Περίληψη:
Objective: To assess the evidence surrounding the use of certain
complementary supplements in otolaryngology. We specifically focussed on
four commonly used supplements: spirulina, Ginkgo biloba, Vertigoheel
(R) and nutritional supplements (cod liver oil, multivitamins and
pineapple enzyme).
Materials and methods: A systematic review of the English and foreign
language literature. Inclusion criteria: in vivo human studies.
Exclusion criteria: animal trials, in vitro studies and case reports. We
also excluded other forms of ‘alternative medicine’ such as reflexology,
acupuncture and other homeopathic remedies.
Results: Lack of common outcome measures prevented a formal
meta-analysis. Three studies on the effects of spirulina in allergy,
rhinitis and immunomodulation were found. One was a double-blind,
placebo, randomised, controlled trial (RCT) of patients with allergic
rhinitis, demonstrating positive effects in patients fed spirulina for
12 weeks. The other two studies, although non-randomised, also reported
a positive role for spirulina in mucosal immunity. Regarding the use of
Ginkgo biloba in tinnitus, a Cochrane review published in 2004 showed no
evidence for this. The one double-blind, placebo-controlled trial that
followed confirmed this finding. Regarding the use of Vertigoheel in
vertigo, two double-blind RCTs and a meta-analysis were identified. The
first RCT suggested that Vertigoheel was equally effective in reducing
the severity, duration and frequency of vertigo compared with
betahistine. The second RCT suggested that Vertigoheel was a suitable
alternative to G biloba in the treatment of atherosclerosis-related
vertigo. A meta-analysis of only four clinical trials confirms that
Vertigoheel was equally effective compared with betahistine, G biloba
and dimenhydrinate. Regarding multivitamins and sinusitis, two small
paediatric pilot studies reported a positive response for chronic
sinusitis and otitis media following a course of multivitamins and cod
liver oil. Regarding bromelain (pineapple enzyme) and sinusitis, one
randomised, multicentre trial including 116 children compared bromelain
monotherapy to bromelain with standard therapy and standard therapy
alone, for the treatment of acute sinusitis. The bromelain monotherapy
group showed a faster recovery compared with the other groups.
Conclusion: The positive effects; of spirulina in allergic rhinitis and
of Vertigoheel in vertigo are based on good levels of evidence, but
larger trials are required. There is overwhelming evidence that G biloba
may play no role in tinnitus. There is limited evidence for the use of
multivitamins in sinus symptoms, and larger randomised trials are
required.
Συγγραφείς:
Karkos, P. D.
Leong, S. C.
Arya, A. K.
Papouliakos, S. M.
and Apostolidou, M. T.
Issing, W. J.
