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Potential Medication Risk Analysis of Chinese Patent Medicine in the Treatment of Stable Chronic
Obstructive Pulmonary Disease
ZHENG Chunxia，ZHENG Xiaoying，KONG Lingxi，QIU Feng，SHAN Xuefeng（Dept. of Pharmacy，the First
Affiliated Hospital of Chongqing Medical University，Chongqing 400016，China）

ABSTRACT OBJECTIVE：To study the potential risk of Chinese patent medicine for the treatment of stable chronic obstructive
pulmonary disease（COPD），and to provide reference for the safety of clinical drug use. METHODS：Retrieved from Chinese
journal full-text database，CBM，Wanfang database and VIP，using“stable”“Chronic obstructive pulmonary disease”“COPD”
“Chinese patent medicine”as retrieval words，relative literatures about Chinese patent medicine in the treatment of stable COPD
were retrieved，and retrieval time limitation was from their establishment to Sept. 2019. The type and components of Chinese patent
medicine were collected. The potential risk of Chinese patent medicine was analyzed in terms of the contraindications of traditional
Chinese medicines，the interaction between traditional Chinese medicines and chemical medicines，and its effects on stable COPD
with other common chronic diseases. RESULTS：Eleven related studies covering 29 kinds of Chinese patent medicines for the
treatment of stable COPD were included in this study. There were several incompatibility between two Chinese patent medicines
containing Aconitum carmichaelii and eleven Chinese patent medicines containing“Pinellia ternata，Trichosanthes kirilowii，
Bolbostemma paniculatum，Ampelopsis japonica，Bletilla striata”as an ancient rule of traditional Chinese medicine incompatibility
“Eighteen antagonisms”and“Nineteen mutual”inhibitors. Meanwhile，it should be avoided that four Chinese patent medicines
containing ephedra combined with β 2 receptor agonists or theophylline. Moreover，oral antibiotics and 14 kinds of Chinese patent
medicine containing licorice would reduce the curative effect. In addition，patients with stable COPD who also had hypertension，
hyperlipidemia or diabetes should be careful to use Chinese patent medicines containing ingredients such as Glycyrrhiza uralensis，
A. carmichaelii，Ephedra sinica，Citrus aurantium，Cornus officinalis，Fritillaria cirrhosa，Panax ginseng（Panax notoginseng）.
CONCLUSIONS：There are many potential risks（such as combined use，compatibility）in the use of Chinese patent medicines for
stable COPD. It is suggested to comprehensively evaluate the patient’s previous medical history and medication before using
Chinese patent medicines，so as to provide scientific guide for clinical rational medication.
KEYWORDS Stable chronic obstructive pulmonary disease；Chinese patent medicine；Drug combination；Incompatibility；
Medication risk

慢性阻塞性肺疾病（Chronic obstructive pulmonary 合理用药、保障患者用药安全提供参考。
disease，COPD），简称慢阻肺，是一种以持续气流受限为 1 资料与方法
特征的呼吸系统常见性疾病，气流受限多呈进行性发 1.1 检索稳定期COPD治疗用中成药种类
展，与气道和肺对有毒颗粒或气体的慢性炎症反应增强 对中国期刊全文数据库、中国生物医学文献数据
[1]
有关 。由于COPD急性加重期频发的患者肺功能下降 库、万方数据库和维普网等中文数据库进行检索，以“稳
程度明显高于非频发急性加重患者，且急性加重越频 定期”“慢性阻塞性肺疾病”“COPD”“中成药”为检索词，
发，再次急性加重和病死风险也越高。因此，以减少 采用全文检索法，检索时限为各库建库起至 2019 年 9
COPD 急性加重发病为目标，对 COPD 稳定期患者进行 月。纳入标准为稳定期COPD治疗用中成药，排除急性
[2]
干预的治疗方案愈发受到临床重视 。《慢性阻塞性肺疾 期 COPD 治疗用中成药以及治疗稳定期 COPD 的医院
[3]
病中医诊疗指南（2011版）》 中指出，采用中医药或中西 自制制剂和中药方剂。
医联合治疗稳定期 COPD 具有明显疗效，在改善症状、 1.2 查找稳定期COPD治疗用中成药成分
减少急性加重次数、提高生活质量等方面的疗效均优于 通过丁香园用药助手、中国医药信息查询平台查找
单纯西医治疗。但中成药成分复杂，中成药与中成药之 此类中成药说明书，明确其组方成分。对于同一药品多
间、中成药与化学药之间均可能存在联合用药风险（比 个生产厂家的情况，对所有厂家的中成药说明书进行查
如中成药与中成药联用可能出现“十八反”“十九畏”的 找、对比分析。
配伍禁忌），同时中成药对稳定期 COPD 患者的常见并 1.3 分析稳定期COPD治疗用中成药的中药药理作用
发症也会产生潜在的用药风险。因此，本研究采用文献 对所有稳定期 COPD 治疗用中成药进行“十八反”
检索的方法，拟对稳定期COPD治疗用中成药的种类及 “十九畏”的配伍禁忌分析。并对其成分进行中药药理
成分进行统计，分析其潜在用药风险以及对合并其他常 分析，整理出可增加稳定期COPD治疗用化学药风险的
见慢病用药的影响，旨在为指导稳定期COPD治疗临床 中成药，分析中成药与化学药之间存在怎样的用药风

·842 · China Pharmacy 2020 Vol. 31 No. 7 中国药房 2020年第31卷第7期