As the smallest combination unit of Chinese medicinals， herbal pairs serve as the bridge between medicinals and formulas， whose combination theory reflects the basic characteristics of Chinese medicinals combination and the core essence of prescription composition. Simultaneously， as a key combination of medicinals in clinical treatment of diseases， syndromes， and symptoms， herbal pairs are the main form of clinical medication in traditional Chinese medicine （TCM） as well as the characteristic advantage of treating diseases. This article summarized that “mutual complement of medicinals of same or antagonism flavor and nature” theory is the theoretical origin， and efficacy-enhancement and toxicity-attenuation is the core purpose of the combination of herbal pairs. The property theory of Chinese medicinals and the thought of differentiation and treatment are the main basis of the combination of herbal pairs， and pertinence and flexibility are the key points in clinical application. All mentioned above are expected to provide theoretical guidance for the clinical use and modern research of herbal pairs.
Herb-Drug Interactions

Animals ; Anticarcinogenic Agents ; pharmacology ; Cytochrome P-450 Enzyme System ; drug effects ; genetics ; metabolism ; Food-Drug Interactions ; Gene Expression Regulation, Enzymologic ; Herb-Drug Interactions ; Humans ; Plant Preparations ; pharmacology

In the past century, as medical research has become increasingly precise, it has become clear that the incidence and progression of many diseases involve multiple factors and pathologies; this is particularly true for the degenerative and metabolic diseases facing industrialized societies. At the same time, it becomes increasingly clear that single-target action drugs cannot effectively treat these diseases. Researchers are looking toward the chemical industry as well as traditional herbal medicines to find multi-target interventions. Thus, a new era in drug discovery has begun. Specifically, three approaches have proven effective in seeking multi-target drugs. These are: (1) designing drugs with multiple components; (2) discovering drugs through the study of synergistic compound-compound interactions in medicinal herbs or among chemical drugs and herbal components; and (3) developing drugs to tackle complex multi-component diseases. The authors conclude that there is an increasing need for multi-component remedies to treat the complex chronic diseases afflicting modern populations. Given this situation and the growing body of evidence that these new approaches are effective, multi-target intervention appears to have great potential for discovering, designing, and developing effective new drugs for today's diseases.
Drug Design ; Drug Discovery ; trends ; Drug Synergism ; Herb-Drug Interactions ; Humans ; Molecular Targeted Therapy ; trends ; Plants, Medicinal

In order to prove safety and efficacy, herbal medicines must undergo the rigorous scientific researches such as pharmacokinetic and bioavailability, before they are put on the market in the foreign countries. Botanical Drug Products promulgated by the US FDA could guide industry sponsors to develop herbal drugs, which was also an important reference for investigating Chinese herbal medicines. This paper reviews and discusses novel approaches for how to assess systemic exposure and pharmacokinetic of Chinese herbal medicines, which were in line with FDA guidance. This mainly focus on identifying pharmacokinetic markers of botanical products, integral pharmacokinetic study of multiple components, Biopharmaceutics drug disposition classification system, and population pharmacokinetic-pharmacodynamic study in herb-drug interaction.
Animals ; Biomarkers, Pharmacological ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Herb-Drug Interactions ; Herbal Medicine ; legislation & jurisprudence ; Humans

The necessity of establishing an evaluation system about the combination program of Chinese medical pharmacy and Western medical pharmacy was addressed in this paper. Besides, its contents were systematically clarified. Besides, existent problems and its future development trend were also explained. The author believed that it was necessary to perform researches on constructing the evaluation system on the basis of patients' needs and physicians' responsibilities. The ultimate goal of this system was to produce an optimal combination program of Chinese medical pharmacy and Western medical pharmacy for a specific disease. This optimal program was the results of comparing and analyzing the therapeutic efficacies of different combination programs. In this program, Chinese medical pharmacy and Western medical pharmacy combined together. On the one hand, it is safe; on the other hand, they do not produce adverse reaction. Their therapeutic effects were synergetic. Chinese medical pharmacy could not only advance the cure effects of Western medical pharmacy, but also supplement the insufficiency of Western medical pharmacy. Of course, the author put forward some assumptions only from the perspective of clinical application in this paper. The evaluation system will become perfect along with further deepening researches of basic sciences.
Drugs, Chinese Herbal ; adverse effects ; pharmacology ; Evaluation Studies as Topic ; Herb-Drug Interactions ; Integrative Medicine

This article review and discuss the complimentary and alternative medicine (CAM), where it all began, practices and ideas self- defined by their users as preventing and treating illnesses or promoting health and well-being.
HERB-DRUG INTERACTIONS ; HERBALS ; ECHINACEA ; TANACETUM PARTHENIUM ; GARLIC ; GINKGO BILOBA ; PANAX ; KAVA ; VALERIAN ; HYPERICUM ; EPHEDRA

China ; Drugs, Chinese Herbal ; pharmacology ; Evidence-Based Medicine ; Herb-Drug Interactions ; Humans ; Integrative Medicine

To explore the mechanism of the absorption enhancement of borneol, the effect of borneol on the intestinal absorption and the pharmacokinetics of tetramethylpyrazine phosphate after oral administration were investigated. In situ intestinal recirculation was performed to study the effect of various concentrations of borneol on the absorption of tetramethylpyrazine phosphate at duodenum, jejunum, ileum and colon. After oral administration of tetramethylpyrazine phosphate, the mixture of tetramethylpyrazine phosphate and borneol and the mixture of tetramethylpyrazine phosphate and verapamil in rats, the concentrations of tetramethylpyrazine phosphate in plasma were determined by RP-HPLC at predesigned time. The pharmacokinetic parameters were compared based on the results of the three animal experiments, and analyzed with software program 3p97. The result showed that tetramethylpyrazine phosphate could be absorbed at all of the four intestinal segments with increasing absorption amount per unit as follows: colon > duodenum > jejunum > ileum, but without saturation, which demonstrated that tetramethylpyrazine phosphate was absorbed via simple diffusion. Borneol could enhance the intestinal absorption of tetramethylpyrazine phosphate, however, not in proportion. There was no obvious difference between the test group and the control group when 10 microg x mL(-1) borneol was added (P > 0.05), while when the concentration comes to 25 microg x mL(-1) and 50 microg x mL(-1), significant differences were observed (P < 0.05). Borneol and verapamil did enhance the bioavailability of tetramethylpyrazine phosphate after oral administration in rats. The enhancing effect of borneol showed only when the concentration came to a certain level but with no specific sites existed in the intestine. One of the mechanisms of borneol on the enhancing effect on absorption of tetramethylpyrazine phosphate might be the inhibition of the metabolism of CYP 3A and exocytosis of P-gp.
Animals ; Biological Availability ; Bornanes ; pharmacokinetics ; Herb-Drug Interactions ; Intestinal Absorption ; drug effects ; Male ; Pyrazines ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

Cardiovascular diseases are a global public health problem, and the combination of Chinese and western medicine tends to be a major solution in China. However, the complex components in traditional Chinese medicine may interact with the therapeutic western medicines for the diseases, which will lead to the herb-drug interaction(HDI). The information on the interaction can serve as a reference for the rational combination of the Chinese and western medicines in the clinical treatment of cardiovascular diseases and help avoid the occurrence of clinical safety events. However, the research on the interaction of Chinese medicine is limited as compared with that on western medicine, and no systematic review on HDI in the treatment of cardiovascular diseases is available. Therefore, this study first introduced the mechanism of HDI, then summarized the research on HDI for the commonly used drugs for cardiovascular diseases, analyzed the problems in the available studies, and put forward suggestions on the application, regulation, and research. This study aims to highlight HDI in clinical drug use and provide a reference for rational use of combination of Chinese and western medicines in the treatment of cardiovascular diseases.
Humans ; Drugs, Chinese Herbal/therapeutic use* ; Cardiovascular Diseases/drug therapy* ; Herb-Drug Interactions ; Medicine, Chinese Traditional ; China

Physiological changes associated with aging affect the absorption, distribution, metabolism, and excretion of drugs and thus therapeutic outcomes. These changes may be further amplified by interactions with nutrients. The purpose of this review was to summarize drug-nutrient interactions found in elderly patients. Mechanisms of the interactions can be categorized as ex vivo bio-inactivations, interactions in absorption and elimination phases, and physiological interactions. The goal of enteral nutrition (EN) is to maximize the therapeutic response of medication without adversely affecting EN tolerance. Therefore, to ensure safety, consistent monitoring is necessary for enteral feeding of patients receiving medication via an enteral tube. Elderly patients receiving parenteral nutrition (PN) are often treated concomitantly with medication via the parenteral route. The stability and compatibility of PN formulations infused with other additives, including medication, may be influenced. Limitation of the number of prescriptions to essential medications only during the minimum period along with periodic re-evaluations of the treatment are thus necessary to minimize undesirable drug-nutrient interactions in elderly patients.
Absorption ; Aged* ; Aging ; Enteral Nutrition ; Food-Drug Interactions ; Humans ; Metabolism ; Nutritional Support ; Parenteral Nutrition ; Prescriptions