Wong Raymond S M, Cheng Gregory, Chan Thomas Y K
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Drug Saf. 2003;26(8):585-8. doi: 10.2165/00002018-200326080-00004.
Patients receiving warfarin therapy are discouraged from taking herbal medicines. Whether patients adhere to this advice and, if they do not, the types of products they use, are not known.
The objective of this observational study was to estimate the magnitude of use of herbal medicines among Chinese patients attending the Warfarin Clinic of the Prince of Wales Hospital in Hong Kong.
A medical officer interviewed all patients who attended the Warfarin Clinic during May 2001. Patients were asked about the use of herbal medicines in the preceding week. Demographic data, indication and duration of warfarin therapy, and International Normalised Ratio (INR) value at the time of the visit were also noted.
Of 107 patients interviewed, 28 (26%) claimed to have taken herbal medicines during the week prior to the clinic visit. The users of herbal medicines had lower INR values than non-users (mean INR value 2.41 +/- 0.65 vs 2.75 +/- 0.65, p = 0.019), possibly because of a lower warfarin dosage (mean dosage 2.93 mg/day +/- 1.23 vs 3.34 mg/day +/- 1.45; p = 0.185) and because a smaller proportion of such patients had heart valve replacement (21% vs 39%, p = 0.141). 'Herbal soup' (soup made at home from vegetables, meat and certain herbs for consumption with the main meals) and 'cool tea' (herbal decoction for the treatment of 'endogenous heat') were the most popular and were taken by 12 (11%) and 11 (10%) patients, respectively. Four patients took proprietary medicines each containing between one and three different herbs that could potentially enhance or antagonise the effects of warfarin. None of the patients in this study showed any evidence of thromboembolism or bleeding on the day of clinic visit.
Among Chinese patients treated with warfarin at a Hong Kong clinic, the use of herbal medicines was relatively common. Healthcare professionals play an important role in educating the patients and updating the list of herbal medicines that should be avoided by patients taking warfarin.
接受华法林治疗的患者不建议服用草药。患者是否遵循此建议，若不遵循，他们使用的产品类型尚不清楚。
这项观察性研究的目的是估计香港威尔士亲王医院华法林诊所的中国患者中使用草药的比例。
一名医务人员于2001年5月对所有前往华法林诊所就诊的患者进行了访谈。询问患者在前一周是否使用过草药。还记录了人口统计学数据、华法林治疗的适应症和持续时间，以及就诊时的国际标准化比值（INR）值。
在接受访谈的107名患者中，28名（26%）称在诊所就诊前一周服用过草药。服用草药的患者INR值低于未服用者（平均INR值2.41±0.65对比2.75±0.65，p = 0.019），这可能是因为华法林剂量较低（平均剂量2.93毫克/天±1.23对比3.34毫克/天±1.45；p = 0.185），且此类患者中接受心脏瓣膜置换的比例较小（21%对比39%，p = 0.141）。“草药汤”（在家用蔬菜、肉类和某些草药熬制，与正餐一起食用的汤）和“凉茶”（用于治疗“内火”的草药汤剂）最受欢迎，分别有12名（11%）和11名（10%）患者饮用。4名患者服用了 proprietary medicines，每种药物含有一至三种不同的草药，这些草药可能增强或拮抗华法林的作用。本研究中的患者在诊所就诊当天均未出现任何血栓栓塞或出血迹象。
在香港一家诊所接受华法林治疗的中国患者中，草药的使用相对普遍。医疗保健专业人员在教育患者以及更新服用华法林的患者应避免使用的草药清单方面发挥着重要作用。
