9):7-13.
  47. Mirmolaei ST, Olfatbakhsh A, Falah Huseini H, Kazemnezhad Leyli E, Sotoodeh Moridiani A. The effect of Nigella Sativa syrup on the relief of cyclic mastalgia: a triple-blind randomized clinical trial. J Hayat 2017; 23(1):33-43.
  48. Saghafi N, Rhkhshandeh H, Pourmoghadam N, Pourali L, Ghazanfarpour M, Behrooznia A, et al. Effectiveness of Matricaria chamomilla (chamomile) extract on pain control of cyclic mastalgia: a double-blind randomised controlled trial. J Obstet Gynaecol 2018; 38(1):81-4.
  49. Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlova-Wuttke D. Chaste tree (Vitex agnus-castus)–pharmacology and clinical indications. Phytomedicine 2003; 10(4):348-57.
  50. Akhavan Amjadi M, Mojab F, Shagbazzadegan S. Efficacy of cinnamomum zeylanicum on primary dysmenorrhea and systemic symptom of it on the students of Gilan university of medical sciences 2007. J Ardabil Univ Med Sci 2009; 9(3):204-9.
  51. Lee HJ, Hyun EA, Yoon WJ, Kim BH, Rhee MH, Kang HK, et al. In vitro anti-inflammatory and anti-oxidative effects of Cinnamomum camphora extracts. J Ethnopharmacol 2006; 103(2):208-16.
  52. Tschvdin S, Huber R. Traatrment of cyclic mastalgia with solution containing vitex agnus C.astus extraet. . Breast. 1999;8:175-81.
  53. Tschivdin S, Huber R. Treatment of cyclic mastalgia with solution cantainig vitex agnus castus. Breast. 2000;3:162-4.
  54. Niroumand MC, Heydarpour F, Farzaei MH. Pharmacological and therapeutic effects of Vitex agnus-castus L.: a review. Pharm Rev 2018; 12(23):103.
  55. Ohyama K, Akaike T, Hirobe C, Yamakawa T. Cytotoxicity and apoptotic inducibility of Vitex agnus-castus fruit extract in cultured human normal and cancer cells and effect on growth. Biol Pharm Bull 2003; 26(1):10-8.
  56. Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med 2000; 9(3):315-20.
  57. Sivini F, Molina A. cyclical mastalgia: a nonpharnacological treatment. Rev Bras Ginecol Obstet. 2001;23:77-82.
  58. Daniele C, Coon JT, Pittler MH, Ernst E. Vitex agnus castus. Drug Safety 2005; 28(4):319-32.
  59. Halaska M, Raus K, Bĕles P, Martan A, Paithner K. Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo. Ceska gynekologie. 1998;63(5):388-92.
  60. Abraham GE, Schwartz UD, Lubran MM. Effect of vitamin B-6 on plasma and red blood cell magnesium levels in premenopausal women. Ann Clin Lab Sci 1981; 11(4):333-6.
  61. Pruthi S, Wahner-Roedler DL, Torkelson CJ, Cha SS, Thicke LS, Hazelton JH, et al. Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study. Altern Med Rev 2010; 15(1):59-67.
  62. Sushel C, Syed BM, Sangrasi AK, Qureshi JN, Talpur AH. Role of vitamin E in mastalgia in young women. J Liaquat Univ Med Health Sci 2016; 15(2):67-70.
  63. Fathizadeh N, Takfallah L, Ehsanpour S, Namnabati M, Askari S. Effects of evening primrose oil and vitamin E on the severity of periodical breast pain. . Isfahan J Nurs Midwife Res. 2008;13(3):90-3.
  64. Prego-Dominguez J, Hadrya F, Takkouche B. Polyunsaturated fatty acids and chronic pain: a systematic review and meta-analysis. Pain Physician 2016; 19(8):521-35.
  65. Mehnazadehfalahieh F, Jaafarnejad F. Comparison of the effects of nigella sativa and Mefenamic acid on primary dismenorreha. Mashhad: Mashhad University of Medical Sciences.; 2015.
  66. Behzadi K, Jafarirad S, Mousavi P, Saki O. Effect of dried black seed grape on controlling the severity of premenstrual syndrome symptoms. Iran J Obstet Gynecol Infertil 2016; 19(3):26-34.
  67. Aqel M, Shaheen R. Effects of the volatile oil of Nigella sativa seeds on the uterine smooth muscle of rat and guinea pig. J Ethnopharmacol 1996; 52(1):23-6.
  68. Ali BH, Blunden G, Tanira MO, Nemmar A. Some phytochemical, pharmacological and toxicological properties of ginger (Zingiber officinale Roscoe): a review of recent research. Food Chem Toxicol 2008; 46(2):409-20.
  69. Sharifi F, Simbar M, Mojab F, Majd HA. Comparison of the effects of Matricaria chamomila (Chamomile) extract and mefenamic acid on the intensity of premenstrual syndrome. Complement Ther Clin Pract 2014; 20(1):81-8.
  70. Yazdani M, Shahriari M, Hamedi B. Comparison of fennel and chamomile extract and placebo in treatment of premenstrual syndrome and dysmenorrheal. Hormozgan Med J 2004; 8(1):e90600.
  71. Jenabi E, Ebrahimzadeh S. Chamomile tea for relief of primary dysmenorrhea. Iran J Obstet Gynecol Infertil 2010; 13(1):39-42.