Toxicity of Chinese Herbal Medicine and drug-herb Interactions

中藥毒性及中藥與西藥之交互作用

賴永昌(Yung-Chang Lai) ； 陳玉蘭(Yu-Lan Chen) ； 賴婕瑄(Jie-Shiuan Lai)

《中山醫學雜誌》 18卷2期 (2007/12) Pp. 343-357

https://doi.org/10.30096/CSMJ.200712.0015

摘要

許多醫學報導指出合併使用某些中藥及西藥可能對人體產生危害。這些報導引起世人對中藥、草藥與西藥合併使用的安全性疑慮。雖然多數人認為中藥或西方草藥的藥性溫和不會產生副作用，但臨床證據顯示它們仍可能引起不良反應。因此醫學相關人員都應具備常用中藥之毒性相關知識，並了解草藥及西藥之間可能產生的交互作用。
一般來說中藥的毒性可分為兩部份討論：中藥本身的毒性及藥物間的交互作用。調配或處理有毒中藥時，醫學相關人員必須特別注意藥物的屬性、致死劑量、常用劑量、毒性強度及其炮製方法。舉例來說，當醫師處方附子、天南星、蟾酥、半夏、馬錢子或巴豆等毒劇藥時，應特別注意給藥劑量、藥物煎煮時間及方法，以及配伍禁忌等因素。另外還必須了解病患正服用哪些藥品，以免產生交互作用而發生危險。
本篇文章探討中藥毒性的基本概念、常見有毒中藥的炮製方法、草藥及西藥的交互作用，以及醫師處方藥草時之注意事項。希望能對讀者有所助益。

關鍵字

毒性 ； 中藥 ； 交互作用 ； 中藥與西藥之交互作用

並列摘要

According to some clinical reports, simultaneous administrations of particular herbs and modern medications might lead to severe damages to patients' health. Those publications have attracted the public's attention toward the safety of Chinese herbal medicines and the combinations of herbs and modern drugs. Even though most of the public believe Chinese herbal medicines or western herbal remedies are not associated with side effects, but the fact shows herbs could be toxic or interact with other medications. Hence, it is necessary for doctors, pharmacists, and other medical experts to understand the toxicity of commonly used herbs and drugs, and interactions among them.
In general, toxicity of Chinese medicine herbs can be discussed in two parts: toxicity originates from existing toxins in raw herbs, and adverse effects result from the combinations of herbs. From the aspect of handling raw herbs, medical professionals should know the property, lethal dose, usual dose, degree of potency, and preparations of toxic herbs. For example, one need to concern about the dose, methods of preparation, and compatibility of combinations when dispensing strong toxic herbs, such as Aconiti Tuber, Arisaematis Rhizoma, Bufonis Venenum, Pinelliae Tuber, Strychni Semen, Tiglii Semen, etc. Meanwhile, the medical professionals also need to consult patients with their current medications so as to avoid possible drug interactions. Similar concepts should be applied when co-administrate herbs, drugs, food, or nutrient supplements.
In order to assist in revealing the knowledge of toxicity of Chinese herbal medicine, and mechanisms of drug-herb interactions, we undertook a reviewed research on the general idea of toxicity of the Chinese herbal medicine, the basic concept regarding the processes how to reduce the toxicity of some commonly used Chinese medicine herbs, discussion on the evidence-based drug-herb and herb-food interactions, and the cautions clinical practitioners might need to concern. Hoping this article might contribute valuable ideas to the readers.

並列關鍵字

Toxicity ； Chinese herbal medicine ； interactions ； drug-herb interactions