柑橘属中药的药物相互作用研究进展

Research Progress in Drug Interactions Induced by Citrus Herbs

目的总结柑橘属中药药物相互作用的研究进展,为探究柑橘属中药的药物相互作用及机制提供参考。方法通过检索中国知网、PubMed等数据库,总结国内外文献,对柑橘属中药的药物相互作用及机制等进行综述。结果柑橘属中药的药物相互作用按发生原理可分为药代动力学相互作用与药效学相互作用。前者主要与橙皮苷、柚皮苷等黄酮类成分及佛手柑素等香豆素类成分有关,柑橘属中药通过影响细胞色素P450等药物代谢酶及P-糖蛋白等药物转运体,引起他克莫司、环孢素、丁螺环酮、奥美拉唑等化学药的药代动力学过程改变;后者主要表现为对联用药物的减毒和(或)增效,尤其是与抗肿瘤药的联用,与橙皮苷、橘皮素等黄酮类成分等有关。结论应加强柑橘属中药药物相互作用的临床观察与基础研究,促进临床合理用药。

Objective To summarize the recent research progress in drug interactions induced by Citrus herbs in order to gain keen insights into the interactions and related mechanism. Methods By searching CNKI, PubMed and other databases, literature related to drug interactions induced by Citrus herbs and the related mechanism was reviewed. Results Drug interactions induced by Citrus herbs could be divided into pharmacokinetic ones and pharmacodynamic ones according to the mechanism. The former type was related to flavonoids including hesperidin and naringin, and coumarins such as bergamottin. Citrus herbs could influence the pharmacokinetics of such chemical drugs as tacrolimus, ciclosporin, buspirone and omeprazole via drug enzymes including cytochrome P450, and drug transporters including P-glycoprotein. The latter type was characterized by a decrease in adverse reactions and/or an increase in curative effects of combined drugs, especially antineoplastic drugs, which were associated with f lavonoids including hesperidin and tangeretin. Conclusion Clinical observation and basic studies on drug interactions induced by Citrus herbs need to be improved to promote rational combined medication in clinical practice.