5种中成药中铅、镉、砷含量测定

目的测定复方丹参片、小柴胡颗粒、补中益气丸、板蓝根颗粒和妇科千金片5种中成药中铅、镉、砷的含量。方法按照2005版《中国药典》采用石墨炉原子吸收光谱法测定其中的铅、镉的含量；用氢化物发生一原子荧光法测定砷的含量。结果5种中成药中铅、镉、砷的含量较低，低于相关标准的规定。结论5种中成药中铅、镉、砷的含量合格。     

儿童意外误服的相关因素分析及预防

目的了解儿童意外误服的相关因素,探讨如何降低儿童意外误服的发生,为儿童营造一个健康安全的环境.方法采用回顾性调查方法对2002年8月-2003年12月期间急诊救治的86例误服儿童案例进行分析,了解儿童误服产生的原因及相关因素.结果儿童意外误服,男性发生比例高于女性,1～6岁是误服发生的高发年龄段,家长的文化程度、地区差异与儿童误服的发生都有着不可分割的联系.结论普及儿童误服的相关知识及预防措施,减少甚至避免儿童误服的发生.     

社区居民家庭药品安全管理现状调查

目的了解社区居民家庭药品安全管理现状,为社区护理服务提供依据。方法对243户居民家庭药品进行入户清查及调查,内容为居民的一般资料、居家药品管理清单、安全用药认知和安全用药行为等方面。结果 97.5%家庭有药品储备,且种类繁多;82.3%家庭药品存储不符合要求,存在内用药和外用药、成人药和儿童药混放,无包装盒或包装不完整零散存放,未按要求低温保存等安全隐患;46.8%家中有过期药品,以抗感冒药、抗菌消炎、胃肠道和清热解毒药居多;居民在安全用药认知与行为方面存在不足。结论居民家庭药品储备普遍,但存在严重安全隐患。对居民加强安全用药健康教育,提升居民正确储药和安全合理用药行为。     

Western herbal medicines in the treatment of irritable bowel syndrome: A systematic review and meta-analysis

ObjectiveTo evaluate the efficacy of Western herbal medicines in the treatment of irritable bowel syndrome (IBS).DesignA computer-based search of MEDLINE, EMBASE, CINAHL, AMED, GreenFILE, Health Source: Nursing/Academic Edition, and the Cochrane Library was conducted. A hand-search of the bibliographies of relevant papers and previous meta-analyses and reviews was also undertaken. Trials were included in the review if they were double-blind and placebo-controlled investigating the effects of Western herbal medicines on IBS-related symptoms or quality of life. There were no language restrictions. Eligibility assessment and data extraction were performed by two independent researchers. For herbal medicines where there was more than 1 trial of similar design, data were synthesised using relative risk of symptoms improving using the random effects model.ResultsThirty-three trials were identified that met all eligibility criteria. Seventeen of these evaluated peppermint essential oil, fifteen other Western herbal medicines, and one trial evaluated peppermint oil in one arm and aniseed essential oil in the other arm. Eighteen different herbal preparations were evaluated in these trials. Data suggests that a number of Western herbal medicines may provide relief of IBS symptoms. Meta-analyses suggest that peppermint essential oil is both efficacious and well-tolerated in the short-term management of IBS. Aloe vera and asafoetida also demonstrated efficacy in reducing global IBS symptoms in meta-analyses. The herbal formulas STW 5, STW 5-II and Carmint, along with Ferula assa-foetida, Pimpenella anisum oil, the combination of Curcumin and Foeniculum vulgare oil, and the blend of Schinopsis lorentzii, Aesculus hippocastanum, and peppermint essential oil also demonstrated efficacy in rigorously-designed clinical trials.ConclusionA number of Western herbal medicines show promise in the treatment of IBS. With the exception of peppermint essential oil, Aloe vera, and asafoetida, however, none of the positive trials have been replicated. This lack of replication limits the capacity to make definitive statements of efficacy for these herbal medicines.     

Hepatotoxicity evaluation of traditional Chinese medicines using a computational molecular model

Background: Liver injury caused by traditional Chinese medicines (TCMs) is reported from many countries around the world. TCM hepatotoxicity has attracted worldwide concerns.

Objective: This study aims to develop a more applicable and optimal tool to evaluate TCM hepatotoxicity.

Methods: A quantitative structure-activity relationship (QSAR) analysis was performed based on published data and U.S. Food and Drug Administration’s Liver Toxicity Knowledge Base (LTKB).

Results: Eleven herbal ingredients with proven liver toxicity in the literature were added into the dataset besides chemicals from LTKB. The finally generated QSAR model yielded a sensitivity of 83.8%, a specificity of 70.1%, and an accuracy of 80.2%. Among the externally tested 20 ingredients from TCMs, 14 hepatotoxic ingredients were all accurately identified by the QSAR model derived from the dataset containing natural hepatotoxins.

Conclusions: Adding natural hepatotoxins into the dataset makes the QSAR model more applicable for TCM hepatotoxicity assessment, which provides a right direction in the methodology study for TCM safety evaluation. The generated QSAR model has the practical value to prioritize the hepatotoxicity risk of TCM compounds. Furthermore, an open-access international specialized database on TCM hepatotoxicity should be quickly established.     

证据与基本药物:药物目录的筛选、评价和持续

1　前言在许多医院和卫生经济系统 ,药典和基本药物目录屡见不鲜。虽然其使用和有效性缺乏高质量的研究去论证 ,但这体现了资源的有效管理。反映出证据的宁缺毋滥。药典 (我将从这里开始使用这个术语 )的价值基于 :确保一套适用于所有人的基本药物 ;确保病人可随时获取所需要药物 ;确保高质量地治疗常见病。此外 ,药典便于药剂师购买药物和管理库存 ,鼓励地方生产和批发销售 ,而且能够直接培训低年资医生并指导他们处方。药典的编订很费时 ,需要一丝不苟 ,并且容易过时。药典过时后对任何人都毫无裨益 ,只能废弃。我将在本文讨论其中的一些…     

Pharmaceutical company influences on medication prescribing and their potential impact on quality use of medicines

Background: Pharmaceuticals are big business, reporting strong market growth year after year. The ‘gatekeepers’ of this market are prescribers of medicines, who are the major target of pharmaceutical companies, utilizing direct and indirect influences. Methods: This paper draws on previous research investigating pharmaceutical company prescribing influences to develop a qualitative model demonstrating the synergism between commercial influences on prescribing. The generic model was used to explore a realistic but hypothetical scenario to ascertain the applicability of the model. Results and Discussion: A generic influence model was developed. The model was readily able to be adapted to reflect a realistic practice scenario. Conclusion: Prescriber awareness of the linkages between various seemingly separate marketing techniques could potentially improve medicines usage in an evidence‐based practice paradigm.     

Use of herbal medicines: Pilot survey of UK users’ views

Increasing sales of medicinal plants as supplements or health foods continue to indicate widespread self-medication. We conducted a survey on users’ views on obtaining information on herbal medicines and their experiences and opinions about their use. Responses over one-year period (01.08.2015–31.07.2016) were analysed.157 participants took part (87% aged 45–64y, and 13% >65y). 80% participants used medicinal plants for multiple health benefits [i.e. health protection (74%), disease prevention (38%) and treatment (49%]). 95% believed in the medicinal powers of plants. Information regarding use of medicinal plants was predominantly based on books (57%), the internet (53%), friends, colleagues or neighbours (51%) and health practitioners (42%). 51% of participants felt herbs were safe (51%) with less side effects (55%) than pharmaceutical medicines. 24% of medicinal plant users informed their medical doctor, with majority of informed medical professional (47%) accepting the use of medicinal plants.This pilot survey provides new and valuable information for use in designing future more comprehensive surveys to provide essential information about the use of herbal medicines by the general population and health care providers’ attitudes in the UK.     

Herbal medicines for suppressing appetite: A systematic review of randomized clinical trials

The suppression of appetite with herbal medicines has become very popular in recent years. We conducted this systematic review to evaluate the recent scientific evidence regarding herbal medicines that are used to suppress appetite. We retrieved clinical trials from PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Scientific Information Database, and IranMedex from January 1, 2013 to April 24, 2018. English and Persian language randomized clinical trials that used herbal medicines to suppress appetite in healthy or obese or overweight individuals were included. Risk of bias was assessed using Cochrane methodology. Out of 591 articles, 22 trials with 973 participants were included. One study on the Meratrim formulation which contained the Sphaeranthus indicus flower heads extract and Garcinia mangostana fruit, revealed longer-term evidence; while 6 studies on Ilex paraguariensis, Spinacia oleracea, Phaseolus vulgaris, Secale cereale, Sorghum bicolor and Plantago showed short-term evidence for suppressing appetite. No serious adverse events were reported. Despite some methodological concerns in the included studies, there is promising evidence for suppressing appetite with herbal medicines that needs to be confirmed in long-term clinical trials with adequate sample size and higher methodological quality with more attention to safety, effective dose and side effects.     

鼻渊舒口服液与西药治疗慢性鼻窦炎的临床疗效及安全性对比分析

目的研究并对比鼻渊舒口服液与西药治疗慢性鼻窦炎的临床疗效及安全性。方法 2013年1~12月该院门诊就诊的慢性鼻窦炎患者共186例。以数字法随机分成观察组(93例)和对照组(93例)。观察组患者使用鼻渊舒口服液进行治疗;对照组患者则使用西药进行治疗。对两组患者进行为期40d的治疗后,通过患者的治疗效果、用药后并发症以及治疗后的复发情况来比较两组患者的治疗情况。结果通过40d的治疗后发现观察组和对照组的临床疗效都比较好,两组的治疗效果差异无统计学意义(P0.05)。在治疗中因为用药导致全身多个系统出现并发症,观察组的总并发症发生率为4.3%,对照组30.11%,两组恶心呕吐、头晕目眩、全身乏力及总并发症发生率差异均有统计学意义(均P0.05)。在治疗结束后两组患者均出现不同程度上的病情复发,观察组有8例(8.60%)患者出现复发,而对照组中则有32例(34.41%)患者出现复发,两组复发率差异有统计学意义(P0.05)。结论使用鼻渊舒口服液对慢性鼻窦炎进行治疗后发现治疗结果良好,并发症少,值得在临床上广泛推广。     

Indian herbal medicines: possible potent therapeutic agents for rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease of unknown etiology and is mainly characterized by the progressive erosion of cartilage leading to chronic polyarthritis and joint distortion. Although the exact pathogenesis of the disease has yet not been elucidated, however, studies suggest that cellular proliferation of synoviocytes result in pannus formation which damages the cartilage and bone. Recent reports also support the role of free radicals in its pathogenesis. Apart from the conventional treatment strategies using nonsteroidal anti-inflammatory drugs, disease modifying antirheumatic drugs and glucocorticoids, newer and safer drugs are continuously being searched, as long term usage of these drugs have resulted in adverse effects. Alternative medicine provides another approach for treatment of RA and currently a number of medicinal plants are under scientific evaluation to develop a novel drug. There is a dire need to investigate the complete therapeutic potential and adverse effects, if any, of these herbals for providing newer and safer treatment options with minimum side effects. In this review we have tried to explore various Indian ancient Ayurvedic, Unani and Tibbi, as also some Chinese and Korean, herbals for their potential to treat RA.     

献血者服用中药后延期献血期限设定的探讨

目的　探讨服用过中药的献血者须延期献血的时间。方法　采用药动学方法。有致敏、致畸作用的药物推迟时间从最后一次服药算起为tmax+2 0×t1 / 2 ,无致敏、致畸作用的药物为tmax+7×t1 / 2 。有其它特殊药理作用的药物根据具体情况而定。结果　探讨了 2 2种中药、中成药的安全间隔时间。结论　服用过中药的献血者一般应推迟献血的时间 ,从而有效排除中药对血液质量的影响     

Herbal medicines in children with attention deficit hyperactivity disorder (ADHD): A systematic review

ObjectiveThe purpose of this review is to identify evidence in herbal therapy in the treatment of ADHD concerning effectiveness and drug tolerability.MethodFor this Medline/PubMed, Scopus and the Cochrane Central Register of Controlled Trials (Central) were searched from their inception to 15 July 2016. Only randomized controlled trails (RCT) with children (0–18 years) suffering from ADHD were included in this review.ResultsNine RCTs with 464 patients comparing herbal pharmaceuticals to placebo or active control were included. Seven different herbs were tested in the treatment of ADHD symptoms. Low evidence could be found for Melissa officinalis, Valeriana officinalis and Passiflora incarnata. Limited evidence could be found for pine bark extract and Gingko biloba. The other herbal preparations showed no efficacy in the treatment of ADHD symptoms.ConclusionWhile there is still a lack of sufficient numbers of RCTs no concrete recommendations for use can be made so far.     

In vitro inhibitory effects of Kampo medicines on metabolic reactions catalyzed by human liver microsomes

BACKGROUND: Although it is well known that drug-drug interactions may lead to toxicity and therapeutic failure, little is known about the incidence and consequences of herb-drug interactions in patients receiving Kampo medicines. METHODS: We evaluated the frequency of the combined use of Kampo medicines and Western drugs at Osaka University Hospital, and investigated the effects of these formulae on the metabolic activity of different cytochrome P450 (CYP) isoforms using pooled microsomes obtained from human liver. RESULTS: Twenty-two Kampo formulae were used together with 40 Western drugs catalyzed by the CYP isoforms CYP3A4, CYP2C9, CYP2D6 and CYP1A2. Among the Kampo medicines, HOCHUEKKI-TO, SHOSAIKO-TO, NINJINYOUEI-TO, SAIREI-TO and KAKKON-TO were most frequently used during the study period (1996-2000). These were co-administered with 11 categories of drugs, which are substrates for CYP3A4. HOCHUEKKI-TO and SAIREI-TO were competitive inhibitors of CYP3A4 with Ki values of 0.65 and 0.1 mg/mL, respectively. HOCHUEKKI-TO, SHOSAIKO-TO and SAIREI-TO inhibited the metabolic activities of CYP2C9, but had no effect on CYP2D6. HOCHUEKKI-TO and SAIREI-TO exhibited non-competitive inhibition of the metabolic activity of CYP2C9 with a similar Ki value (0.7-0.8 mg/mL). SAIRE-TO (0.25 mg/mL) was a potent inhibitor of CYP1A2 (inhibition > 68%). CONCLUSIONS: Frequently used Kampo medicines may interact with Western drugs, which are substrates for CYP3A4, CYP2C9 and CYP1A2. Their co-administration should be undertaken with care.