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迄今为止,几种临床上重要的药物已被鉴定与常用的草药相互作用。这些药物包括华法林、咪达唑仑、地高辛、阿米替林、茚地那韦、环孢素A、他克莫司、伊立替康。重要的是这些药物大多治疗指数极窄,大部分是细胞色素P450(CYP)和(或)P糖-蛋白(P-gp)的底物。由于药物-草药相互作用能显著地影响药物的循环浓度,改变临床结果,因此与常用的草药相互作用的药物的鉴定在药物开发中具重要的意义。计算机模拟、体外、动物和人体研究经常用于鉴定药物和草药的相互作用。建议将药物-草药和草药-CYP相互作用研究纳入药物开发中。
To date, several clinically important drugs have been identified that interact with commonly used herbs. These drugs include warfarin, midazolam, digoxin, amitriptyline, indinavir, cyclosporin A, tacrolimus, and irinotecan. Importantly, most of these drugs have very narrow therapeutic indices and are mostly substrates for cytochrome P450 (CYP) and / or P-glycoprotein (P-gp). Since drug-herb interactions can significantly affect the circulating concentrations of drugs and alter clinical outcomes, the identification of drugs that interact with commonly used herbs is of great importance in drug development. Computer simulations, in vitro, animal and human studies are often used to identify drug and herbal interactions. Proposed drug-herb and herbal-CYP interaction studies into drug development.