Evidence-based toxicity evaluation and scheduling of Chinese herbal medicines

被引:67
作者
Kim, Ellie J. Y. [1 ]
Chen, Yuling [1 ]
Huang, Johnson Q. [1 ]
Li, Kong M. [2 ]
Razmovski-Naumovski, Valentina [1 ,3 ]
Poon, Josiah [4 ]
Chan, Kelvin [1 ,3 ]
Roufogalis, Basil D. [1 ]
McLachlan, Andrew J. [1 ]
Mo, Sui-Lin [5 ]
Yang, Depo [6 ]
Yao, Meicun [6 ]
Liu, Zhaolan [1 ,7 ]
Liu, Jianping [7 ]
Li, George Q. [1 ]
机构
[1] Univ Sydney, Fac Pharm, Sydney, NSW 2006, Australia
[2] Univ Sydney, Bosch Inst, Discipline Pharmacol, Sydney, NSW 2006, Australia
[3] Univ Western Sydney, Ctr Complementary Med Res, Sydney, NSW 2560, Australia
[4] Univ Sydney, Sch Informat Technol, Sydney, NSW 2006, Australia
[5] Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou 510080, Guangdong, Peoples R China
[6] Sun Yat Sen Univ, Sch Pharmaceut Sci, Guangzhou 510080, Guangdong, Peoples R China
[7] Beijing Univ Chinese Med, Ctr Evidence Based Chinese Med, Beijing 100029, Peoples R China
关键词
Evaluation criteria; Toxicity; Scheduling; Chinese herbal medicines; Aristolochia; Aconite; BODY-WEIGHT REDUCTION; CHRONIC-RENAL-FAILURE; ARISTOLOCHIC-ACID-I; MA-HUANG EPHEDRA; DIETARY-SUPPLEMENTS; INTERSTITIAL FIBROSIS; HONG-KONG; PYRROLIZIDINE ALKALOIDS; ALTERNATIVE MEDICINE; MYOCARDIAL NECROSIS;
D O I
10.1016/j.jep.2012.12.027
中图分类号
Q94 [植物学];
学科分类号
071001 ;
摘要
Ethnopharmacological relevance: While there is an increasing number of toxicity report cases and toxicological studies on Chinese herbal medicines, the guidelines for toxicity evaluation and scheduling of Chinese herbal medicines are lacking. Aim: The aim of this study was to review the current literature on potentially toxic Chinese herbal medicines, and to develop a scheduling platform which will inform an evidence-based regulatory framework for these medicines in the community. Materials and methods: The Australian and Chinese regulations were used as a starting point to compile a list of potentially toxic herbs. Systematic literature searches of botanical and pharmaceutical Latin name, English and Chinese names and suspected toxic chemicals were conducted on Medline, PubMed and Chinese CNKI databases. Results: Seventy-four Chinese herbal medicines were identified and five of them were selected for detailed study. Preclinical and clinical data were summarised at six levels. Based on the evaluation criteria, which included risk-benefit analysis, severity of toxic effects and clinical and preclinical data, four regulatory classes were proposed: Prohibited for medicinal usage, which are those with high toxicity and can lead to injury or death, e.g., aristolochia; Restricted for medicinal usage, e.g., aconite, asarum, and ephedra; Required warning label, e.g., coltsfoot; and Over-the-counter herbs for those herbs with a safe toxicity profile. Conclusion: Chinese herbal medicines should be scheduled based on a set of evaluation criteria, to ensure their safe use and to satisfy the need for access to the herbs. The current Chinese and Australian regulation of Chinese herbal medicines should be updated to restrict the access of some potentially toxic herbs to Chinese medicine practitioners who are qualified through registration. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:40 / 61
页数:22
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