Efectos de los extractos de plantas y los suplementos dietéticos en la percepción del tinnitus en adultos: Una revisión sistemática y metaanálisis
DOI:
https://doi.org/10.14306/renhyd.28.1.2308Palabras clave:
Tinnitus, Suplementos dietéticos, Melatonina, Extractos de plantas, Ensayos controlados aleatorizadosResumen
Introducción. El tinnitus, la percepción de sonido sin una fuente externa, afecta a millones de personas en todo el mundo y tiene un impacto significativo en la calidad de vida relacionada con la salud (CVRS). A pesar de las diversas estrategias de manejo, no existe un tratamiento universalmente efectivo. Si bien los afectados por tinnitus utilizan frecuentemente suplementos dietéticos, su eficacia sigue siendo incierta. Esta revisión sistemática y metaanálisis evaluó la efectividad de los extractos de plantas y los suplementos dietéticos en el tratamiento de los síntomas del tinnitus.
Metodología. Realizamos una búsqueda sistemática de ensayos controlados aleatorios (ECA) o ensayos cruzados que compararan extractos de plantas y suplementos dietéticos con grupos de placebo o control en adultos con tinnitus. Los criterios de selección incluyeron pacientes con tinnitus subjetivo y estudios que examinaran extractos de plantas o suplementos dietéticos. Utilizando un modelo de efectos aleatorios, estimamos las diferencias de medias estandarizadas y las razones de momios con intervalos de confianza del 95% (IC del 95%). La calidad de los estudios se evaluó utilizando la herramienta de riesgo de sesgo revisada de Cochrane para ensayos aleatorios. Protocolo registrado en PROSPERO (CRD42023446824).
Resultados. 21 estudios involucraron a 1,759 participantes y evaluaron cuatro extractos de plantas y 6 suplementos dietéticos. 5 ensayos investigaron extractos de plantas (Euterpe oleracea, medicina herbal tradicional Hangekobokuto, Neurotec y cafeína), mientras que 16 examinaron suplementos dietéticos (melatonina, zinc, ácido alfa-lipoico, manganeso, complejo de vitamina B y nicotinamida). El metaanálisis reveló que no hubo una eficacia significativa de la cafeína en la reducción del impacto del tinnitus en la CVRS (DME=0.07; IC del 95%: -0.73 a 0.86; I²=0.0%). La melatonina mostró una reducción modesta en la intensidad del tinnitus vs placebo (OR=2.52; IC del 95%: 1.33-4.80; k=2, 168).
Conclusiones. Solo la melatonina mostró una eficacia modesta en la reducción del tinnitus, aunque la evidencia sigue siendo incierta debido a limitaciones metodológicas. Se necesitan más investigaciones de calidad con seguimiento a largo plazo que confirmen estas observaciones.
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