Patel M, Bessong P, Liu H
Department of Clinical Microbiology and Infectious Diseases, National Health Laboratory Services, and School of Pathology, University of the Witwatersrand, Johannesburg, South Africa.
Adv Dent Res. 2011 Apr;23(1):159-64. doi: 10.1177/0022034511400077.
Traditional medicines are an integral part of health care worldwide, even though their efficacy has not been scientifically proven. HIV-infected individuals may use them singularly or in combination with conventional medicines. Many in vitro studies have proven the anti-HIV, anti-Candida, and anti-herpes simplex virus potential of traditional plants and identified some of the mechanisms of action. Very few in vivo studies are available that involve a small number of participants and show controversial results. In addition, knowledge is limited of the role of traditional medicines in the enhancement of the immune system. The use of traditional medicines with antiretroviral drugs (ARVs) has created a problem because drug interactions compromise the efficacy of ARVs. Several currently popular plants have been studied in the laboratory for their interaction with ARVs, with disadvantageous results. Unfortunately, no clinical trials are available. The science of traditional medicines is relatively new and is at present being modernized worldwide. However, there are still ethical issues regarding traditional medicines that need to be addressed-for example, regulations regarding quality control and standardization of medicines, regulation and education of healers who deliver these medicines, and unregulated clinical trials. The workshop addressed the following questions about traditional medicine and their use in HIV infection: What are the mechanisms of action of anti-HIV traditional medicines? Should traditional medicines be used in conjunction with ARV? Do traditional medicines enhance the immune system? Should medicinal plants be used for the control of oral infections associated with HIV? What are the ethical issues surrounding the use of traditional medicines for the treatment of HIV and associated infections?
传统药物是全球医疗保健不可或缺的一部分,尽管其疗效尚未得到科学验证。感染艾滋病毒的个体可能单独使用传统药物,或与传统药物联合使用。许多体外研究已证实传统植物具有抗艾滋病毒、抗念珠菌和抗单纯疱疹病毒的潜力,并确定了一些作用机制。体内研究很少,涉及的参与者数量不多,结果也存在争议。此外,对于传统药物在增强免疫系统方面的作用,人们了解有限。将传统药物与抗逆转录病毒药物(ARV)一起使用产生了一个问题,因为药物相互作用会损害抗逆转录病毒药物的疗效。目前已经在实验室研究了几种目前流行的植物与抗逆转录病毒药物的相互作用,结果不利。不幸的是,尚无临床试验。传统药物科学相对较新,目前正在全球范围内实现现代化。然而,关于传统药物仍存在一些需要解决的伦理问题,例如药品质量控制和标准化的规定、提供这些药物的治疗师的监管和教育,以及未经监管的临床试验。该研讨会讨论了以下有关传统药物及其在艾滋病毒感染中使用的问题:抗艾滋病毒传统药物的作用机制是什么?传统药物是否应与抗逆转录病毒药物联合使用?传统药物是否能增强免疫系统?药用植物是否应用于控制与艾滋病毒相关的口腔感染?围绕使用传统药物治疗艾滋病毒及相关感染存在哪些伦理问题?