Das Spektrum universitärer Forschung in der Naturheilkunde/Komplementärmedizin wird anhand klinischer Phytotherapie bei Patienten mit chronischen Erkrankungen aufgezeigt. Methoden der Evidenzbasierten Medizin (EbM) werden angewandt (Metaanalyse, randomisierte kontrollierte Studie (RCT), Beobachtungsstudie), um sowohl die Wirksamkeit und Sicherheit pflanzlicher Extrakte als auch die Kombinationsbegründung und Konfounder in Studien zu pflanzlichen Arzneimitteln zu untersuchen: Zwei Metaanalysen zeigen - bei der Reanalyse der Rohdaten nach Intention-to-treat-Prinzip - eine signifikante und klinisch relevante Reduktion, zum einen gastrointestinaler Symptome durch das Kombinationspräparat STW5 bei 273 Patienten mit funktioneller Dyspepsie und zum anderen der krankheitsspezifischen Mortalität bei 602 Patienten mit alkoholtoxischer Leberzirrhose durch das Monopräparat Silymarin - jeweils im Vergleich zu Placebo. Zwei RCTs zeigten i) bei 204 Patienten mit Fingergelenkspolyarthrose unter topischer Anwendung eines Arnika-Gels keine signifikante Unterlegenheit im Vergleich zu einem nichtsteroidalen Antirheumatikum bezüglich Schmerz sowie Handfunktion und ii) bei 182 Patienten mit somatoformen Störungen mit der Behandlung durch das Kombinationspräparat Ze 185 (4 Pflanzenextrakte) im Vergleich zur 3er-Kombination und Placebo eine signifikante Reduktion depressiver und ängstlicher Symptome. Eine Beobachtungsstudie mit 1541 ambulanten Patienten mit unipolaren leicht- bis mittelgradigen depressiven Episoden ergab, ähnlich wie bei synthetischen Antidepressiva, eine negative Assoziation zwischen Erkrankungsdauer, Symptomstärke und Erkrankungsalter mit dem Outcome. Je nach klinischer Fragestellung eignen sich verschiedene Methoden der EbM zur Untersuchung pflanzlicher Extrakte hinsichtlich der eingangs erwähnten Aspekte.

Keywords:
Naturheilkunde, Komplementärmedizin, Evidenzbasierte Medizin, EbM, Klinische Phytotherapie, Universitäre Forschung, Chronische Erkrankungen, Phytotherapie
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