Zhou Xian, Seto Sai Wang, Chang Dennis, Kiat Hosen, Razmovski-Naumovski Valentina, Chan Kelvin, Bensoussan Alan
School of Science and Health, National Institute of Complementary Medicine, Western Sydney University Penrith, NSW, Australia.
Faculty of Medicine, University of New South WalesSydney, NSW, Australia; School of Medicine, Western Sydney UniversityCampbelltown, NSW, Australia; Faculty of Medicine and Health Sciences, Macquarie UniversitySydney, NSW, Australia.
Front Pharmacol. 2016 Jul 12;7:201. doi: 10.3389/fphar.2016.00201. eCollection 2016.
Traditional Chinese medicine (TCM) is an important part of primary health care in Asian countries that has utilized complex herbal formulations (consisting 2 or more medicinal herbs) for treating diseases over thousands of years. There seems to be a general assumption that the synergistic therapeutic effects of Chinese herbal medicine (CHM) derive from the complex interactions between the multiple bioactive components within the herbs and/or herbal formulations. However, evidence to support these synergistic effects remains weak and controversial due to several reasons, including the very complex nature of CHM, misconceptions about synergy and methodological challenges to study design. In this review, we clarify the definition of synergy, identify common errors in synergy research and describe current methodological approaches to test for synergistic interaction. We discuss the strengths and weaknesses of these models in the context of CHM and summarize the current status of synergy research in CHM. Despite the availability of some scientific data to support the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low, and the clinical relevancy of most of these findings is undetermined. There remain significant challenges in the development of suitable methods for synergistic studies of complex herbal combinations.
传统中医（TCM）是亚洲国家初级卫生保健的重要组成部分，数千年来一直使用复杂的草药配方（由两种或更多种草药组成）来治疗疾病。人们似乎普遍认为，中药（CHM）的协同治疗效果源于草药和/或草药配方中多种生物活性成分之间的复杂相互作用。然而，由于多种原因，包括中药的极其复杂的性质、对协同作用的误解以及研究设计的方法学挑战，支持这些协同作用的证据仍然薄弱且存在争议。在本综述中，我们阐明了协同作用的定义，确定了协同作用研究中的常见错误，并描述了测试协同相互作用的当前方法学途径。我们在中药的背景下讨论了这些模型的优缺点，并总结了中药协同作用研究的现状。尽管有一些科学数据支持多草药和/或草药-药物组合的协同作用，但证据水平仍然很低，而且这些发现中的大多数的临床相关性尚未确定。在开发适用于复杂草药组合协同作用研究的方法方面仍然存在重大挑战。
