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Aktuelle Rheumatologie 2015; 40(06): 444-448
DOI: 10.1055/s-0035-1548862
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Phytotherapie bei entzündlich-rheumatischen Erkrankungen – ist für alles ein Kraut gewachsen?

Phytotherapy in Inflammatory Rheumatic Diseases – A Herb for all Cases?
J. Georgi
1   Abteilung Innere Medizin/Rheumatologie, Helios Ostseeklinik, Damp
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Publication History

Publication Date:
22 July 2015 (online)

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Zusammenfassung

Die jahrtausendealte Nutzung von Pflanzen als Heilmittel wird bis zum heutigen Tage auch bei entzündlich-rheumatischen Erkrankungen praktiziert. Diese Arbeit beleuchtet die Wirksamkeit von oral zugeführten Inhaltsstoffen aus Pflanzen nach heutigen wissenschaftlichen Standards bei rheumatoider Arthritis, Spondyloarthritiden und Kollagenosen. Im Gegensatz zum guten Ruf dieser angeblich „sanften“ oder „natürlichen“ Behandlung in der Regenbogenpresse sind die Studienergebnisse ernüchternd. Bestimmte ungesättigte Fettsäuren (Gamma-Linolensäure, GLA) in sehr hohen Dosen, enthalten im Borretsch-Samen, Nachtkerzen oder Samen der Schwarzen Johannisbeere, können möglicherweise zu einer mäßigen Schmerzbesserung bei der rheumatoiden Arthritis (RA) führen. Extrakte aus Hagebutte, Weidenrinde und indischem Weihrauch bessern die Schmerzen bei RA-Patienten nicht. Ein Extrakt aus der asiatischen Giftpflanze Tripterygium wilfordii Hook F (TwHF) ist in einer Arbeit Sulfasalazin überlegen, in einer anderen MTX nicht unterlegen. Eine hohe Rate an Nebenwirkungen und Mängel im Studien-Design limitieren die Aussagekraft dieser Ergebnisse. Zur Behandlung von Spondyloarthritiden und Kollagenosen ist die Datenlage unbefriedigend. Es gibt bisher keinen „Durchbruch“ in der Therapie entzündlich-rheumatische Erkrankungen durch Phytotherapie. Zukünftige Studien zur Wirksamkeit, Nebenwirkungen und Langzeitverträglichkeit von Phytopharmaka sind dringend geboten.

Abstract

For thousands of years herbs have been used as remedies also in inflammatory rheumatic diseases. This work highlights the efficacy of orally applied ingredients of plants according to present scientific standards in rheumatoid arthritis, spondyloarthritis and mixed connective tissue disease. Contrary to the good reputation of this supposed “smooth” or “natural” treatment in the yellow press, study results are sobering. Certain unsaturated fatty acids (gamma-linolenic acid, GLA) in very high doses, contained in borage seed, evening primrose or blackcurrant seed, may lead to a moderate improvement of pain in rheumatoid arthritis (RA). Extracts from rosehip, willow bark and Indian frankincense do not alleviate pain in RA patients. An extract from the Asian poisonous plant Tripterygium wilfordii Hook F (TwHF) is in one study superior to sulfasalazine, in another not inferior to methotrexate. A high rate of side effects and poor study design limit the evidence of these results. Referring to the treatment of spondyloarthritis and mixed connective tissue disease the data are unsatisfactory. So far there has been no breakthrough in the treatment of inflammatory rheumatic diseases by phytotherapy. Future studies concerning efficacy, side effects and long-term compatibility of phytopharmacology are badly needed.

Schlüsselwörter

Rheumatoide Arthritis - Phytotherapie - TwHF

Key words

rheumatoid arthritis - phytotherapy - TwHF
 

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