Therapeutic use of traditional Chinese herbal medications for chronic kidney diseases.
Therapeutic use of traditional Chinese herbal medications for chronic kidney diseases.
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DOI：
10.1038/ki.2013.276
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发表时间：
2013-12
影响因子：
19.6
通讯作者：
中科院分区：
文献类型：
--
作者：
在中国和许多其他亚洲国家，传统中药（TCHM）经常与西方药物治疗相结合，用于治疗慢性肾脏疾病（CKD）。中医的实践是以累积的经验为指导的。最近的体外和动物研究证实了几种中药在慢性肾病中的生物活性和治疗作用。然而，支持中药的证据水平仅限于小型非随机试验。由于中药处方模式的变化和需要频繁的剂量调整是中医实践所固有的，因此设计和实施中药的大型随机临床试验一直是一个挑战。一些中药有显著的不良反应，包括肾毒性。然而，与中药相关的不良反应的报道还不充分。为了充分实现中药在CKD中的治疗作用，我们需要通过分子研究来确定中药的有效成分及其作用机制，需要通过严格的药理学研究来确定中药的安全性并满足临床治疗药物的监管标准，需要精心设计的临床试验来为其安全性和有效性提供循证支持。
Traditional Chinese herbal medications (TCHM) are frequently used in conjunction with western pharmacotherapy for treatment of chronic kidney diseases (CKD) in China and many other Asian countries. The practice of traditional Chinese medicine is guided by cumulative empiric experience. Recent in vitro and animal studies have confirmed the biological activity and therapeutic effects of several TCHM in CKD. However, the level of evidence supporting TCHM is limited to small, non-randomized trials. Due to variations in the prescription pattern of TCHM and the need for frequent dosage adjustment, which are inherent to the practice of traditional Chinese medicine, it has been challenging to design and implement large randomized clinical trials of TCHM. Several TCHM are associated with significant adverse effects, including nephrotoxicity. However, reporting of adverse effects associated with TCHM has been inadequate. To fully realize the therapeutic use of TCHM in CKD we need molecular studies to identify active ingredients of TCHM and their mechanism of action, rigorous pharmacologic studies to determine the safety and meet regulatory standards required for clinical therapeutic agents, and well-designed clinical trials to provide evidence-based support of their safety and efficacy.
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