Carboxylesterases mediated herb-drug interactions:a systematic review

酯酶参与约10%临床药物(含有酯键或酰胺键)的代谢。但长期以来,酯酶介导的药物/草药相互作用(DDI或HDI)尚未得到深入研究。羧酸酯酶(CEs)是哺乳动物代谢器官中表达最丰富的一类酯酶,其在多种内源性和外源性酯类化合物的水解过程中发挥了重要作用。人体中主要分布了hCE1和hCE2两种羧酸酯酶亚型,其在过去十多年中被广泛研究。这两种羧酸酯酶已被证实参与多种内源性酯类化合物和外源性酯类药物的水解。最近研究表明,强效抑制hCEs可减缓CEs底物药物的水解,这可能影响它们的药代动力学行为,进而引发潜在的DDI或HDI。在过去十年中,已经发现多种草药提取物和草药成分对CEs具有强烈的抑制作用,同时它们带来的草药相互作用(HDI)潜在风险也引发了广泛关注。本综述重点介绍了hCEs介导的药物相互作用的最新研究进展,全文总结了hCEs在药物代谢中的作用,以及多种草药提取物和草药成分对hCEs的抑制能力和抑制机制。此外,作者还对该研究领域面临的挑战和未来的前景进行了展望。本综述中提供的所有信息和知识将有助于药理学家更深入地了解草药成分与hCEs间的代谢性相互作用,同时也有助于临床医生更加合理的使用草药进而减轻hCEs介导的药物毒性或避免发生具有临床意义的hCE介导的草药相互作用。

Potential Mechanism of Herb-Drug Interaction Mediated by Angelica dahurica: Inhibition on CYP3A Enzymes in Rats

Angelica dahurica is commonly referred to as ‘Baizhi’ in China and has been noted for its therapeutic significance. The major active ingredients of Angelica dahurica is coumarin, which is reported as a kind of potent inhibitor of cytochrome P450 enzymes (CYP450s). The aim of this study was to investigate the inhibition of CYP3A enzymes by total coumarin extract (TCE) obtained from dried root of Angelica dahurica by using in situ single pass intestinal perfusion (SPIP) and in situ liver perfusion in rats. When midazolam (MDZ) which is a substrate of CYP3A co-perfused with TCE (198 μg/mL) from Baizhi in duodenum and ileum segments, the Peff of MDZ has increased significantly compared with the MDZ single perfused group (p 0.05) (n = 6). During in situ liver perfusion study, the results demonstrated that, 3 days oral administration of TCE obtained from Baizhi could significantly reduce the elimination rate of MDZ in the perfusate (p Angelica dahurica extract co-administrated with drugs which are the substrates of CYP3A, much more attention should be paid rather than that of other CYP450 enzymes. These findings may facilitate in predicting possible herb-drug interactions (HDIs) when Angelica dahurica is used in combination with other drugs, and decrease the incidence of the CYP450-mediated HDIs.

Drug and herb induced liver injury: Council for International Organizations of Medical Sciences scale for causality assessment

Causality assessment of suspected drug induced liver injury(DILI) and herb induced liver injury(HILI) is hampered by the lack of a standardized approach to be used by attending physicians and at various subsequent evaluating levels. The aim of this review was to analyze the suitability of the liver specific Council for International Organizations of Medical Sciences(CIOMS) scale as a standard tool for causality assessment in DILI and HILI cases. PubMed database was searched for the following terms: drug induced liver injury; herb induced liver injury; DILI causality assessment; and HILI causality assessment. The strength of the CIOMS lies in its potential as a standardized scale for DILI and HILI causality assessment. Other advantages include its liver specificity and its validation for hepatotoxicity with excellent sensitivity, specificity and predictive validity, based on cases with a positive reexposure test. This scale allows prospective collection of all relevant data required for a valid causality assessment. It does not require expert knowledge in hepatotoxicity and its results may subsequently be refined. Weaknesses of the CIOMS scale include the limited exclusion of alternative causes and qualitatively graded risk factors. In conclusion, CIOMS appears to be suitable as a standard scale for attending physicians, regulatory agencies, expert panels and other scientists to provide a standardized, reproducible causality assessment in suspected DILI and HILI cases, applicable primarily at all assessing levels involved. 2014 Baishideng Publishing Group Co., Limited. All

Perspectives and challenges of tropical medicinal herbs and modern drug discovery in the current scenario

Tropical diseases such as malaria, tuberculosis, trypanosomiasis, and leishmaniasis, account for a large number of deaths annually. Herbs are an excellent source of tropical medicines. Many advancements and discoveries have taken place in the field of drug discovery but still, a major population of tropical diseases relies on herbal traditional medicine. There are some challenges related to policy implementation, efficacy, resistance and toxicity of tropical medicines. There are many tropical diseases such as such as schistosomiasis, leishmaniasis, African sleeping sickness, filariasis and chagas disease which are neglected because very few pharmaceutical companies have shown their interest in developing therapeutics against these diseases of poor people. There are many benefits associated with herbal medicine such as the cost of production, patient tolerance, large scale availability, efficacy, safety, potency, recyclability, and environment friendly. A large number of natural extracts such as curcumin, artemisinin, morphine, reserpine, and hypericin, are in use for treatment of different tropical diseases for a long time. The current review is to discuss the overview of tropical medicinal herbs, its scope and limitations in the modern drug discovery process.

Critical Evaluation for Alternative Causes of Drug Induced and Herbal Induced (DILI/HILI) Hepatotoxicity

The objective of this review is to highlight the continued exclusion of discussion in the literature regarding alternative causes and proper causality assessment of cases of hepatotoxicity when use of dietary supplements is reported. Though independent experts are working diligently to advance the discussion related to alternative causes of hepatotoxicity resulting in idiosyncratic drug-induced liver injury/herb-induced liver injury (DILI/HILI), the literature continues to recite the same cases, such as those presented here, to reiterate potentially biased positions and ignore current, standardized and valid evaluations utilizing the Roussel Uclaf Causality Assessment Method (RUCAM). Several historical cases purporting hepatotoxicity induced by use of dietary supplements are presented in this review to demonstrate how such cases may be improperly assessed due to bias, inconsistent use of causality assessment methods, as well as use of causality assessment methods deemed obsolete. This in essence, delays any true progress in establishing sound criteria to determine and address the actual cause(s) of DILI/HILI.

7576张含丹参-当归药对的门诊中药饮片处方回顾性分析

目的:了解江苏省中西医结合医院南部院区/南京市溧水区中医院(以下简称“该院”)含丹参-当归药对的门诊中药饮片处方情况,探究该药对的临床配伍应用规律,为该药对的合理使用提供参考。方法:采用回顾性分析方法,统计2020—2022年该院使用丹参-当归药对的7576张门诊中药饮片处方,对患者的性别、年龄、处方药味数、金额、疗程、涉及科室及病症、使用剂量、常用的配伍比例及配伍饮片等相关内容进行统计分析。结果:7576张含丹参-当归药对的门诊中药饮片处方中,女性患者处方数约为男性患者处方数的3.21倍(5776张vs.1800张),>30~40岁患者居多。单张处方的中药饮片味数多集中在16~20味,开具的疗程均<30 d。丹参的使用剂量为《中华人民共和国药典》规定的10~15 g的处方有6490张,占85.67%;当归的使用剂量为《中华人民共和国药典》规定的6~12 g的处方有6608张,占87.22%。处方数排序居前3位的科室依次为国医堂、妇科及脑病科,治疗的病证以冲任失调、心脾两虚及气滞血瘀证为主。单张处方中丹参用量大于等于当归用量,丹参与当归的配伍比例以1∶1为多,高频配伍饮片为茯苓、川芎、炒白芍。结论:基于处方用药分析,该院含丹参-当归药对的门诊中药饮片处方基本合理,为丹参-当归药对的使用剂量范围及配伍规律研究提供了数据支持,有利于促进临床合理用药。

基于中药特色技术传承概述广东芸香科道地药材

基于中药传统特色技术,文章通过现场观摩调研与文献检索,概述在十大广药中占有1/3的芸香科药物的药用历史、产地采收加工、性状鉴别特点。芸香科药物多含挥发油,具有芳香气,大部分具有宽中理气的功效,临床应用广泛。据考证,柚类橘红始自清代,此前使用橘类橘红;广陈皮主产区在新会地区,也称新会陈皮,药用时间至今约有600年;广佛手以肇庆高要地区产量多且质优,“佛手柑”的记载最早见于元朝。化橘红的传统加工方法是将化州柚的外层果皮切成角状,加工成7角的毛橘红药材,称为“毛七爪”;新会陈皮需在新会地区内陈化三年,方可称为“新会陈皮”。化橘红鉴别特点为表面密被柔软毡状细绒毛,有油点,气清香;新会陈皮“鬃眼”明显,对光照视呈半透明状,香气浓郁。广佛手切面的外皮呈黄色,肉呈白色,俗称“金边白肉”。文章基于中药传统理论、技术对广东地区芸香科道地药材进行概述,以期守正创新,使中药的传统特色技术得到传承发展。

基于问卷调研的中药材质量监测机制优化探索

目的:为进一步优化完善中药材质量监测机制,探索建立国家与省级中药材质量监测统筹模式提供参考。方法:基于国家药品抽检协作网络,在国家药品抽检信息系统内,采用在线问卷调研的方式,面向国家药品抽检承检机构以及省级药品监督管理部门征集意见建议。结果:共有46家承检机构与32家药品监督管理部门作答问卷,汇总分析显示,中药材质量监测逐步建立相互衔接、各有侧重的国家与省级协作体系,适当扩大监测品种范围,对药材市场与种植基地、饮片和中成药生产企业重点监测,建立风险分级管理制度,并与国家药品抽检协同发布监测结果。结论:中药材质量监测应当基于国家药品抽检协作网络,进一步优化品种遴选流程与范围,围绕药品生产企业、药材市场与种植基地,完善风险处置机制。

腹泻奶牛源大肠杆菌的分离鉴定及中药的体外抑菌效果

为了研究贵州毕节某奶牛场荷斯坦奶牛发生腹泻的原因,从该奶牛场采集50份新鲜粪便样本,通过平板划线法对大肠杆菌进行分离纯化和PCR鉴定,采用K-B纸片法进行药物敏感试验,并对多种耐药基因进行PCR检测。针对多重耐药菌,选取虎耳草和杜鹃花2种中草药进行体外抑菌效果研究。结果显示:从腹泻奶牛粪便中分离出31株细菌,其菌落形态和生化特性与大肠杆菌相符;16S rRNA基因测序比对发现该牛场分离的菌株与NCBI数据库中大肠杆菌参考菌株的同源性达到99.65%~99.86%,确定该奶牛场的腹泻病原为大肠杆菌;药敏试验发现该牛场来源的大肠杆菌对多种抗生素(强力霉素、红霉素、青霉素G和四环素)耐药,而对磺胺异恶唑、头孢曲松、环丙沙星、庆大霉素、多黏菌素B、磷霉素等10种抗生素敏感;PCR扩增相关耐药基因发现,导致该牛场腹泻的大肠杆菌携带2种β-内酰胺类(blaCTX-M、blaTEM),4种四环素类(TetD、TetB、TetK、TetD、TetA),2种氨基糖苷类(ant(3″)-Ia、rmtB)和3种喹诺酮类(qnrS、qepA、oqxA)耐药基因。体外抑菌研究发现,杜鹃花(3.125 mg/mL)的水提物有显著的抑菌效果。试验结果可为该奶牛场防治大肠杆菌性腹泻提供用药指导,同时为开发替抗中草药产品提供了依据。

Herbal hepatotoxicity:Challenges and pitfalls of causality assessment methods

The diagnosis of herbal hepatotoxicity or herb induced liver injury(HILI) represents a particular clinical and regulatory challenge with major pitfalls for the causality evaluation.At the day HILI is suspected in a patient,physicians should start assessing the quality of the used herbal product,optimizing the clinical data for completeness,and applying the Council for International Organizations of Medical Sciences(CIOMS) scale for initial causality assessment.This scale is structured,quantitative,liver specific,and validated for hepatotoxicity cases.Its items provide individual scores,which together yield causality levels of highly probable,probable,possible,unlikely,and excluded.After completion by additional information including raw data,this scale with all items should be reported to regulatory agencies and manufacturers for further evaluation.The CIOMS scale is preferred as tool for assessing causality in hepatotoxicity cases,compared to numerous other causality assessment methods,which are inferior on various grounds.Among these disputed methods are the Maria and Victorino scale,an insufficiently qualified,shortened version of the CIOMS scale,as well as various liver unspecific methods such as thead hoc causality approach,the Naranjo scale,the World Health Organization(WHO) method,and the Karch and Lasagna method.An expert panel is required for the Drug Induced Liver Injury Network method,the WHO method,and other approaches based on expert opinion,which provide retrospective analyses with a long delay and thereby prevent a timely assessment of the illness in question by the physician.In conclusion,HILI causality assessment is challenging and is best achieved by the liver specific CIOMS scale,avoiding pitfalls commonly observed with other approaches.

Radix Polygoni Multiflori Praeparata and Dioscorea Bulbifera Rhizome Decoctions Display Combined Effects Detected by a Three-Probe Drug Cocktail with Substrates of Rat Hepatic Cytochrome P450 Enzymes

Objectives: Radix Polygoni Multiflori Praeparata (RPMP) and Dioscorea Bulbifera Rhizomes (DBR) are used in Chinese herbal medicine and have been frequently reported for adverse reactions on liver. In this research, we aimed to evaluate in vivo effects of RPMP and DBR on rat cytochrome P450 enzymes (CYP1A2, CYP2E1 and CYP3A2) with their respective substrates as probes. Methods: Rats were orally administered RPMP, DBR and RPMP/DBR combination at 12, 10 and (12 + 10) g/kg, respectively, or saline as a control, once daily for 7 days. Thereafter, a cocktail containing 10 mg/kg caffeine, 20 mg/kg chlorzoxazone and 10 mg/kg dapsone was tail vein injected to rats. At defined time points, plasma drug concentrations were simultaneously evaluated by HPLC. Pharmacokinetic parameters simulated by DAS software were used to assess RPMP and/or DBR effects on cytochrome P450 enzymes activity. ANOVA and Dunnett’s test were used for data analysis. Results: Caffeine metabolism was enhanced in RPMP animals and reduced after pretreatment with DBR, but no effect was observed in RPMP/DBR combination group. Chlorzoxazone and dapsone metabolism was enhanced in both RPMP and DBR groups and consequently in combination group. The data suggested that RPMP independently induces rat CYP1A2, CYP2E1 and CYP3A2 activity, while DBR independently inhibits activity of rat CYP1A2 and induces that of CYP2E1 and CYP3A2. RPMP/DBR combination showed no significant benefit compared with the two drugs alone and even showed a neutralized effect in CYP1A2 activity. Conclusions: Caution is needed when RPMP and/or DBR are co-administered with drugs metabolized by human CYP1A2, CYP2E1 and CYP3A4.

Comprehensive review of hepatotoxicity associated with traditional Indian Ayurvedic herbs

With growing antipathy toward conventional prescription drugs due to the fear of adverse events,the general and patient populations have been increasingly using complementary and alternative medications(CAMs)for managing acute and chronic diseases.The general misconception is that natural herbal-based preparations are devoid of toxicity,and hence short-and long-term use remain justified among people as well as the CAM practitioners who prescribe these medicines.In this regard,Ayurvedic herbal medications have become one of the most utilized in the East,specifically the Indian sub-continent,with increasing use in the West.Recent well-performed observational studies have confirmed the hepatotoxic potential of Ayurvedic drugs.Toxicity stems from direct effects or from indirect effects through herbal metabolites,unknown herb-herb and herbdrug interactions,adulteration of Ayurvedic drugs with other prescription medicines,and contamination due to poor manufacturing practices.In this exhaustive review,we present details on their hepatotoxic potential,discuss the mechanisms,clinical presentation,liver histology and patient outcomes of certain commonly used Ayurvedic herbs which will serve as a knowledge bank for physicians caring for liver disease patients,to support early identification and treatment of those who present with CAM-induced liver injury.

Cocktail探针药物法评价玄参对大鼠细胞色素P450酶的影响

采用Cocktail探针药物法研究玄参对大鼠4种细胞色素P450(CYP3A4、CYP2D6、CYP2C9和CYP1A2)活性的影响.24只健康雄性SD大鼠(Sprague-Dawley rat)随机分为三组:A组为多剂量组,连续7 d给予150 mg/kg玄参.B组为单剂量组,第7 d给予150 mg/kg玄参.C组为对照组.第7 d,各组在给予玄参30 min后,再给予4种探针药物的混合溶液,其中咪达唑仑3 mg/kg、美托洛尔20 mg/kg、氯沙坦5 mg/kg、非那西汀5 mg/kg,分别用以评价CYP3A4、CYP2D6、CYP2C9和CYP1A2的活性.根据设定的时间点收集大鼠血浆样品,处理后的样品采用超高效液相色谱-串联质谱(UHPLC-MS/MS)法测定样品中4种探针药物的浓度.结果可见,玄参对大鼠体内氯沙坦和非那西汀的药代动力学参数无显著影响.单剂量的玄参导致咪达唑仑代谢减慢,多剂量给予的玄参显著诱导美托洛尔代谢.玄参对CYP2C9和CYP1A2的酶活性无明显影响,可以抑制CYP3A4或诱导CYP2D6的酶活性.

数据可视化技术在药品监管中的应用探索——以我所近三年中药材及中药饮片重金属监测为例

目的:通过对我所近三年中药材及饮片重金属监测数据进行可视化分析,展示应用数据可视化技术可为药品监管部门提供决策支持。方法:采用Power BI软件,对我所近三年中药材及中药饮片重金属检测数据进行多维度可视化分析,挖掘并发现中药材及中药饮片在重金属污染上存在的问题。结果:依托Power BI的可视化图表呈现,可使药品监管部门快速直观地发现中药材及中药饮片重金属污染问题及其规律,助力监管部门制定监管方案。结论:基于Power BI的数据分析和可视化展示,可为药品监管机构智慧监管、科学监管、精准监管提供高水平技术支撑。

基于德尔菲法的中草药肝毒性评估量表研制

目的构建中草药肝毒性评估量表,对中草药及其相关制剂的肝毒性进行综合性证据评估。方法通过文献荟萃分析法结合专家访谈法收集国内外含有中草药肝毒性有效信息的数据库并进行遴选。制作专家咨询德尔菲问卷,采用德尔菲法进行2轮专家咨询,分析专家权威系数、意见集中度及一致性。根据专家意见进行修改和调整后计算指标条目权重,结合综合评价模型构建中草药肝毒性评估量表,并进行信效度测试。使用ROC曲线确定最佳诊断阈值。结果研究小组初步整理出9个相关因素,共涉及12个相关指标。经2轮咨询后,各指标条目咨询的专家共识度均不低于70%。第一、二轮咨询中Kendall协调系数W分别为0.162(χ^(2)=68.88,P<0.001)、0.246(χ^(2)=27.50,P<0.001)。最终形成包含8个条目的中草药肝毒性评估量表。量表的内容效度指数(I-CVI)>0.78,平均内容效度指数(S-CVI/Ave)=0.84,K^(*)=0.83,Cronbach’α系数为0.656。诊断模型ROC曲线下面积为0.906,Youden指数确定最佳阈值为0.99,灵敏度为95%,特异度为75%。根据四分位数法确定评分≥1.44(P75)者为高风险药物。结论初步建立了适合中草药肝毒性评估的工具量表,可用于评估中草药潜在的肝毒性,优化现有毒性药材评价体系,及时发现“高风险”“高警戒”中草药,为临床安全用药提供参考依据。

药食同源中药联合抑菌作用及抑菌喷雾剂的研制

探讨7味药食同源中药水提取物及其联用对大肠杆菌、金黄色葡萄球菌、白色念珠菌的体外抑菌效果,并将其应用于抑菌喷雾剂。采用水提法提取药液,用纸片扩散法测得单药最低抑菌浓度(MIC)及最小杀菌浓度(MBC),同时以“棋盘法+中药互配”筛选对上述致病菌具有较强协同抑制作用的药物组合,并确定适宜的药物配伍制备抑菌喷雾剂。结果显示,7味药食同源中药对3种供试病原菌均具有不同程度的抑菌效果,五味子、金银花、牡丹皮、肉桂、白芍和山楂的抑菌作用较强,其对大肠杆菌的抑菌圈直径为12.50~26.50 mm,最低抑菌浓度(MIC)<250.00 mg/mL,最小杀菌浓度(MBC)<500.00 mg/mL;其中,五味子的抑菌作用最显著,对大肠杆菌、金黄色葡萄球菌、白色念珠菌的MIC分别为31.25 mg/mL、15.62 mg/mL、250.00 mg/mL。互配试验结果表明,10种不同的药物组合对3种供试菌的联合抑菌作用各不相同,牡丹皮和肉桂的配伍组合对大肠杆菌以及肉桂和五味子的配伍组合对金黄色葡萄球菌的联合抑菌指数(FICI)均≤0.50,表现为协同作用,其中肉桂和白芍、牡丹皮和白芍的配伍组合对致病菌也有协同或相加作用。因此,选择牡丹皮、肉桂、五味子、白芍4味药食同源中药制备抑菌喷雾剂。同时初步确定药食同源中药抑菌喷雾制剂的制备工艺流程为在40℃水浴中,向中药提取液中依次搅拌加入0.2%苯甲酸、1.0%吐温-80和5.0%1,2-丙二醇。多种药食同源中药具有抗菌作用,且合理的配伍可以产生协同增效的效果,为无毒副作用抗菌喷雾剂的开发奠定了基础。

马蔺子本草考证

目的:对马蔺子进行系统本草考证,为该药材质量标准的制订提供参考,也为进一步挖掘其新的药用功效提供线索。方法:查阅历代本草及中医典籍,比较马蔺子在16个地方标准中质量标准的差异,从其名称、产地、形态、药性及功用等方面进行本草考证。结果:马蔺子以“蠡实”之名始载于《神农本草经》,且别名众多,清代以后均以马蔺子作为药名;植物形态描述及绘图表明,马蔺子无混淆品,且与《中华本草》记述基本一致;古代本草记载产地以河北冀县最为道地,且清代以后全国各地均有出产;药性方面主要为性温、平,味甘,无毒,归肝、脾、胃、肺经,有清热利湿、解毒消肿、止血的功效。可治疗小便不利、寒痹湿滞、便血、寒疝、血崩、白带、痈肿等,其外敷还可治疗虫蛇咬伤。结论:通过对马蔺子进行本草考证,可为国家制定该药材的中药质量标准提供科学依据,为进一步开发其新功效提供重要参考。

Efficacy of integrating short-course chemotherapy with Chinese herbs to treat multi-drug resistant pulmonary tuberculosis in China: a study protocol

Background:Tuberculosis(TB)causedMycobacterium tuberculosis(M.tb)is one of infectious disease that lead a large number of morbidity and mortality all over the world.Although no reliable evidence has been found,it is considered that combining chemotherapeutic drugs with Chinese herbs can significantly improves the cure rate and the clinical therapeutic effect.Methods:Multi-drug resistant pulmonary tuberculosis(MDR-PTB,n=258)patients with Qi-yin deficiency syndrome will be randomly assigned into a treatment group(n=172)or control/placebo group(n=86).The treatment group will receive the chemotherapeutic drugs combined with Chinese herbs granules(1+3 granules),while the control group will receive the chemotherapeutic drugs combined with Chinese herbs placebo(1+3 placebo granules).In addition,MDR-PTB(n=312)patients with Yin deficiency lung heat syndrome will be randomly assigned to a treatment(n=208)or control/placebo(n=104)group.The treatment group will receive the chemotherapeutic regimen combined with Chinese herbs granules(2+4 granules),while the control group will receive the chemotherapeutic drugs and Chinese herbs placebo(2+4 placebo granules).The primary outcome is cure rate,the secondary outcomes included time to sputum culture conversion,lesion absorption rate and cavity closure rate.BACTEC^(TM)MGIT^(TM)automated mycobacterial detection system will be used to evaluate theM.tb infection and drug resistance.Chi-square test and Cox regression will be conducted with SAS 9.4 Statistical software to analyze the data.Discussion:The treatment cycle for MDR-PTB using standardized modern medicine could cause lengthy substantial side effects.Chinese herbs have been used for many years to treat MDR-PTB,but are without high-quality evidence.Hence,it is unknown whether Chinese herbs enhances the clinical therapeutic effect of synthetic drugs for treating MDR-PTB.Therefore,this study will be conducted to evaluate the clinical therapeutic effect of combining Chinese herbs and chemotherapeutic drugs to treat MDR-PTB cases.It will assist in screening new therapeutic drugs and establishing treatment plan that aims to improve the clinical therapeutic effect for MDR-PTB patients.Trial registration This trial was registered at ClinicalTrials.gov(ChiCTR1900027720)on 24 November 2019(prospective registered).

中药有效成分、中药制剂和食物对CYP2D6的抑制作用研究进展

人细胞色素P450(CYP)2D6酶是CYP450酶系中一种重要的氧化代谢酶,参与临床中抗心律失常药、抗高血压药、镇痛药、止咳药、抗精神病药等多种药物代谢。近年来,关于中药有效成分、中药制剂和食物对CYP2D6抑制作用的研究也日益增多。本文查阅、整理并归纳了近年来国内外文献报道的对人CYP2D6有抑制作用的中药有效成分、中药制剂和食物,通过预测潜在的药物相互作用,以避免因中药-药物相互作用和食物-药物相互作用而引发的不良反应,并为临床上中药和经CYP2D6代谢药物的联合应用提供参考依据。