Ho N K
Department of Neonatology 1, Kandang Kerbau Hospital, Singapore.
Singapore Med J. 1996 Dec;37(6):645-51.
Treatment with herbs may increase the risk of neonatal jaundice (NNJ). It is logical to look into the current practice in some hospitals in China where herbs are being used in the treatment of NNJ. It is also the purpose of this study to find out the chemical constituents and actions of the herbs, and the rationale of the treatment.
Twenty reports, from 1973 to 1989, from different parts of China, come in a published book and the paediatric journals written in the Chinese language. The Zhong Yao Da Zi Dian, an encyclopedia of Chinese materia medica, and other books on the pharmacology and applications of Chinese materia medica were also referred to in the study.
Yin-chen (oriental wormwood or Artemisia) was the most commonly used herbs for NNJ (95%). Others were Da-huang (rhubarb or Rheum officinale), Huang-qin (skullcap root or Scutellaria), Gan-cao (licorice or glycyrrhiza) and Huang-lian (goldthread rhizome or Copts chinesis). Huang-lian, which contains the alkaloid berberine, was used in 4 centers (20%). Berberine can cause severe acute hemolysis in babies with G6PD deficiency. Currently, Yin-chen comes as a decoction Artemisia composita and an intravenous preparation. These preparations have potential central nervous system and cardiovascular toxicities.
Chinese herbs have many pharmacological substances and therefore multiple actions. In recent years, Chinese herbs are used in conjunction with "Western" drugs, rendering the study of the effects of herbs on NNJ extremely difficult. The efficacy and safety of phototherapy for NNJ have been firmly established, thus diminishing the need for drug treatment. What is the present day role, therefore, of herbal medicine for NNJ? Is there a place for further research of these herbal medicines?
使用草药治疗可能会增加新生儿黄疸(NNJ)的风险。研究中国一些使用草药治疗NNJ的医院的当前做法是合理的。本研究的目的还包括找出草药的化学成分和作用,以及治疗的基本原理。
从1973年至1989年来自中国不同地区的20篇报告,收录在一本已出版的书籍和中文儿科期刊中。本研究还参考了《中药大辞典》(一部中药学百科全书)以及其他关于中药药理学和应用的书籍。
茵陈(茵陈蒿或滨蒿)是治疗NNJ最常用的草药(95%)。其他的有大黄(掌叶大黄、唐古特大黄或药用大黄)、黄芩(黄芩)、甘草(甘草)和黄连(黄连)。含有生物碱黄连素的黄连在4个中心被使用(20%)。黄连素可导致葡萄糖-6-磷酸脱氢酶(G6PD)缺乏的婴儿发生严重急性溶血。目前,茵陈有复方茵陈汤和静脉制剂。这些制剂有潜在的中枢神经系统和心血管毒性。
中药含有多种药理物质,因此有多种作用。近年来,中药与“西药”联合使用,使得研究草药对NNJ的影响极其困难。光疗对NNJ的疗效和安全性已得到充分证实,从而减少了药物治疗的需求。那么,草药在当今NNJ治疗中扮演着什么角色呢?这些草药是否还有进一步研究的空间?