Shii Takashi, Kuroda Minpei, Shamoto Noriko, Mimaki Yoshihiro
Department of Medicinal Pharmacognosy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences.
Department of Pharmacy, Kitasato University Hospital.
Nihon Ronen Igakkai Zasshi. 2020;57(1):72-80. doi: 10.3143/geriatrics.57.72.
Kampo medicines containing Scutellariae Radix (the root of Scutellaria baicalensis Georgi; SR) sometimes cause serious adverse effects, including interstitial pneumonia and liver dysfunction. Baicalin (BL) is the major active component of SR and is presumed to be responsible for the adverse effects. We analyzed the amounts of BL in Kampo medicines to better understand how they can be used safely.
We determined the amounts of BL in 28 Kampo decoctions containing SR (recommended daily dose: 1.5-4 g/day) and corresponding Kampo extract products by high-performance liquid chromatography.
The amounts of BL in the Kampo decoctions were 1.7-4.0-fold higher than those of the corresponding Kampo extract products. Inter-product variations in the amounts of BL in Shosaikoto, Otsujito, Daisaikoto, Saibokuto, Orengedokuto, and Saireito Kampo extracts from various companies were also examined. Significant differences in the amounts of BL were observed for Shosaikoto, Otsujito, Daisaikoto, and Saibokuto extract products (up to 2.6, 1.6, 1.5, and 1.3-fold differences, respectively), whereas no significant differences were observed for Orengedokuto and Saireito extract products.
Because the Kampo decoctions containing SR that we examined contained 1.7-4.0 times as much BL as the corresponding Kampo extract products, medical doctors and pharmacists should be aware that Kampo decoctions containing SR might cause more severe side effects than corresponding Kampo extract products. Furthermore, we recommend that the amounts of BL and its aglycone, baicalein (BA), in Kampo extract products be made known to practitioners and patients.
含有黄芩(黄芩根;SR)的汉方药有时会引起严重不良反应,包括间质性肺炎和肝功能障碍。黄芩苷(BL)是SR的主要活性成分,被认为是不良反应的原因。我们分析了汉方药中BL的含量,以便更好地了解如何安全使用它们。
我们通过高效液相色谱法测定了28种含SR的汉方汤剂(推荐日剂量:1.5 - 4克/天)及相应汉方提取物产品中BL的含量。
汉方汤剂中BL的含量比相应汉方提取物产品高1.7 - 4.0倍。还检查了不同公司的小柴胡汤、大柴胡汤、柴胡桂枝汤、柴朴汤、黄连解毒汤和柴苓汤汉方提取物中BL含量的产品间差异。小柴胡汤、大柴胡汤、柴胡桂枝汤和柴朴汤提取物产品中BL含量存在显著差异(分别高达2.6、1.6、1.5和1.3倍差异),而黄连解毒汤和柴苓汤提取物产品未观察到显著差异。
因为我们检测的含SR的汉方汤剂中BL含量是相应汉方提取物产品的1.7 - 4.0倍,医生和药剂师应意识到含SR的汉方汤剂可能比相应汉方提取物产品引起更严重的副作用。此外,我们建议向从业者和患者告知汉方提取物产品中BL及其苷元黄芩素(BA)的含量。