Wagner H, Ulrich-Merzenich G
Department of Pharmacy, Center of Pharma Research, Ludwig-Maximilians-University, Butenandtstr. 5-13, House B, D-81377 Munich, Germany.
Phytomedicine. 2009 Mar;16(2-3):97-110. doi: 10.1016/j.phymed.2008.12.018.
The longstanding, successful use of herbal drug combinations in traditional medicine makes it necessary to find a rationale for the pharmacological and therapeutic superiority of many of them in comparison to isolated single constituents. This review describes many examples of how modern molecular-biological methods (including new genomic technologies) can enable us to understand the various synergistic mechanisms underlying these effects. Synergistic effects can be produced if the constituents of an extract affect different targets or interact with one another in order to improve the solubility and thereby enhance the bioavailability of one or several substances of an extract. A special synergy effect can occur when antibiotics are combined with an agent that antagonizes bacterial resistance mechanisms. The verification of real synergy effects can be achieved through detailed pharmacological investigations and by means of controlled clinical studies performed in comparison with synthetic reference drugs. All the new ongoing projects aim at the development of a new generation of phytopharmaceuticals which can be used alone or in combination with synthetic drugs or antibiotics. This new generation of phytopharmaceuticals could lend phytotherapy a new legitimacy and enable their use to treat diseases which have hitherto been treated using synthetic drugs alone.
在传统医学中，草药复方长期成功应用，这就使得有必要找出其中许多复方相较于单一成分在药理和治疗方面具有优越性的原因。本综述描述了诸多实例，展示了现代分子生物学方法（包括新的基因组技术）如何使我们能够理解这些效应背后的各种协同机制。如果提取物的成分作用于不同靶点或相互作用以改善溶解性，从而提高提取物中一种或几种物质的生物利用度，就会产生协同效应。当抗生素与一种能对抗细菌耐药机制的药物联合使用时，会出现一种特殊的协同效应。通过详细的药理研究以及与合成参比药物对照进行的对照临床研究，可以验证真正的协同效应。目前所有正在进行的新项目都旨在开发新一代植物药，这些植物药可以单独使用，也可以与合成药物或抗生素联合使用。这新一代植物药可为植物疗法赋予新的合理性，并使其能够用于治疗迄今仅使用合成药物治疗的疾病。
