Matthews H B, Lucier G W, Fisher K D
National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709-2233, USA.
Environ Health Perspect. 1999 Oct;107(10):773-8. doi: 10.1289/ehp.99107773.
Virtually all cultures have, throughout history, used a variety of plants or materials derived from plants for the prevention and treatment of disease. Evidence of the beneficial therapeutic effects of these medicinal herbs is seen in their continued use. Additionally, the development of modern chemistry permitted the isolation of chemicals from medicinal herbs that have served as drugs or starting materials for the synthesis of many important drugs used today. Many more modern drugs have been synthesized as a result of knowledge gained from studies of mechanisms of actions of chemicals first isolated from medicinal herbs. Thus, medicinal herbs have played a major role in the development of modern medicine and continue to be widely used in their original form. Whereas it is generally agreed that most medicinal herbs are safe under the conditions used, some are toxic and should be avoided even though they are readily available, and others have significant adverse side effects when misused. Also, little has been done to investigate potential adverse effects that may be associated with extended or high-dose use of medicinal herbs. Thus, concern has been expressed that the lack of quality control used in the preparation of medicinal herbs, plus their unregulated sale and uninformed use, pose potential adverse health effects for consumers. There is also concern regarding potential herb/herb or herb/drug interactions and possible untoward health effects of medicinal herbs in sensitive subpopulations such as the young and the elderly and certain genetically predisposed individuals. In this paper, we discuss these concerns at some length and make recommendations for additional research and education discussed in the recent International Workshop to Evaluate Research Needs on the Use and Safety of Medicinal Herbs.
实际上，纵观历史，所有文化都曾使用过各种植物或源自植物的材料来预防和治疗疾病。这些草药的有益治疗效果在其持续使用中可见一斑。此外，现代化学的发展使得从草药中分离出化学物质成为可能，这些化学物质已成为药物或当今许多重要药物合成的起始原料。由于从最初从草药中分离出的化学物质的作用机制研究中获得的知识，更多的现代药物得以合成。因此，草药在现代医学的发展中发挥了重要作用，并继续以其原始形式被广泛使用。虽然人们普遍认为大多数草药在使用条件下是安全的，但有些草药有毒，即使容易获得也应避免使用，还有一些草药在误用时有显著的不良副作用。此外，对于与长期或高剂量使用草药可能相关的潜在不良反应，几乎没有进行过研究。因此，有人担心草药制备过程中缺乏质量控制，加上其销售不受监管和使用缺乏相关知识，会给消费者带来潜在的健康危害。人们还担心草药之间或草药与药物之间的潜在相互作用，以及草药对敏感亚人群（如年轻人、老年人和某些具有特定遗传易感性的个体）可能产生的不良健康影响。在本文中，我们将详细讨论这些问题，并就最近召开的评估草药使用和安全性研究需求国际研讨会上讨论的进一步研究和教育提出建议。
