Introduction: the combination of traditional Chinese and western medicine embodies the combination of traditional Chinese and western medicine, but it is not the mechanical addition of drug effects and the simple superposition of drug flavors. Let me talk about the combination of traditional Chinese and western medicine. Welcome to read!
[Abstract] According to herbal literature, the integration of traditional Chinese and western medicine began in the early 20th century. In recent years, with the development of medicine, there are more and more kinds of drugs. At the same time, due to the combination of traditional Chinese and western medicine, in order to speed up the cure of diseases, the combination of traditional Chinese and western medicine has been widely used in clinic. This paper analyzes the reasonable and unreasonable phenomena of integrated traditional Chinese and western medicine in clinic.
[Paper Keywords] rational combination of Chinese and Western medicine: synergy; Reduce toxic and side effects; Reduce dosage and shorten the course of treatment; Immune regulation. Unreasonable combination of traditional Chinese and western medicine: reducing curative effect; Produce or increase toxic and side effects
1 Reasonable combination of traditional Chinese and western medicine
The synergistic effect of 1. 1 Glycyrrhiza uralensis Fisch and hydrocortisone are used for anti-inflammatory and anti-allergic. Because glycyrrhizin has glucocorticoid-like effect, it can inhibit the metabolic inactivation of hydrocortisone in the body, increase its concentration in the blood, and thus enhance the curative effect. The reason why Fructus Aurantii Immaturus is combined with gentamicin is that Fructus Aurantii Immaturus can relax the sphincter of biliary tract, which is beneficial for gentamicin to enter the biliary tract and enhance its anti-infection effect. The reason why Herba Artemisiae Scopariae and the compound containing Herba Artemisiae Scopariae are used together with griseofulvin is that the hydroxyl phenylbutanone contained in Herba Artemisiae Scopariae can promote the secretion of bile, and bile can increase the solubility and absorption of griseofulvin, thus enhancing the antibacterial effect of griseofulvin.
1.2 Reducing toxic and side effects The combination of Shaoyao Gancao Decoction and antispasmodic drugs can not only improve the curative effect, but also eliminate side effects such as abdominal distension and constipation. Coptidis Rhizoma, Cortex Phellodendri and other traditional Chinese medicines with strong antibacterial properties can be combined with antibiotics to reduce the adverse reactions of antibiotics. The combination of Rhizoma Polygonati, Rhizoma Drynariae, Radix Glycyrrhizae and streptomycin can eliminate or alleviate adverse reactions such as tinnitus and deafness caused by streptomycin. Xiaoyao powder has the function of protecting liver, and can reduce the damage of western anti-tuberculosis drugs to the liver when combined with western anti-tuberculosis drugs. When traditional Chinese medicine containing ephedra is used to treat asthma, the central nervous system is often excited by ephedrine. If combined with barbiturate western medicine, this side effect can be alleviated.
1.3. 1 Reduce the dosage and shorten the course of treatment. For patients with shock or hypotension, if the blood pressure cannot be maintained after the application of antihypertensive drugs such as dopamine and alamin, the blood pressure will be stable after the addition of Shenfu injection. When blood pressure rises, blood pressure will drop again if antihypertensive drugs are stopped or reduced. If Shenfu injection is used in advance, blood pressure can be maintained and stabilized even if antihypertensive drugs are stopped or reduced. Because Shenfu injection is combined with alamin and dopamine, modern pharmacological research proves that Ginseng Radix Rubri and Radix Aconiti Lateralis Preparata in Shenfu injection (composed of Ginseng Radix Rubri, Radix Aconiti Lateralis Preparata and Radix Salviae Miltiorrhizae) have cardiotonic, analgesic and adrenocortical stimulation effects, and Radix Salviae Miltiorrhizae can dilate coronary artery, increase coronary blood flow and enhance cardiac contraction function. It can be seen that Shenfu injection combined with antihypertensive drugs such as alamin and dopamine can strengthen the effect of antihypertensive drugs, reduce the dosage of antihypertensive drugs and shorten the course of treatment.
1.3.2 Guizhi decoction and ginseng prescription combined with corticosteroid western medicine can reduce the dosage and side effects of western medicine.
1.3.3 The combination of traditional Chinese medicine compound with antiepileptic effect such as Chaihu Guizhi decoction and western antiepileptic drugs can reduce the dosage of antiepileptic drugs and side effects such as liver damage and drowsiness.
1.4 immunomodulation
1.4. 1 Xiaoyan 6 is used with antibiotics. It is reported that the combination of penicillin, streptomycin and chloramphenicol has obvious inhibitory effect on the random movement of neutrophils. Streptomycin and chloramphenicol alone can obviously inhibit the chemotaxis of neutrophils. If penicillin, streptomycin and chloramphenicol are used together, this inhibition effect is more obvious, and the inhibition rate can reach 35.4%. Anti-inflammatory No.6 (composed of Flos Lonicerae, Herba Taraxaci, Folium Isatidis and Herba Houttuyniae) can not only promote the voluntary movement and chemotaxis of neutrophils stably and persistently, but also completely relieve the inhibition of voluntary movement and chemotaxis when the above three antibiotics are used together, so that the chemotaxis far exceeds the normal value. It is suggested that traditional Chinese medicine for clearing away heat and toxic materials is not only simple sterilization or bacteriostasis, but also of great significance to improve the immunity of the body. Anti-inflammatory No.6 can not only directly relieve bacterial endotoxin, but also activate complement bypass pathway and indirectly degrade endotoxin. Therefore, Anti-inflammatory No.6 has the functions of sterilization, bacteriostasis, enhancing immune function and degrading endotoxin, which may be the theoretical basis for enhancing the curative effect of combined use with antibiotics in the treatment of infectious diseases.
1.4.2 Traditional Chinese medicines for strengthening body resistance such as Ligustrum lucidum, Pyrrosia, Psoralea corylifolia, Cornus officinalis and Scrophularia can protect animals from leukopenia caused by cyclophosphamide injection and improve their immunity. According to statistics, among 175 tumor patients, 156 patients did not have leukopenia during radiotherapy and chemotherapy combined with Fuzheng drugs, and the effective rate was close to 90%. 1.4.3 The combination of Shiquan Dabu decoction, Buzhong Yiqi decoction and Xiaochaihu decoction with western medicine anti-tumor drugs can improve the curative effect. Among them, traditional Chinese medicine can improve the activity of natural killer cells and improve the immunity of the body.
2 the combination of traditional Chinese and western medicine is unreasonable
2. 1 reduce the curative effect.
2. 1. 1 tolbutamide, Jiangtangling and other antagonistic hypoglycemic drugs, if combined with licorice, velvet antler and their preparations, can reduce the role of hypoglycemic drugs. Because glycyrrhizic acid can be hydrolyzed into glycyrrhetinic acid and glucuronic acid after oral administration, glycyrrhetinic acid has the structure of adrenocorticoid; The composition of velvet antler also has glucocorticoid-like structure. Glucocorticoid can transfer amino acids and protein from skeletal muscle to liver. Because of the increase of glucose and glycogen produced by enzyme, it has the function of raising blood sugar, and has pharmacological antagonism to hypoglycemic drugs, which reduces the hypoglycemic effect.
Preparations containing Herba Ephedrae, such as Maxingshi Dried Tablets, Zhike Dingchuan Ointment, Chuanjing Tablets, Fangfeng Tongsheng Powder, etc. Used for relieving cough, resolving phlegm and relieving asthma. Ephedra is an adrenergic drug, mainly composed of ephedrine, which can constrict blood vessels and raise blood pressure. These drugs have pharmacological antagonism with antihypertensive drugs, thus reducing the antihypertensive effect.
2. 1.2 forms insoluble matter, which affects absorption and reduces curative effect. Danshen injection should not be combined with quinolones injection [1]. Danshen injection is a compound traditional Chinese medicine injection made of Danshen and Dalbergia odorifera. Its main components are water-soluble danshensu, protocatechuic acid and Dalbergia odorifera volatile oil [2]. Danshensu and protocatechuic acid are weakly acidic, soluble in alkali, but precipitated in acid. Adding quinolone injection (ph value is about 4. 1) to Danshen injection can reduce the ph value of Danshen injection and precipitate its fat-soluble tanshinone, water-soluble protocatechuic acid and catechol derivatives. Zhang Yuying reported [3] adding ciprofloxacin into Danshen injection can lead to precipitation and flaky precipitation. Similarly, salvia miltiorrhiza injection combined with propranolol injection, vitamin B 1 injection, vitamin B6 injection, vitamin C injection, kanamycin sulfate injection, gentamycin sulfate injection and metoclopramide injection can also produce precipitation.
2.2 Produce or increase toxic and side effects
2.2. 1 Rauvolfia and traditional Chinese medicines containing alkaloids such as Herba Ephedrae, Maxingshi Dry Decoction, Jiusan, Dahuoluo Pill, Ginseng Zaizao Pill, Asthma Granule, etc. Not suitable for compatibility with glibenclamide, phenelzine and furazolidone. You Jiangning inhibits monoamine oxidase to inactivate the' transmitter' stored in adrenergic nerve endings, significantly enhances the pressor effect of ephedrine in ephedra and its preparations, which may lead to hypertensive crisis and cerebral hemorrhage [4].
2.2.2 Ephedrine-containing traditional Chinese medicines and their preparations, such as Compound Fritillaria Bulbus Fritillariae Cirrhosae Tablets, Laiyang Pear Cough Syrup, Compound Loquat Syrup, Zhike Dingchuan Ointment, Banxia Dew, etc. , should not be combined with cardiotonic. Ephedrine can excite myocardium? Receptors, strengthen myocardial contractility, so it can enhance the effect of cardiotonic drugs such as digitalis and digoxin, increase toxicity, and easily lead to adverse reactions such as arrhythmia and heart failure [5]. Traditional Chinese medicines and preparations containing scopolamine alkaloids, such as Datura stramonium, Datura flower, fairy, belladonna mixture, etc. , not suitable for compatibility with cardiac glycoside. Scopolamine alkaloids can relax smooth muscle, slow gastrointestinal peristalsis, and increase the absorption and accumulation of cardiac glycosides. In addition, patients with heart failure are sensitive to cardiac glycosides and prone to toxic reactions [6, 7].
2.2.3 Traditional Chinese medicines containing calcium ions, such as gypsum, keel and concha arcae. It is not suitable to be combined with cardiac glycoside, because cardiac glycoside releases calcium ions through myocardium when it acts, and Chinese medicine containing a lot of calcium ions will enhance the action and toxicity of cardiac glycoside, especially digitalis glycoside. The compatibility of compound licorice tablets with cardiac glycoside can easily lead to heart allergy to cardiac glycoside and cause poisoning [8].
To sum up, the combination of traditional Chinese and western medicine embodies the combination of traditional Chinese and western medicine, but it is not a mechanical addition of curative effects, nor a simple overlap of medicines and flavors. On the basis of modern medicine and related theories, clinicians should reasonably combine Chinese and western medicine through clinical medication practice according to the main components, physical and chemical properties, pharmacological effects, adverse reactions and individual differences of drugs, so as to produce synergy and increase curative effect; Reduce toxic and side effects; Reduce dosage and shorten the course of treatment; Improve the immunity of the body, promote the recovery of the body, really play an ideal synergistic role, and improve the clinical treatment effect. Avoid the unreasonable combination of Chinese and western medicine, which leads to antagonism, reduced curative effect and increased toxic and side effects. In the case of unknown compatibility pharmacology, it is suggested that Chinese and western medicines should be used at intervals to avoid unreasonable compatibility. To achieve safe, effective and rational drug use, thus improving the survival rate and quality of life of patients.
refer to
Li, Chen. Contraindications between Compound Danshen Injection and Quinolones Injection [J]. Journal of Guangdong Pharmaceutical University, 200 1, 17 (2): 120.
[2] edited by Zhao Xinxian. Traditional Chinese medicine injection [M]. Beijing: People's Health Publishing House, 1998: 286.
[3] Zhang Yuying. Contraindications of compatibility between Danshen injection and ciprofloxacin injection [J]. journal of traditional chinese medicine, Yunnan, 200 1, 22 (5): 28.
[4] Liu Anning. A Brief Analysis of the Reasonable Compatibility and Compatibility Taboos of Chinese and Western Medicine [J]. Journal of Pharmaceutical Practice, 1997, 15 (5): 28 1.
[5], Lei Jianlin, Cheng, Contraindications and Clinical Analysis of Compatibility of Chinese and Western Drugs [J]. Journal of Shaanxi College of Traditional Chinese Medicine, 2000,23 (4): 58.
[6] Liu Anning. On the rational compatibility and incompatibility of Chinese and western medicines [J]. Journal of Pharmaceutical Practice, 1997, 15 (5): 28 1.
Jia Gongfu, Xie Huimin. Interaction between Chinese and western medicine and combined medication [M]. Changsha: Hunan Science and Technology Press, 1987: 73.
[8] Liu Anning. On the rational compatibility and incompatibility of Chinese and western medicines [J]. Journal of Pharmaceutical Practice, 1997, 15 (5): 28 1.
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