中药对华法林作用的影响及机制概述

Effects of traditional Chinese medicine on the role of warfarin and the mechanisms

华法林是临床常用的一种香豆素类口服抗凝药,具有蛋白结合率高、依赖细胞色素P450酶代谢及治疗窗窄等特点,易与其他药物发生相互作用,造成患者出血风险增加或抗凝治疗不足等严重后果。中药在治疗心脑血管疾病等方面具有独特的优势,临床应用广泛,与华法林合用的机会较多。本文根据已有的实验研究和临床案例报道,分别对单味中药及中药复方制剂对华法林抗凝作用的影响及相关机制进行了综述和探讨,以期为临床合理用药和相关研究提供参考。

Warfarin is an oral coumarin anticoagulants which has been commonly used in clinic for anticoagulant therapy,with high protein binding rate,relying on the cytochrome P450 enzyme metabolism,and with narrow therapeutic window,etc..It easily interacts with other drugs,resulting in serious consequences,such as increased bleeding risk or inadequate anticoagulant therapy.Traditional Chinese medicine has been widely used in the treatment of cardiovascular diseases with unique advantages,and has more opportunities to be coadministered with warfarin.According to the experimental and clinical researches that have been published,the effects and the mechanisms of single traditional Chinese herbs and compound Chinese traditional medicine preparations on warfarin were reviewed and discussed in this paper,in order to provide reference for clinical rational drug use and related researches.