Efficacy and Safety of Saffron and Ashwagandha for Stress-Related Mental Health Outcomes: A Systematic Review of Randomized Controlled Trials.
完整摘要 · 中文译文
藏红花（Crocus sativus L.）和南非醉茄（Withania somnifera Dunal）是药用植物，新兴的临床证据支持其用于压力相关心理健康状况。本系统评价遵循PRISMA 2020规范，已在前瞻性注册平台PROSPERO注册（CRD420261385134），综合了两种植物在八项心理健康结局方面的随机对照试验证据，文献检索更新至2026年8月31日。从494条初始记录中，去除重复后剩余452条；34项研究符合纳入标准（19项藏红花、14项南非醉茄、1项综合综述），其中包含31项随机对照试验。藏红花在标准化提取物15-30 mg/日剂量下对抑郁（10项随机对照试验[RCT]）、焦虑（9项RCT）和睡眠（8项RCT）显示出疗效。南非醉茄在醉茄内酯标准化提取物30-600 mg/日剂量下对焦虑（10项RCT）、压力（8项RCT）和睡眠（3项RCT）显示出疗效，合并皮质醇降低值为-3.27 µg/dL。31项试验中10项偏倚风险为低，其余大多数存在一些担忧，GRADE证据确定性最高为中等。两种植物均表现出良好的安全性特征，但南非醉茄相关肝毒性提示长期使用期间需监测肝酶。关键的是，尽管有机制证据表明下丘脑-垂体-肾上腺轴正常化、神经炎症减轻以及单胺能和γ-氨基丁酸能调节，两种植物均无针对职业倦怠或创伤后应激障碍的RCT；该证据主要来自临床前研究，需要 需要临床确认。本系统综述将这些病症确定为精心设计的临床试验的优先目标。藏红花中的生物活性成分——藏红花素和藏红花醛，以及南非醉茄中的醉茄内酯——共享与这些服务不足、高负担疾病高度相关的重叠机制通路。
完整摘要 · 英文原文
Saffron (Crocus sativus L.) and ashwagandha (Withania somnifera Dunal) are medicinal plants with emerging clinical evidence supporting their use for stress-related mental health conditions. This PRISMA 2020-compliant systematic review, prospectively registered with PROSPERO (CRD420261385134), synthesizes randomized controlled trial evidence for both plants across eight mental health outcomes, with the literature search updated to 31 August 2026. From 494 initial records, 452 remained after duplicate removal; 34 studies met eligibility criteria (19 saffron, 14 ashwagandha, 1 comprehensive review), comprising 31 randomized controlled trials. Saffron demonstrated efficacy for depression (10 randomized controlled trials [RCTs]), anxiety (9 RCTs), and sleep (8 RCTs) at 15-30 mg/day standardized extract. Ashwagandha showed efficacy for anxiety (10 RCTs), stress (8 RCTs), and sleep (3 RCTs) at 30-600 mg/day with a withanolide-standardized extract, with a pooled cortisol reduction of -3.27 µg/dL. Risk of bias was low in 10 of 31 trials and raised some concerns in most of the remainder, and GRADE certainty was moderate at best. Both plants exhibited favorable safety profiles, although ashwagandha-associated hepatotoxicity warrants liver enzyme monitoring during prolonged use. Critically, no RCTs exist for burnout or posttraumatic stress disorder in either plant, despite mechanistic evidence of hypothalamic-pituitary-adrenal axis normalization, reduced neuroinflammation, and monoaminergic and gamma-aminobutyric acid-ergic modulation; this evidence is predominantly preclinical and requires clinical confirmation. This systematic review identifies these conditions as priority targets for well-designed clinical trials. The bioactive constituents-crocin and safranal in saffron, and withanolides in ashwagandha-share overlapping mechanistic pathways highly relevant to these underserved, high-burden disorders.
摘要 待译
Saffron (Crocus sativus L.) and ashwagandha (Withania somnifera Dunal) are medicinal plants with emerging clinical evidence supporting their use for stress-related mental health conditions. This PRISMA 2020-compliant systematic review, prospectively registered with PROSPERO (CRD420261385134), synthesizes randomized controlled trial evidence for both plants across eight mental health outcomes, with the literature search updated to 31 August 2026.…