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Santé
Médicaments à base de plantes en provenance
du Tibet
En mai 1999, à l'occasion d'un colloque consacré
aux 10 ans de la recherche sur le sida en Suisse, une
série de travaux inédits étaient
présentés (sur ce colloque, voir l'article
dans
Le Temps du 25 mai 1999). Parmi ceux-ci, une étude
abordait le thème du traitement du sida au moyen
de plantes médicinales chinoises et concluait
à son inefficacité dans des conditions
médicales occidentales.
Pour en savoir un peu plus, voici un résumé de l'article
que l'équipe du Dr Rainer Weber, Département
de médecine interne de l'Hôpital universitaire
de Zurich, Division des maladies infectieuses et de
l'hygiène hospitalière, vient de faire
paraître.
Nos remerciements au Dr Weber de nous avoir transmis ce résumé.
Weber R, Christen L, Loy M, Schaller S, Christen S, Joyce CR, Ledermann
U, Ledergerber B, Cone R, Luthy R, Cohen MR. Randomized, placebo-controlled
trial of Chinese herb therapy for HIV-1-infected individuals. J Acquir
Immune Defic Syndr 1999 Sep 1;22(1):56-64 Department of Internal Medicine,
University Hospital, Zurich, Switzerland. infweb@usz.unizh.ch
Abstract
CONTEXT: Alternative medicine or complementary
remedies that have not been scientifically tested are nonetheless
widely used to treat chronic illnesses, particularly if curative options
are limited. OBJECTIVES: To assess the effectiveness of Chinese medicinal
herbs in reducing symptoms and improving the quality of life of HIV-infected
persons. DESIGN: Prospective, placebo-controlled double-blind study.
SETTING: University-based HIV outpatient clinic.
PATIENTS: 68
HIV-infected adults with CD4 cell counts <0.5 x 10(9)/L.
INTERVENTION: Participants were randomized to receive four
daily doses of seven pills containing a standardized preparation of
35 Chinese herbs or placebo for 6 months.
MAIN OUTCOME MEASURES: Symptoms, HIV disease progression, HIV-1 RNA
plasma viral loads, CD4 and CD8 cell counts, and scores on standard
questionnaires for quality of life, depression, anxiety, and coping.
RESULTS: Intervention and placebo groups were equivalent at baseline
regarding, respectively, previous antiretroviral therapy (74% versus
79%), median CD4 cell counts (0.20 x 10(9)/L versus 0.25 x 10(9)/L),
and median HIV-1 plasma viral loads (35,612 copies/ml versus 52,027
copies/ml). At enrollment, none of the study subjects was seriously
ill or depressed, and average coping and quality of life scores were
in the normal range. In all, 53 (78%) participants completed the study.
Patients taking Chinese herbs reported significantly more gastrointestinal
disturbances (79% versus 38%; p = .003) than those receiving placebo.
No therapy-related toxicities were observed. At completion of the
study, no significant differences between the intervention and placebo
groups were found regarding plasma viral loads, CD4 cell counts, symptoms,
and psychometric parameters. HIV-1 RNA level was unchanged at study
end. Among participants who were not on concomitant antiretroviral
therapy, median CD4 cell counts declined by 0.05 x 10(9)/L in both
the intervention and placebo groups.
CONCLUSIONS:
This standardized formulation of Chinese herbs for HIV-infected individuals
did not improve quality of life, clinical manifestations, plasma virus
loads, or CD4 cell counts. The data suggest that this formulation
of Chinese herbs is not effective when administered in a Western medicine
setting.
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