Liu X, Han Y, Peng K, Liu Y, Li J, Liu H
Department of Traditional Chinese Medicine and Oral Medicine, Peking University, Beijing, China.
Adv Dent Res. 2011 Apr;23(1):56-60. doi: 10.1177/0022034511399286.
As an opportunistic infection, candidiasis is common among individuals infected with HIV. About 90% of patients develop oral and/or oropharyngeal candidiasis in various stages of AIDS. Triazole antifungal agents, such as fluconazole and itraconazole, are considered to be first-choice agents for treatment and prevention because of their relatively low side effects and high effectiveness on mucosal infections. However, with prolonged exposure to azoles, drug resistance becomes a challenge for clinicians and patients alike. In traditional Chinese medicine, more than 300 herbs have been discovered to have "pesticidal" activities, and some of these have been used as antifungal agents in clinical practice for many years. Crude extracts from a number of medicinal herbs have been shown to exhibit antifungal activities in vitro. These include cortex moutan, cortex pseudolaricis, rhizoma alpiniae officinarum, rhizoma coptidis, clove and cinnamon, anemarrhena cortex phellodendri, ramulus cinnamomi, and Chinese gall. The effective anti-Candida principals were identified to be berberine, palmatine, allincin, pseudolaric acid A and B, magnolol, honokiol, and galangin. Thus, traditional Chinese medicinal herbs provide abundant choices for the treatment of refractory candidiasis commonly seen in HIV/AIDS patients. However, there remains a need for further screening of effective extracts and for study of the antifungal mechanisms involved. Importantly, ahead of clinical application, the safety of these compounds must be firmly established.
作为一种机会性感染，念珠菌病在感染艾滋病毒的个体中很常见。约90%的患者在艾滋病的各个阶段会出现口腔和/或口咽念珠菌病。三唑类抗真菌药物，如氟康唑和伊曲康唑，因其副作用相对较低且对黏膜感染疗效高，被认为是治疗和预防的首选药物。然而，随着长期接触唑类药物，耐药性对临床医生和患者来说都成为了一个挑战。在传统中医中，已发现300多种草药具有“杀虫”活性，其中一些已在临床实践中用作抗真菌药物多年。许多草药的粗提物已显示在体外具有抗真菌活性。这些草药包括牡丹皮、土荆皮、高良姜、黄连、丁香和肉桂、黄柏、桂枝和五倍子。已确定有效的抗念珠菌成分是小檗碱、巴马汀、大蒜素、土荆酸A和B、厚朴酚、和厚朴酚以及高良姜素。因此，传统中药为治疗艾滋病毒/艾滋病患者中常见的难治性念珠菌病提供了丰富的选择。然而，仍需要进一步筛选有效的提取物并研究其抗真菌机制。重要的是，在临床应用之前，必须牢固确立这些化合物的安全性。
