Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, 4349 Martin Luther King Boulevard, Houston, Texas, 77204, United States.
Department of Pharmaceutical Science, College of Pharmacy and Health Sciences, Texas Southern University, 3100 Cleburne Street, Houston, Texas, 77004, United States.
Curr Drug Metab. 2023;24(6):422-433. doi: 10.2174/1389200224666230817102224.
BACKGROUND: Chemotherapeutic drugs used in cancer treatment often result in gastrointestinal toxicity, notably diarrhea, impacting patients' quality of life. Complementary and Alternative Medicine (CAM) has garnered increasing interest as an alternative to conventional approaches as a potential solution for managing chemotherapyinduced diarrhea (CID). OBJECTIVE: To summarize current research focusing on herbal medicines as adjuvant therapy to prevent or treat chemotherapy-induced diarrhea, including clinical assessments, mechanism of actions, active components, and potential pharmacokinetic interactions between herbal medicines and chemotherapeutic drugs. METHODS: We performed the literature review from PubMed, CNKI, Google Scholar, Web of Science, and Scopus using "Chemotherapy", "Diarrhea," and "Complementary and Alternative Medicine" as the search keywords. RESULTS: Using herbal medicines as adjuvants provides an effective approach to treating or preventing CID with improved or unaffected antitumor activity of chemotherapeutic drugs. Among these herbal formulations, scutellaria, ginger, and ginseng are the most frequently used herbs in the prescriptions for CID. The main antidiarrheal components in herbs include wogonin, baicalin, chrysin, quercetin, gingerol, and ginsenosides. These herbs, formulations, and bioactive components relieved CID through different mechanisms, including directly decreasing local drug exposure, anti-inflammation, inhibiting epithelial apoptosis, or promoting epithelium stem cell regeneration. The application of herbal medicines as adjunctive therapies showed efficacy in preventing or treating CID in multiple clinical trials. However, more well-designed clinical studies are expected to validate the results further. Despite some clinical studies demonstrating that certain herbal medicines could potentially attenuate CID and improve efficacy, it remains necessary to evaluate herbal safety. The interactions between herbs and drugs are also potential concerns, but few clinical trials have focused on investigating this aspect. CONCLUSION: In clinical practise, herbal medications show potential as adjuvant treatments for gastrointestinal toxicities induced by chemotherapy, particularly diarrhoea. Further well-designed clinical studies are needed to validate their efficacy, ensure safety, and explore potential drug-herb interactions.
背景：癌症治疗中使用的化疗药物常导致胃肠道毒性，特别是腹泻，影响患者的生活质量。补充和替代医学（CAM）作为传统方法的替代方法，作为管理化疗引起的腹泻（CID）的潜在解决方案，引起了越来越多的关注。 目的：总结目前关于草药作为辅助治疗预防或治疗化疗引起的腹泻的研究，包括临床评估、作用机制、活性成分以及草药与化疗药物之间的潜在药代动力学相互作用。 方法：我们使用“化疗”、“腹泻”和“补充和替代医学”作为搜索关键词，从 PubMed、CNKI、Google Scholar、Web of Science 和 Scopus 进行文献综述。 结果：使用草药作为辅助治疗提供了一种有效治疗或预防 CID 的方法，同时不影响化疗药物的抗肿瘤活性。在这些草药配方中，黄芩、生姜和人参是 CID 处方中最常用的草药。草药中的主要止泻成分包括黄芩素、黄芩苷、白杨素、槲皮素、姜辣素和人参皂苷。这些草药、配方和生物活性成分通过不同的机制缓解 CID，包括直接减少局部药物暴露、抗炎、抑制上皮细胞凋亡或促进上皮干细胞再生。在多项临床试验中，草药作为辅助治疗的应用显示出预防或治疗 CID 的疗效。然而，需要更多精心设计的临床试验进一步验证结果。尽管一些临床研究表明某些草药可能潜在地减轻 CID 并提高疗效，但仍有必要评估草药的安全性。草药与药物之间的相互作用也是潜在的关注点，但很少有临床试验专注于研究这方面。 结论：在临床实践中，草药药物显示出作为化疗引起的胃肠道毒性，特别是腹泻的辅助治疗的潜力。需要进一步进行精心设计的临床试验，以验证其疗效、确保安全性并探索潜在的药物-草药相互作用。
Curr Drug Metab. 2023
J Ethnopharmacol. 2016-2-17
J Ethnopharmacol. 2024-10-28
Crit Rev Food Sci Nutr. 2017-4-13
J Ethnopharmacol. 2017-8-4
Phytomedicine. 2023-10
Zotero 插件