熊胆粉、体外培育牛黄在肿瘤科的合理应用分析

Analysis on reasonable application of bear bile powder and bezoar cultured in vitro in tumor treatment

目的:了解熊胆粉、体外培育牛黄在肿瘤科的应用情况,通过对这两味药的药理研究文献和临床实际案例的分析,为其在临床肿瘤使用的合理性、经济性提供依据。方法:分类统计和应用分析。结果:临床上熊胆粉和体外培育牛黄被广泛用于各种肿瘤,证型多为肝郁气滞、热毒蕴结等,用量均未超说明书推荐的范围;现代药理研究显示,熊胆粉对肝癌、白血病、骨髓瘤、胃癌细胞有明显的抑制作用,并能预防亚硝酸类诱发的癌症,体外培育牛黄对消化道肿瘤尤其有效;临床实际案例显示,熊胆粉、体外培育牛黄对肝胆毒热、痰瘀阻络型肿瘤有显著疗效,为肿瘤中医治则清热解毒法所用中药。结论:熊胆粉、体外培育牛黄对部分肿瘤如消化道肿瘤、肝癌等,以及肝胆毒热型肿瘤疗效显著,但并不是适用所有的癌种或者癌症的所有阶段,而且药材价格昂贵。因此在临床需辨证应用,同时中药临床药师积极帮助医师选择替代饮片、加强药学监护,保证其临床应用安全、合理、有效、经济,减轻患者负担,节约相关资源。

OBJECTIVE To understand the application of bear bile powder and bezoar cultivated in vitro in oncology department,and to provide the basis for rationality and economy of clinical use of these two drugs through the analysis of pharmacological research literature and clinical practice cases.METHODS Classified statistic and application analysis were performed.RESULTS In clinic,bear bile powder and bezoar cultured in vitro are widely used in various tumors,mainly for liver depression and Qi stagnation syndrome and heat-toxin accumulation syndrome,and the dosage didn’t exceed the recommended range of instructions.Modern pharmacological studies have shown that bear bile powder has obvious inhibitory effects on liver cancer,leukemia,myeloma and gastric cancer cells,and can prevent nitrite-induced cancers.Bezoar cultured in vitro is especially effective in digestive tract tumors.Practical clinical cases have shown that bear bile powder and bezoar cultured in vitro have significant efficacy in tumors of hepatobiliary toxin-heat syndrome and phlegm and blood stasis syndrome,and are traditional Chinese medicines for clearing away heat and toxic material in the treatment of tumors.CONCLUSION Bear bile powder and bezoar cultured in vitro have excellent effects in clearing hepatobiliary toxin and heat with remarkable efficacy in some tumors,such as gastrointestinal tumors,liver cancer,etc.However,they are not suitable for all cancers or all stages of cancers and are expensive.Therefore,they should be used dialectically in clinic.At the same time,clinical pharmacists of traditional Chinese medicine should strengthen pharmaceutical care to ensure their safety,rationality,effectiveness and economy in clinical application,so as to reduce the burden of patients and save related resources.