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华法林与药草的相互作用。

Warfarin interactions with medicinal herbs.

作者信息

Milić Natasa, Milosević Natasa, Golocorbin Kon Svetlana, Bozić Teodora, Abenavoli Ludovico, Borrelli Francesca

出版信息

Nat Prod Commun. 2014 Aug;9(8):1211-6.

Abstract

Recognition of the adverse effects of medicinal herbs is not routine and the reports on such effects are even less frequent in clinical practice. Potential herb-drug interactions are of a major safety concern, especially for drugs with narrow therapeutic indices like warfarin, which can lead to severe adverse reactions that are sometimes life-threatening. The interactions between warfarin and medicinal herbs described in the literature have been summarized in this paper relying on Medline database (via PubMed) using the key words: warfarin, herbal supplements and interactions. The references on the analyzed literature have been investigated in order to collect the existing data. The case reports with severe adverse effects such as spontaneous postoperative bleeding, formation of hematomas, hematemesis, melena, thrombosis, subarachnoid hemorrhage and/or subdural hematomas after concomitant use of warfarin and the medicinal herbs: Panax ginseng, Hypericum perforatum, Salvia milthiorizza, Gingko biloba, Serenoa repens, Angelica sinensis, Vaccinium species, Allium sativum, Zingiber officinale, Tanacetum parthenium, Lucium barbarum, Matricaria chamomilla, Boswellia serrata and Camellia sinensis have been estimated. Some of the interactions between warfarin and medicinal herbs have been well assessed proving that they are closely-dependent. The interactions between warfarin and medicinal herbs, not generally reported in previous reviews, are presented in our review. The health professionals who are involved in treating the patients are expected to be fully informed about the interactions between warfarin and medicinal herbs in order to minimize the health risks of the patients.

摘要

对药草不良反应的认识并非常规操作,而且在临床实践中关于此类效应的报告甚至更少。潜在的药草 - 药物相互作用是主要的安全问题,尤其是对于像华法林这样治疗指数狭窄的药物,这可能导致严重的不良反应,有时甚至危及生命。本文依靠Medline数据库(通过PubMed),使用关键词:华法林、草药补充剂和相互作用,总结了文献中描述的华法林与药草之间的相互作用。对分析文献的参考文献进行了调查,以收集现有数据。对同时使用华法林和以下药草后出现严重不良反应的病例报告进行了评估,这些不良反应包括术后自发性出血、血肿形成、呕血、黑便、血栓形成、蛛网膜下腔出血和/或硬膜下血肿:人参、贯叶连翘、丹参、银杏、锯叶棕、当归、越橘属、大蒜、生姜、小白菊、枸杞、洋甘菊、乳香和茶树。华法林与药草之间的一些相互作用已得到充分评估,证明它们密切相关。我们的综述展示了华法林与药草之间此前综述中未普遍报道的相互作用。参与治疗患者的医疗专业人员应充分了解华法林与药草之间的相互作用,以尽量降低患者的健康风险。

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