Shi Yue, Tang Rui, Luo Fangmei, Li Hong, Pan Zouxian, Xu Guogang, Yang Yongshi, Zhao Zuotao, Liang Aihua, Wei Ji-Fu, Piao Yuanlin, Chang Christopher, Sun Jin-Lyu, Platts-Mills Thomas A E
Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China.
Department of Allergy, Peking Union Medical College Hospital, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China.
Clin Rev Allergy Immunol. 2022 Feb;62(1):103-122. doi: 10.1007/s12016-020-08812-7. Epub 2021 Feb 19.
Traditional Chinese medicines (TCM) have been used in China for thousands of years. Although TCM has been generally perceived to be safe, adverse reactions to Chinese materia medica (CMM) have been reported. Most of the adverse reactions are allergic in nature, but other mechanisms may play a role. This review focuses on the mechanism and clinical presentation of these allergic reactions. Allergic reactions can occur as a result of the active and inactive ingredients of CMM. Impurities and chemicals generated during the production process can also lead to allergic or adverse reactions. Environmental factors such as temperature, humidity, and light can cause changes in the allergenicity of drugs. Human error in formulating CMM drugs also contributes to adverse drug reactions. The management of allergic reactions to CMM includes taking a good history, avoidance of medications in the same class as those which caused prior reactions, the proper training of staff, adherence to manufacturer guidelines and expiration dates, evaluation of benefit and risk balance, and the formulation of a risk management strategy for the use of CMM. A small test dose of a considered drug before using, improvements in drug purification technology, and proper storage and clinical administration help reduce allergic reactions due to CMM.
中药在中国已使用了数千年。尽管人们普遍认为中药是安全的，但关于中药材的不良反应已有报道。大多数不良反应本质上是过敏反应，但其他机制可能也起作用。本综述聚焦于这些过敏反应的机制和临床表现。过敏反应可能由中药材的活性成分和非活性成分引起。生产过程中产生的杂质和化学物质也可能导致过敏或不良反应。温度、湿度和光照等环境因素会导致药物变应原性发生变化。中药材配方中的人为失误也会导致药物不良反应。对中药材过敏反应的管理包括详细询问病史、避免使用与先前引起反应的药物同类的药物、对工作人员进行适当培训、遵守制造商指南和有效期、评估效益与风险平衡以及制定使用中药材的风险管理策略。使用前对考虑使用的药物进行小剂量测试、改进药物提纯技术以及妥善储存和临床给药有助于减少因中药材引起的过敏反应。
