摘要
目的:调查艾滋病住院患者中成药使用情况,并探讨基于细胞色素P450酶(CYP450)以及P糖蛋白(P-gp)与HIV抗病毒药物的潜在药物相互作用。方法:统计2016年1~12月我院艾滋病区中成药使用种类和频度;查阅文献,分析常用中成药或其活性成分对CYP450及P-gp活性的影响;归纳一线HIV抗病毒药物对CYP450及P-gp的影响;分析中西药潜在相互作用。结果:艾滋病区2016年DDDs排名前5的中成药分别为痰热清注射液、地榆升白片、注射用血塞通、丹参滴注液、喜炎平注射液;其中,痰热清注射液、丹参滴注液、喜炎平注射液抑制CYP3A4活性,联用可能会增加洛匹那韦、齐多夫定、依非韦伦和奈韦拉平的血药浓度;注射用血塞通抑制P-gp底物外排、丹参滴注液降低P-gp的表达,与洛匹那韦、齐多夫定、奈韦拉平联用时,可能会影响其转运的过程。结论:中成药与HIV抗病毒药物的药物相互作用理论上是存在的,临床意义需进一步研究。
Objective： To investigate the use of Chinese patent drugs in AIDS inpatients, and explore the potential drug interac- tions between Chinese patent drugs and HIV antiviral drugs based on CYP450 and P glycoprotein （P-g-p）. Methods： The variety and frequency of Chinese patent medicines used in the AIDS ward from January 2016 to December 2016 were statistically analyzed. The effects of common Chinese patent drugs and the active ingredients on the activity of CYP450 and P-gp were analyzed by consulting liter- atures. The effects of the first-line HIV antiviral drugs on CYP450 and P-gp were summarized. The potential interactions between Chi- nese medicines and western medicines were explored. Results： The first five of Chinese patent medicines used in the AIDS ward were Tanreqing injection, Diyushengbai tablets, Xuesaitong injection, Danshen injection and Xiyanping injection in 2016. Tanreqing injec- tion, Danshen injection and Xiyanping injection inhibited the activity of CYP3A4, so the combined use could increase the blood con- centrations of lopinavir, zidorf, efavirenz and nevirapine. Xuesaitong injection inhibited the efflux of P-gp substrates, and Danshen in- jection reduced the expression of P-gp, so the combined use could affect the transport process of lopinavir, zidorf and nevirapine. Conclusion： The interactions between Chinese patent medicines and HIV antiviral drugs theoretically exist, however, clinical significance needs to be further studied.
出处
《中国药师》
CAS
2018年第9期1611-1612,1636,共3页
China Pharmacist
基金
四川省医学科研青年创新课题项目(编号:Q16013)
