A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.
A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.
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对抗凝剂/抗血小板剂与中草药之间的潜在有害相互作用的回顾。
DOI：
10.1371/journal.pone.0064255
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Mahady GB
中科院分区：
文献类型：
--
作者：
Tsai HH;Lin HW;Lu YH;Chen YL;Mahady GB
药物-草药相互作用的风险，即使是已知的，也常常被忽视或低估，特别是对于那些涉及抗凝血药物和中药的药物。本研究的目的是从结构上检索和评价与抗凝/抗血小板药物和中草药（CHMs）之间潜在药物相互作用相关的现有循证数据，并评价记录的相互作用机制、后果和/或严重程度。抗凝/抗血小板药物-中草药相互作用的相关信息来自8本基于相互作用的教科书、4个网络资源和现有的主要生物医学文献。使用二级数据库（例如，PubMed、Airiti Library、中国期刊全文数据库）。检索词包括相应的医学主题词和关键词。不作为单一实体中药或中药处方使用的草药或天然产物被排除在进一步审查之外。使用MicroMedex®、Lexicomp®和Natural Medicines Comprehensive Database®检索相互作用的相应机制和严重程度评级。最后，我们发现90个单一实体CHM促成了306个记录的药物-CHM相互作用。共验证了194（63.4%）例相互作用的证据，描述了可能的机制和严重程度。其中，155种相互作用（79.9%）可归因于药效学相互作用，几乎所有相互作用均被评定为中度至重度相互作用。这些相互作用的主要后果是增加出血的风险，由于添加剂的抗凝血或抗血小板作用的中药，特别是丹参，当归，生姜，银杏，甘草，姜黄。传统的抗凝剂和抗血小板药物被证明与一些常用的单一实体CHMs有有害的相互作用。对于那些正在服用常规抗凝药物和中草药治疗心血管或脑血管疾病的患者，不应忽视药物-中草药相互作用导致出血增加的潜在风险。
The risks attributed to drug-herb interactions, even when known, are often ignored or underestimated, especially for those involving anti-clotting drugs and Chinese medicines. The aim of this study was to structurally search and evaluate the existing evidence-based data associated with potential drug interactions between anticoagulant/antiplatelet drugs and Chinese herbal medicines (CHMs) and evaluate the documented mechanisms, consequences, and/or severity of interactions. Information related to anticoagulant/antiplatelet drug-CHM interactions was retrieved from eight interaction-based textbooks, four web resources and available primary biomedical literature. The primary literature searches were conducted in English and/or Chinese from January 2000 through December 2011 using the secondary databases (e.g., PubMed, Airiti Library, China Journal full-text database). The search terms included the corresponding medical subject headings and key words. Herbs or natural products not used as a single entity CHM or in Chinese Medicinal Prescriptions were excluded from further review. The corresponding mechanisms and severity ratings of interactions were retrieved using MicroMedex®, Lexicomp® and Natural Medicines Comprehensive Database®. Finally, we found 90 single entity CHMs contributed to 306 documented drug-CHM interactions. A total of 194 (63.4%) interactions were verified for its evidence describing possible mechanisms and severity. Of them, 155 interactions (79.9%) were attributable to pharmacodynamic interactions, and almost all were rated as moderate to severe interactions. The major consequences of these interactions were increased bleeding risks due to the additive anticoagulant or antiplatelet effects of the CHMs, specifically danshen, dong quai, ginger, ginkgo, licorice, and turmeric. Conventional anticoagulants and antiplatelet drugs were documented to have harmful interactions with some commonly used single entity CHMs. For those patients who are taking conventional anti-clotting medications with CHMs for cardiovascular or cerebrovascular diseases, the potential risks of increased bleeding due to drug-CHM interactions should not be ignored.
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3.7
作者：
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