Wang Chi Chiu, Li Lu, San Lau Clara Bik, Leung Ping Chung, Fung Kwok Pui
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
Birth Defects Res C Embryo Today. 2013 Dec;99(4):275-91. doi: 10.1002/bdrc.21050.
Chinese medicine is a common name for a collection of Chinese Materia Medica with therapeutic properties for medical treatment and healing. Similar to Western pharmaceuticals, Chinese medicines are not free of risk, and have the potential to cause adverse pregnancy outcomes and affect embryonic and fetal development. However, most clinical data concerning safety of maternal exposure to Chinese medicines during pregnancy are not available and the conclusion remains elusive. Some individual clinical trials of Chinese medicines reported some minor adverse effects during pregnancy, whereas few animal studies identified some adverse maternal and perinatal effects, as well as embryotoxic potentials. Basic research and mechanistic studies of the teratogenicity of Chinese medicines are still lacking. There is an urgent need for testing the safety of Chinese medicines before recommendation and commercialization. Until more reliable and scientific research data become available, clinicians should consider both the risks and benefits before recommending Chinese medicines to pregnant women. More systematic investigations of the safety implications of the use of Chinese medicines are highly recommended, in addition to more clinical trials with a larger sample size to confirm its safety during pregnancy. This review includes a critical overview of available clinical and experimental data and provides directions to study the safety issue of Chinese medicines for pregnancy.
中药是具有治疗和治愈特性的中药材集合的统称。与西药类似,中药并非没有风险,有可能导致不良妊娠结局并影响胚胎和胎儿发育。然而,关于孕期母亲接触中药安全性的大多数临床数据并不存在,结论仍不明确。一些中药的个别临床试验报告了孕期的一些轻微不良反应,而很少有动物研究发现一些母体和围产期的不良影响以及胚胎毒性潜力。中药致畸性的基础研究和机制研究仍然缺乏。在推荐和商业化之前迫切需要对中药安全性进行测试。在获得更可靠和科学的研究数据之前,临床医生在向孕妇推荐中药之前应权衡风险和益处。除了更多大样本量的临床试验以确认其孕期安全性外,强烈建议对使用中药的安全性影响进行更系统的调查。本综述对现有临床和实验数据进行了批判性概述,并为研究孕期中药安全性问题提供了方向。