植物性食品补充剂和植物制剂的不良反应：一项对因果关系进行批判性评估的系统评价
Adverse effects of plant food supplements and botanical preparations: a systematic review with critical evaluation of causality.
作者信息
Di Lorenzo Chiara, Ceschi Alessandro, Kupferschmidt Hugo, Lüde Saskia, De Souza Nascimento Elizabeth, Dos Santos Ariana, Colombo Francesca, Frigerio Gianfranco, Nørby Karin, Plumb Jenny, Finglas Paul, Restani Patrizia
机构信息
Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, via Balzaretti 9, 20133, Milano, Italy.
出版信息
Br J Clin Pharmacol. 2015 Apr;79(4):578-92. doi: 10.1111/bcp.12519.
AIMS
The objective of this review was to collect available data on the following: (i) adverse effects observed in humans from the intake of plant food supplements or botanical preparations; (ii) the misidentification of poisonous plants; and (iii) interactions between plant food supplements/botanicals and conventional drugs or nutrients.
METHODS
PubMed/MEDLINE and Embase were searched from database inception to June 2014, using the terms 'adverse effect/s', 'poisoning/s', 'plant food supplement/s', 'misidentification/s' and 'interaction/s' in combination with the relevant plant name. All papers were critically evaluated according to the World Health Organization Guidelines for causality assessment.
RESULTS
Data were obtained for 66 plants that are common ingredients of plant food supplements; of the 492 papers selected, 402 (81.7%) dealt with adverse effects directly associated with the botanical and 89 (18.1%) concerned interactions with conventional drugs. Only one case was associated with misidentification. Adverse effects were reported for 39 of the 66 botanical substances searched. Of the total references, 86.6% were associated with 14 plants, including Glycine max/soybean (19.3%), Glycyrrhiza glabra/liquorice (12.2%), Camellia sinensis/green tea ( 8.7%) and Ginkgo biloba/gingko (8.5%).
CONCLUSIONS
Considering the length of time examined and the number of plants included in the review, it is remarkable that: (i) the adverse effects due to botanical ingredients were relatively infrequent, if assessed for causality; and (ii) the number of severe clinical reactions was very limited, but some fatal cases have been described. Data presented in this review were assessed for quality in order to make the results maximally useful for clinicians in identifying or excluding deleterious effects of botanicals.
目的
本综述的目的是收集以下方面的现有数据：（i）人类摄入植物性食品补充剂或植物制剂所观察到的不良反应；（ii）有毒植物的误认；以及（iii）植物性食品补充剂/植物药与传统药物或营养素之间的相互作用。
方法
从数据库建立至2014年6月，在PubMed/MEDLINE和Embase中进行检索，使用“不良反应”“中毒”“植物性食品补充剂”“误认”和“相互作用”等术语，并结合相关植物名称。所有论文均根据世界卫生组织因果关系评估指南进行严格评估。
结果
获取了66种植物的数据，这些植物是植物性食品补充剂的常见成分；在所选的492篇论文中，402篇（81.7%）涉及与植物药直接相关的不良反应，89篇（18.1%）涉及与传统药物的相互作用。仅1例与误认有关。在所检索的66种植物性物质中，有39种报告了不良反应。在所有参考文献中，86.6%与14种植物有关，包括大豆（19.3%）、甘草（12.2%）、绿茶（8.7%）和银杏（8.5%）。
结论
考虑到所研究的时间长度和综述中纳入的植物数量，值得注意的是：（i）如果评估因果关系，植物成分引起的不良反应相对较少；（ii）严重临床反应的数量非常有限，但已描述了一些致命病例。对本综述中呈现的数据进行了质量评估，以使结果对临床医生识别或排除植物药的有害影响具有最大的参考价值。
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