Drug-herb interaction among commonly used conventional medicines: a compendium for health care professionals.
Drug-herb interaction among commonly used conventional medicines: a compendium for health care professionals.
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DOI：
10.1097/00045391-200305000-00003
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发表时间：
2003-05-01
影响因子：
4.2
通讯作者：
Levine, Mitchell A H
中科院分区：
文献类型：
--
作者：
Brazier, Nicole C;Levine, Mitchell A H
该综述的目的是巩固药物-草药相互作用的临床和药理学方面，以制定一个信息纲要，为处方者提供相互作用风险的测量、临床后果的描述和证据质量（即有效性）的评估。各种电子数据库和手工检索的参考文献被用来识别草药产品和最常用的治疗类药物之间的相互作用的文件。从1966年至今检索MEDLINE、联合和补充医学数据库、CINHAL、HealthSTAR和EMBASE。确定了162篇引文。只有22篇引文符合纳入标准。使用165种可能的药物-草药相互作用对（15种治疗药物类别和11种草药产品）的矩阵，我们确定了文献中讨论的51种（31%）相互作用。这51对药物中的22对（43%）得到了随机临床试验、病例对照研究、队列研究、病例系列或病例研究的支持。其余的相互作用对反映了在缺乏临床数据的情况下的理论推理。大多数相互作用是药代动力学的，大多数实际上或理论上通过细胞色素p450酶影响受影响产品的代谢。在这篇综述中，华法林是最常见的药物，而圣约翰草是药物-草药相互作用中最常见的草药产品。要建立一个全面和有效的草药药物相互作用的清单，将需要在这一领域的研究活动大幅增加。还必须提高所用方法的质量。
The objective of the review was to consolidate the clinical and pharmacologic aspects of drug-herb interactions to develop a compendium of information to provide prescribers with a measure of the risk of interactions, a description of the clinical consequences, and an assessment of the quality (ie, validity) of evidence. A variety of electronic databases and hand-searched references were used to identify documentation of interactions between herbal products and drugs from the most commonly used therapeutic classes. MEDLINE, Allied and Complementary Medicine Database, CINHAL, HealthSTAR, and EMBASE were searched from 1966 to the present. One hundred sixty-two citations were identified. Only 22 citations met the inclusion criteria. Using a matrix of 165 possible drug-herb interaction pairs (15 therapeutic drug classes by 11 herbal products), we identified 51 (31%) interactions discussed in the literature. Twenty-two of these 51 drug-herb pairs (43%) were supported by randomized clinical trials, case-control studies, cohort studies, case series, or case studies. The remaining interaction pairs reflected theoretic reasoning in the absence of clinical data. Most interactions were pharmacokinetic, with most actually or theoretically affecting the metabolism of the affected product by way of the cytochrome p450 enzymes. In this review, warfarin was the most common drug and St. John's wort was the most common herbal product reported in drug-herb interactions. To create a comprehensive and valid list of herb-drug interactions would require a substantial increase in research activities in this area. Improvements in the quality of methodology used are also necessary.