Echinacea for preventing and treating the common cold.

BACKGROUND: Extracts of the plant Echinacea (family Compositae) are widely used in some European countries and the USA for upper respiratory tract infections. OBJECTIVES: The objective of this review was to assess the effects of preparations containing extracts of Echinacea in the prevention and treatment of the common cold. SEARCH STRATEGY: We searched the Cochrane Acute Respiratory Infections Group and Complementary Medicine Field's trials registers, MEDLINE, EMBASE, Phytodok and reference lists of articles. We also contacted researchers and manufacturers. Date of last search: Spring 1998. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing preparations containing an extract of Echinacea compared with a placebo, no treatment, or another treatment for common colds. DATA COLLECTION AND ANALYSIS: At least two independent reviewers assessed trial quality and extracted data. MAIN RESULTS: Sixteen trials (eight prevention trials, and eight trials on treatment of upper respiratory tract infections) with a total of 3396 participants were included. Variation in preparations investigated and methodological quality of trials precluded quantitative meta-analysis. Overall, the results suggested that some Echinacea preparations may be better than placebo. REVIEWER'S CONCLUSIONS: The majority of the available studies report positive results. However there is not enough evidence to recommend a specific Echinacea product, or Echinacea preparations for the treatment or prevention of common colds.

Monitoring of liver enzymes in patients treated with traditional Chinese drugs.

BACKGROUND: Use of traditional Chinese drug treatment is widespread. While cases of hepatotoxic effects have been reported, little is known about the frequency of such effects. OBJECTIVES: To investigate the frequency, magnitude and course of liver enzyme elevations in patients treated with traditional Chinese drugs. DESIGN: Retrospective study. SETTING: Hospital for traditional Chinese medicine in Germany. PATIENTS: All 1507 patients admitted for inpatient treatment between February 1994 and July 1995. MAIN OUTCOME MEASURE: Number of patients who presented at discharge with a more than 2-fold elevation of alanine amino transferase (ALT) levels (over maximum normal values or elevated admission values). RESULTS: A more than 2-fold elevation of ALT values was observed in 14 patients (0.9%). In 13 cases a causal relationship with Chinese drug therapy seemed possible and, for one patient, likely. However, all patients were also on non-Chinese drug treatment. Follow-up values of ALT within 8 weeks after discharge were normal in 11 patients (six of them had continued to take traditional Chinese drugs) and close to normal in the remaining three. In five patients there were indications for previous liver damage. CONCLUSIONS: In the population and setting studied, clinically relevant liver enzyme elevations occurred in about 1/100 patients treated with traditional Chinese drugs.