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A critical scoping review of external uses of comfrey (Symphytum spp.).

Abstract

BACKGROUND

External preparations of the herb comfrey (most commonly Symphytum officinale L.) are widely available for over-the-counter, practitioner and healthcare professional usage. Traditional practice suggests comfrey can be used to treat musculoskeletal disorders, wounds and various other conditions; however a full and critical coverage of the evidence base has not yet been undertaken.

METHODS

A critical scoping review was undertaken. Six bibliographic databases, 10 grey literature databases and nine trials registers were searched plus reference lists of included studies and a descriptive overview of comfrey. Randomised or non-randomised clinical trials assessing the external use of comfrey for any indication were included and methodological and reporting quality were assessed. Observational studies were included only in the assessment of adverse events. Studies were grouped and summarised according to the type of indication treated.

RESULTS

Of 1348 identified records, 64 full texts were screened for inclusion and 26 were included in the review - 13 RCTs, 5 non-randomised controlled trials and 8 observational studies evaluating treatments for ankle distortion, back pain, abrasion wounds, venous leg ulcers and osteoarthritis. The majority of included trials had an overall unclear risk of bias due to poor quality of reporting. Few adverse events were reported.

CONCLUSIONS

Individual clinical trials showed evidence of benefit for ankle distortion, back pain, abrasion wounds and osteoarthritis. Topical application appears to be safe but further rigorous assessment is needed. Systematic reviews focussing on particular indications may clarify the treatment effect and safety of external comfrey preparations.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    University of York, United Kingdom. Electronic address: rachael.frost@gcu.ac.uk.

    ,

    Source

    Complementary therapies in medicine 21:6 2013 Dec pg 724-45

    MeSH

    Administration, Topical
    Comfrey
    Humans
    Musculoskeletal Pain
    Plant Extracts
    Randomized Controlled Trials as Topic

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    24280482

    Citation

    Frost, R, et al. "A Critical Scoping Review of External Uses of Comfrey (Symphytum Spp.)." Complementary Therapies in Medicine, vol. 21, no. 6, 2013, pp. 724-45.
    Frost R, MacPherson H, O'Meara S. A critical scoping review of external uses of comfrey (Symphytum spp.). Complement Ther Med. 2013;21(6):724-45.
    Frost, R., MacPherson, H., & O'Meara, S. (2013). A critical scoping review of external uses of comfrey (Symphytum spp.). Complementary Therapies in Medicine, 21(6), pp. 724-45. doi:10.1016/j.ctim.2013.09.009.
    Frost R, MacPherson H, O'Meara S. A Critical Scoping Review of External Uses of Comfrey (Symphytum Spp.). Complement Ther Med. 2013;21(6):724-45. PubMed PMID: 24280482.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A critical scoping review of external uses of comfrey (Symphytum spp.). AU - Frost,R, AU - MacPherson,H, AU - O'Meara,S, Y1 - 2013/10/08/ PY - 2013/07/10/received PY - 2013/09/25/revised PY - 2013/09/29/accepted PY - 2013/11/28/entrez PY - 2013/11/28/pubmed PY - 2014/7/16/medline KW - Comfrey KW - Herbal medicine KW - Review SP - 724 EP - 45 JF - Complementary therapies in medicine JO - Complement Ther Med VL - 21 IS - 6 N2 - BACKGROUND: External preparations of the herb comfrey (most commonly Symphytum officinale L.) are widely available for over-the-counter, practitioner and healthcare professional usage. Traditional practice suggests comfrey can be used to treat musculoskeletal disorders, wounds and various other conditions; however a full and critical coverage of the evidence base has not yet been undertaken. METHODS: A critical scoping review was undertaken. Six bibliographic databases, 10 grey literature databases and nine trials registers were searched plus reference lists of included studies and a descriptive overview of comfrey. Randomised or non-randomised clinical trials assessing the external use of comfrey for any indication were included and methodological and reporting quality were assessed. Observational studies were included only in the assessment of adverse events. Studies were grouped and summarised according to the type of indication treated. RESULTS: Of 1348 identified records, 64 full texts were screened for inclusion and 26 were included in the review - 13 RCTs, 5 non-randomised controlled trials and 8 observational studies evaluating treatments for ankle distortion, back pain, abrasion wounds, venous leg ulcers and osteoarthritis. The majority of included trials had an overall unclear risk of bias due to poor quality of reporting. Few adverse events were reported. CONCLUSIONS: Individual clinical trials showed evidence of benefit for ankle distortion, back pain, abrasion wounds and osteoarthritis. Topical application appears to be safe but further rigorous assessment is needed. Systematic reviews focussing on particular indications may clarify the treatment effect and safety of external comfrey preparations. SN - 1873-6963 UR - https://www.unboundmedicine.com/medline/citation/24280482/A_critical_scoping_review_of_external_uses_of_comfrey__Symphytum_spp___ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0965-2299(13)00167-2 DB - PRIME DP - Unbound Medicine ER -