臨床常用科學中藥與西藥交互作用之評估(II)
鮑力恆
國防大學國防醫學院
目前國內在全民健康保險醫療下及在目前國人的就醫習慣上，民眾常以同時服用中醫及西醫的藥物作為治療疾病方式，同時也因缺乏相關的交互作用資訊，中醫與西醫的疾病診治過程中，用藥安全上常常無法兼顧，此可能造成許多藥物不良反應或是中西藥物交互作用，可導致藥物預期的療效降低，或是影響藥物代謝及排泄而產生毒性反應，造成病人用藥安全的顧慮。因此本研究的目的即在於建立臨床常使用的科學中藥與西藥交互作用資料平台，以供醫藥相關人員臨床實用上對於中西藥交互作用發生風險評估之參考，以期能減少可能因中西交互作用而產生的不良反應或副作用，以適時提供醫療團隊或病人相關資訊，更提昇醫療品質。去年在貴署補助下已順利完成了建立一人肝微粒體CYP3A酵素活性篩選評估模式及分析方法，並也達成50種常用單方科學中藥篩選評估的目標，其中常見於複方中配方之單方如黃芩、牡丹皮、雞血藤，與黃耆可顯著的抑制CYP3A酵素活性，抑制率可達70%~99%之間，顯示的確存在臨床中西藥交互作用的可能性。今年則是以中藥複方為評估對象及進行中藥單方體內試驗以獲取更實用的交互作用證據。此兩年篩選結果中呈現顯著及潛在可能引起交互作用的科學中藥有助於日後進行活體動物試驗及臨床上人體交互作用研究之指標參考，以確認交互作用的可能影響程度。
關鍵字：中藥；中藥-西藥交互作用；人肝微粒體；細胞色素CYP3A
Evaluation of Chinese Medicine Extracts-Drug Interactions (II)
Pao, Li-Heng
National Defense Medical Center,National Defense University
Under the national social health care systems and coustums of medicine use in Taiwan, coadministration of herbal medicines and drugs is not unsual for patients taken the medicine. The information of systemic herb-drug interactions is still far form practical applications. Therefore, herb-drug interactions might result in a loss of therapeutic efficacy or toxic effects of drug therapy. The purpose of this project is to study the herb extracts and drug interactions systemically to build up the interactions data bank. These herb-drug interactions data may provide useful information for medical professional stuffs in prescription and consultation to reduce the chance of advers effects and impove the quality of medical care. This year, 20 compound herb extracts in vitro screening in human liver microsome will carrier out. The analytical methodology of testosterone and at hydroxy metabolite in rat plasma will be developed and setup 5 single herb exteacts product in vivo. These herb-drug interactions data base will be very useful in identifing the potential interaction cases for further in vivo animal or clinical interaction study in the future. In vivo study of the fore herbal extract that showed significant impact on CYP3A activity in vitro will be conducted in rats to verify the herbal-drug interactions in vivo.
關鍵字：Herbal；Herbal extract-durg interations；human liver microsomes；CYP3A
