药物联合应用对中草药相关肝损伤的影响

Influence of combined drug administration on herb-induced liver injury

随着中医药在全球范围内的广泛使用和临床中药物联用情况的增多,中草药相关肝损伤(HILI)和药物安全性事件频发,这给中药新药研发和中医产业发展带来了重大挑战。目前,在系统归纳总结药物联用对HILI的影响,梳理其临床特征、发生过程和互作机制,尤其是研究中西药联用后的药效动力学和药代毒理学过程等方面,仍然存在较大不足。亟需进一步构建系统整合的研究体系,特别是在靶标分子、细胞间交流、组织间串扰和体内毒性评价等方面,开展更加精准、特异和早期的研究。通过临床与基础并行的病证基础研究,提出符合中医药理论和应用规律的HILI防控策略,将为提升病证场景下的中西药物联用水平提供基础支撑和可信证据。

With the wide application of traditional Chinese medicine(TCM)globally and combined drug use in clinical practice,there have been significant increases in herb-induced liver injury(HILI)events and drug safety events,bringing great challenges to the research and development of new TCM drugs and the development of the TCM industry.At present,there are still shortcomings in systematically summarizing the effect of combined drug use on HILI and analyzing its clinical features,pathogenesis and interaction mechanism,especially the research on pharmacodynamics and pharmacotoxicology processes after the combination of TCM and Western drugs.It is urgently needed to further construct an integrated research system,especially in the aspects of target molecules,intercellular communication,tissue crosstalk,and in vivo toxicity assessment.Based on the basic research combining clinical and fundamental studies,it is necessary to put forward HILI prevention and control strategies in accordance with TCM theory and application rules,which will provide fundamental support and reliable evidence for improving the level of combined use of TCM and Western drugs in the context of diseases and syndromes.