淺談中藥用藥安全及中、西藥交互作用

The Concepts of Traditional Chinese Medicine and Its Interactions with Western Medicine in Combined Treatment

吳孟霖(Meng-Lin Wu) ； 黃書澐(Shu-Yun Huang) ； 陳俞沛(Yu-Pei Chen)

《台灣老年醫學暨老年學雜誌》 11卷1期 (2016/02) Pp. 1-15

https://doi.org/10.29461/TGG.201602_11(1).0001

摘要

現代醫學昌明，西醫治療雖為醫學之主流，但民眾對替代及輔助醫學仍有相當程度的需求。替代醫療種類多樣，華人社會以傳統中醫藥為主，在台灣中西醫醫療體系雙軌並行，中醫藥使用者大多同時併用西藥治療，在此背景之下，民眾極可能在無明確醫囑之下，同時服用中藥及西藥，而老年人用藥相對複雜，對醫囑的了解及遵從度亦較差，更可能因為不當用藥習慣而造成身體的傷害。本文先由傳統中醫藥角度切入，闡明中醫用藥思路，包括中藥的「分類」、「配伍」及「藥即是毒」的觀念，並分享在藥食同源的歷史背景下，中醫藥與食療的界線與管理；最後根據現代研究成果，討論民眾常用中藥與西藥之交互作用及其應注意事項，特別針對抗凝血藥物、麻黃鹼類藥物、statin類藥物及可能影響鉀離子濃度之中藥，羅列曾發生過的案例及研究，並探討造成中、西藥交互作用的可能機轉。期盼透過提升對中、西藥交互作用的警覺性與瞭解，避免或減少臨床上不良反應的發生，增進民眾用藥安全。

關鍵字

中藥 ； 用藥安全 ； 中西藥交互作用

並列摘要

With modern medical advancements, in spite of the fact that Western medicine remains the mainstream in global medical care, there continues to be a considerable demand for alternative and complementary medicine (CAM), and traditional Chinese medicine is the leading type of CAM in Chinese communities worldwide, especially in Taiwan, where many patients taking Western medicine are simultaneously using Chinese medicine, thus forming a two-track, parallel medical care system. However, many patients may be receiving the combined treatment of traditional Chinese and Western medicine without clear medical advice. This in particular can pose serious health problems to elderly patients who usually require more complicated medication and show a lower degree of understanding and compliance with doctors’ medical advice. In this paper, we first clarify treatment based on Chinese medicine by discussing its major concepts, including ＂classification＂, ＂compatibility＂ and the idea that ＂the dose makes the poison,＂ and proceed the delineate the boundary between Chinese medicine and diet therapy and their management in the historical background concerning the homology of medicine and food. Finally, according to the results of modern researches, we offer necessary precautions by examining the interactions between commonly used Chinese medicine and Western medicine with a focus on anti-coagulant agents, ephedrine species, statin-based medicine and the traditional Chinese medicine which might change the concentration of potassium ion. By reviewing related published studies, we hope to identify the causes and mechanisms that may affect medicine interactions. Sufficient awareness and understanding of the Chinese-Western medicine interactions is crucial for avoiding or reducing the incidence of clinical adverse reactions and for ensuring safe medication.

並列關鍵字

traditional Chinese medicine ； drug interactions ； safety medication