Kumar Nagi B, Allen Kathy, Bell Heather
Department of Nutrition, H. Lee Moffitt Cancer Center & Research Institute, University of South Florida College of Medicine, Tampa, Florida 33612, USA.
Cancer Control. 2005 Jul;12(3):149-57. doi: 10.1177/107327480501200302.
Products made from botanicals that are used to maintain or improve health are known as herbal supplements, botanicals, or phytomedicines. Many herbs have a long history of use and claimed health benefits. However, many herbal supplements and botanicals have potent pharmacologic activity that can contribute to adverse effects and drug interactions. The use of herbal supplements by cancer patients in the perioperative period is common and consistent with the substantial increase in the use of alternative medical therapies.
We reviewed the literature to examine the constituents, safety, pharmacokinetics, and pharmacodynamics of those herbal supplements that are predominantly used by cancer patients.
Different supplements possess antiplatelet activity, adversely interact with corticosteroids and central nervous system depressant drugs, have gastrointestinal manifestations, produce hepatotoxicity and nephrotoxicity, and produce additive effects when used with opioid analgesics.
With the increasing use of herbal supplements by cancer patients, surgical staff need to screen patients pre-surgically for use of these supplements. Clinical practice guidelines are needed for screening and prevention of herbal supplement usage to prevent potential adverse events that may arise from herbal medications taken alone or combined with conventional therapies during the perioperative period.
由植物制成用于维持或改善健康的产品被称为草药补充剂、植物药或植物医学药物。许多草药有着悠久的使用历史并宣称具有健康益处。然而，许多草药补充剂和植物药具有强大的药理活性，可能导致不良反应和药物相互作用。癌症患者在围手术期使用草药补充剂很常见，这与替代医学疗法使用的大幅增加是一致的。
我们查阅文献以研究癌症患者主要使用的那些草药补充剂的成分、安全性、药代动力学和药效学。
不同的补充剂具有抗血小板活性，与皮质类固醇和中枢神经系统抑制药物发生不良相互作用，有胃肠道表现，产生肝毒性和肾毒性，并且与阿片类镇痛药合用时会产生相加作用。
随着癌症患者对草药补充剂的使用增加，手术人员需要在术前对患者使用这些补充剂的情况进行筛查。需要临床实践指南来筛查和预防草药补充剂的使用，以防止在围手术期单独使用草药药物或与传统疗法联合使用时可能出现的潜在不良事件。
