Ben-Arye Eran, Samuels Noah, Goldstein Lee Hilary, Mutafoglu Kamer, Omran Suha, Schiff Elad, Charalambous Haris, Dweikat Tahani, Ghrayeb Ibtisam, Bar-Sela Gil, Turker Ibrahim, Hassan Azza, Hassan Esmat, Saad Bashar, Nimri Omar, Kebudi Rejin, Silbermann Michael
Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel.
Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Cancer. 2016 Feb 15;122(4):598-610. doi: 10.1002/cncr.29796. Epub 2015 Nov 24.
The authors assessed the use of herbal medicine by Middle Eastern patients with cancer, as reported by their oncology health care professionals (HCPs). Herbal products identified by the study HCPs were evaluated for potential negative effects.
Oncology HCPs from 16 Middle Eastern countries received a 17-item questionnaire asking them to list 5 herbal products in use by their patients with cancer. A literature search (PubMed, Micromedex, AltMedDex, and the Natural Medicine Comprehensive Database) was conducted to identify safety-related concerns associated with the products listed.
A total of 339 HCPs completed the study questionnaire (response rate of 80.3%), identifying 44 herbal and 3 nonherbal nutritional supplements. Safety-related concerns were associated with 29 products, including herb-drug interactions with altered pharmacodynamics (15 herbs), direct toxic effects (18 herbs), and increased in vitro response of cancer cells to chemotherapy (7 herbs).
Herbal medicine use, which is prevalent in Middle Eastern countries, has several potentially negative effects that include direct toxic effects, negative interactions with anticancer drugs, and increased chemosensitivity of cancer cells, requiring a reduction in dose-density. Oncology HCPs working in countries in which herbal medicine use is prevalent need to better understand the implications of this practice. The presence of integrative physicians with training in complementary and traditional medicine can help patients and their HCPs reach an informed decision regarding the safety and effective use of these products.
作者评估了中东地区癌症患者使用草药的情况，这些情况由他们的肿瘤医疗保健专业人员（HCPs）报告。对研究中的HCPs所识别出的草药产品进行了潜在负面影响评估。
来自16个中东国家的肿瘤HCPs收到一份包含17个条目的问卷，要求他们列出其癌症患者正在使用的5种草药产品。进行了文献检索（PubMed、Micromedex、AltMedDex和天然药物综合数据库），以确定与所列产品相关的安全问题。
共有339名HCPs完成了研究问卷（回复率为80.3%），识别出44种草药和3种非草药营养补充剂。与安全相关的问题与29种产品有关，包括具有改变药效学作用的草药-药物相互作用（15种草药）、直接毒性作用（18种草药）以及癌细胞对化疗的体外反应增加（7种草药）。
在中东国家普遍存在的草药使用有几种潜在的负面影响，包括直接毒性作用、与抗癌药物的负面相互作用以及癌细胞化疗敏感性增加，这需要降低剂量密度。在草药使用普遍的国家工作的肿瘤HCPs需要更好地了解这种做法的影响。有补充和传统医学培训背景的综合医生的存在可以帮助患者及其HCPs就是否安全有效地使用这些产品做出明智的决定。
