聖約翰草 St. John's Wort × 焦慮
結論：主流反證據
聖約翰草用於「焦慮」與其用於「憂鬱症」必須嚴格區隔：Examine 對憂鬱症給予 A 級（18 篇研究、3,064 人），但對焦慮則「genuinely absent」——Examine 整個聖約翰草條目只有單一憂鬱症結果列，完全沒有焦慮／壓力條目。
U ⚫ U 未驗證 主流反證據 ⚠️ medium — moderate promotional content
聖約翰草用於「焦慮」與其用於「憂鬱症」必須嚴格區隔：Examine 對憂鬱症給予 A 級（18 篇研究、3,064 人），但對焦慮則「genuinely absent」——Examine 整個聖約翰草條目只有單一憂鬱症結果列，完全沒有焦慮／壓力條目。
就焦慮這個精確問題，證據既薄弱又方向偏負面：沒有任何針對焦慮的 meta-analysis 或系統性回顧；僅有的兩項安慰劑對照雙盲 RCT（強迫症 n=60、社交恐懼症 n=40，皆 2005 年）皆為陰性（Y-BOCS 改善 3.43 vs 安慰劑 3.60；LSAS effect size -0.09, p=0.27）；唯一顯示焦慮改善的是一項開放標籤、無安慰劑、業界導向的「憂鬱合併焦慮」研究，無法佐證獨立抗焦慮效果。
我獨立評定 D 級而非 U 級，因為「有反證據存在」——兩項正規 RCT 一致指向無效，並非單純缺乏研究。
但 D 是基於樣本小、皆為焦慮譜系（OCD／社交恐懼症）而非廣泛性焦慮症（GAD）的舊資料，因此評級謹慎。
關鍵安全訊號進一步壓低判讀：NCCIH 明確警告聖約翰草「is a stimulant and may worsen feelings of anxiety in some people」——亦即對焦慮族群可能不只無效、甚至有害；且聖約翰草是本引擎中藥物交互作用風險最高的補充品（強效 CYP3A4／2C9／P-gp 誘導劑，與避孕藥、抗凝血劑、免疫抑制劑、抗 HIV 藥、SSRI 併用屬重大／禁忌風險）。
結論：聖約翰草不應被呈現為焦慮的有效療法，字典條目須以「反證據＋安全警示」框架撰寫。
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評分透明度
所有分數由 7 層證據引擎計算，過程公開可查原始分數 0.40
D
C
B
A
S
← 反證據 / 無效有效 / 強證據 →
最終評級
U · 主流反證據
信心度
74%
證據方向大致一致
證據層級
E6
多篇較小型隨機對照試驗
▸查看完整決策路徑（audit trail）
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.397
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 無高階證據可裁決
- tier_strict_requirement_check — D 級條件未達 (需 E1-E3 negative；實際 E6)
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
St John's wort versus placebo in obsessive-compulsive disorder: results from a double-blind study
結論：In 60 OCD patients randomized to St John's wort or placebo over 12 weeks, mean Y-BOCS change with St John's wort (3.43 points) was not significantly different from placebo (3.60 points), and no Y-BOCS subscale differed; the authors concluded St John's wort is not an efficacious treatment for OCD.
前往 PubMed
St. John's wort versus placebo in social phobia: results from a placebo-controlled pilot study
結論：In 40 outpatients with primary social phobia randomized to St John's wort or placebo over 12 weeks, mean LSAS change did not differ between St John's wort (11.4) and placebo (13.2), p=0.27, effect size -0.09; this pilot RCT failed to provide evidence of efficacy for Hypericum in social anxiety disorder.
前往 PubMed
Treating depression comorbid with anxiety: results of an open, practice-oriented study with St John's wort WS 5572 and valerian extract in high doses
結論：In an open, practice-oriented study of patients with depression comorbid with anxiety, both St John's wort monotherapy and the St John's wort plus valerian combination improved anxiety and depression symptoms; anxiety symptoms improved more quickly with the combination than with St John's wort alone, and treatment was well tolerated. Open-label design without placebo limits causal inference about St John's wort's anxiolytic effect.
前往 PubMed
L4a US FDA
謹慎
St. John's Wort appears to be an inducer of an important metabolic pathway, cytochrome P450. As many prescription drugs used to treat conditions such as heart disease, depression, seizures, certain cancers or to prevent conditions such as transplant rejection or pregnancy (oral contraceptives) are metabolized via this pathway, health care providers should alert patients about these potential dr… 來源↗
L4b EU EFSA
謹慎
L4c UK NHS
反對
St John's wort is a herbal treatment that some people take for depression. ... There's some evidence that it may help less severe depression, but it's not recommended by doctors. This is because the amount of active ingredients varies among individual brands and batches, so you can never be sure what sort of effect it'll have on you. Taking St John's wort with other medicines, such as anticonvu… 來源↗
L4d TW TFDA / 衛福部
謹慎
根據台灣衛生福利部的規定，聖約翰草不能當作一般食品原料使用，因此在台灣無法購買到合法含有聖約翰草的食品。 來源↗
L4e WHO
支持
Herba Hyperici. WHO Monographs on Selected Medicinal Plants, Volume 2 (Geneva: World Health Organization, 2002), pp. 149-171. The crude drug herba hyperici consists of the dried flowering aerial parts of Hypericum perforatum L. Uses supported by clinical data include the symptomatic treatment of mild to moderate depressive disorders. Verbatim section text of the WHO monograph could not be extra… 來源↗
L5a NIH Office of Dietary Supplements
謹慎
L5b Mayo Clinic
謹慎
St. John's wort might help treat somatic symptom disorder, a condition that causes a heightened focus on physical symptoms such as pain or fatigue... Taking St. John's wort with alprazolam (Xanax), a medicine used to ease anxiety symptoms, might lessen the medicine's effect. 來源↗
L5c Cleveland Clinic
謹慎
L5d Harvard Health
未表態
— 本適應症無對應資料
L5e Specialty Society (condition-mapped)
未表態
— 本適應症無對應資料
PTT · Dcard · Mobile01 彙整自公開論壇討論，非統計抽樣，僅反映社群風向。
廣告 / 業配密度 中度
低中高
📍立場總覽
台灣社群對聖約翰草用於焦慮的討論量偏少，且集中在 PTT 芳療版（純露／浸泡油角度）與零星購物討論串；療效心得分歧、樣本小，最強烈且一再被重複的訊號是「藥物交互作用」警告（與抗憂鬱藥等百種以上西藥相衝），多數人持謹慎態度而非背書。
💬社群實感
分歧（少數反映情緒／睡眠改善，但無共識、樣本小，主流輿論偏向「效果一般、未勝過安慰劑」的懷疑態度）
破解迷思 社群最常見的 5 個誤解
✓
事實誤以為聖約翰草是「天然無害」的抗憂鬱／抗焦慮替代品（社群與證據皆強調其與百種以上西藥交互作用、風險不低）
✓
事實誤以為可與抗憂鬱／抗焦慮處方藥併用（社群與藥理皆警告代謝途徑相衝、恐致血清素症候群或加重毒性）
✓
事實把焦慮與輕度憂鬱、助眠效果混為一談（社群實測多以情緒／睡眠主觀感受為主，抗焦慮共識不足）
✓
事實誤以為芳療純露／浸泡油外用等同口服補充劑（社群指外用較安全、造成交互作用的成分不易經皮吸收，但口服才是風險來源）
✓
事實期待即時見效（社群與資料均指需連續使用 3-4 週才可能有感）
🩹 社群通報的副作用
- 與抗憂鬱藥（SSRI）併用之血清素症候群風險
- 與避孕藥、抗凝血劑等多種西藥交互作用導致藥效改變
- 光敏感／皮膚對陽光敏感
- 腸胃不適、口乾、頭暈（少數）
🏷️ 社群熱議品牌
依論壇被提及頻率，非銷售或品質排序。
- 日本 DHC 聖約翰草（天然抗憂鬱減壓素，社群最常被點名的市售口服品牌）
- Natural Factors（iHerb 海外代購，300mg）
- GNC Herbal Plus St. John's Wort（300mg，海外代購）
⚠️ 列出僅代表「TW 社群討論度高」，不代表本站推薦或背書。本站不販售任何產品、無導購連結。
- 認知行為治療（CBT）
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