Rahman Haider, Kim Marina, Leung Galen, Green Jesse A, Katz Seymour
Department of Internal Medicine, Albany Medical Center, 47 New Scotland Ave, Albany, NY, 12208, USA.
Division of Gastroenterology, New York Presbyterian Brooklyn Methodist Hospital Weill Cornell College of Medicine, 506 Sixth Street Suite 312 Buckley Pavilion, Brooklyn, NY, 11215, USA.
Curr Treat Options Gastroenterol. 2017 Dec;15(4):618-636. doi: 10.1007/s11938-017-0154-y.
Inflammatory bowel disease (IBD), which includes conditions such as Crohn's disease and ulcerative colitis, is becoming more prevalent with the elderly being the fastest growing group. Parallel to this, there is an increasing interest in the use of complementary and alternative medicine (CAM). Nearly half of patients with IBD have used CAM at one time. The elderly patients, however, are burdened by comorbid conditions, polypharmacy, and altered functional status. With increasing use of complementary and alternative medicine in our elderly patients with IBD, it is vital for the provider to provide counsel on drug-herb potential interactions. CAM includes herbal products, diet, dietary supplements, acupuncture, and prayer. In this paper, we will review common CAM, specifically herbs, that are used in patients with IBD including the herb background, suggested use, evidence in IBD, and most importantly, potential interactions with IBD medications used in elderly patients. Most important evidence-based adverse events and drug-herb interactions are summarized. The herbs discussed include Triticum aestivum (wheat grass), Andrographis paniculata (chiretta), Boswellia serrata, tormentil, bilberry, curcumin (turmeric), Plantago ovata (blond psyllium), Oenothera biennis (evening primrose oil), germinated barley foodstuff, an herbal preparation of myrrh, chamomile and coffee extract, chios mastic gum, wormwood (absinthe, thujone), Cannabis sativa (marijuana, THC), tripterygium wilfordii (thunder god vine), Ulmus rubra (slippery elm bark), trigonella foenugraecum (fenugreek), Dioscorea mexicana (wild yam), Harpagophytum procumbens (devil's claw), ginger, cinnamon, licorice, and peppermint.
炎症性肠病（IBD），包括克罗恩病和溃疡性结肠炎等病症，正变得越来越普遍，其中老年人是增长最快的群体。与此同时，人们对补充和替代医学（CAM）的使用兴趣日益增加。近一半的IBD患者曾使用过CAM。然而，老年患者受到合并症、多种药物治疗以及功能状态改变的困扰。随着我们老年IBD患者对补充和替代医学的使用增加，医疗服务提供者提供关于药物与草药潜在相互作用的建议至关重要。CAM包括草药产品、饮食、膳食补充剂、针灸和祈祷。在本文中，我们将回顾IBD患者常用的CAM，特别是草药，包括草药背景、建议用法、IBD中的证据，以及最重要的是，与老年患者使用的IBD药物的潜在相互作用。总结了最重要的基于证据的不良事件和药物与草药相互作用。所讨论的草药包括小麦草、穿心莲、乳香、委陵菜、越橘、姜黄素（姜黄）、卵叶车前（亚麻籽车前）、月见草油、发芽大麦食品、没药草药制剂、洋甘菊和咖啡提取物、乳香脂、艾草（苦艾、侧柏酮）、大麻（大麻、四氢大麻酚）、雷公藤、红榆树皮、胡芦巴、墨西哥薯蓣（野山药）、魔鬼爪、生姜、肉桂、甘草和薄荷。
