1.Analysis of the Combination Use of CYP3A4 Inhibitors with Simvastatin or Atorvastatin in the Cardiology De-partment of A Third-grade Class A Hospital
Qingli WANG ; Xiaohui WANG ; Yongli WEI ; Xueping CHEN ; Minglu JIA ; Yuan PEI
China Pharmacy 2015;26(33):4634-4636
OBJECTIVE:To provide reference for strengthening the safety of the combination use of CYP3A4 inhibitors with statins in clinical treatment. METHODS:30 cases per month(totally 300 cases)(the hospitalization time was more than 10 days) discharged from the cardiology department of a third-level class A hospital during Jan. to Oct. 2013 were selected randomly,and statistical analysis was made into general information of patients,whether to use statins and CYP3A4 inhibitor,and whether to monitor safety indicators of liver and kidney function and creatine kinase. RESULTS:Totally 291 patients were treated with statins with a total use rate of 97%,including 265 cases of atorvastatin and 11 cases of simvastatin. The CYP3A4 inhibitors were com-bined with amlodipine,diltiazem,verapammy,amiodarone,Ginkgo biloba leaf,fenofibrate and clarithromycin,etc.,and 162 (59%) patients were given the combination use of simvastatin or atorvastatin with CYP3A4 inhibitors. But the liver and kidney function,creatine kinase and other safety indicators were not monitored by laboratory examination during medication. CONCLU-SIONS:Atorvastatin and simvastatin are used commonly in patients with cardiovascular disease,and the combination use rate with CYP3A4 inhibitor is relatively higher and needs long-term medication,drug dosage should be limited according to the direction of instructions and the adverse reactions induced by drug interactions should be noticed to strengthen medication monitor and education for patients.
2.Gegen Qinliantang and Its Modification in Treatment of Ulcerative Colitis: A Review
Minglu ZHAO ; Jia ZHENG ; Yuting GUO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(20):239-246
Gegen Qinliantang composed of Puerariae Lobatae Radix, Scutellariae Radix, Coptidis Rhizoma, and Glycyrrhizae Radix et Rhizoma exhibits exterior-releasing and interior-clearing effects and can treat diarrhea caused by fever invasion. Therefore, it is highly praised by physicians for treating damp-heat dysentery. This article systematically reviews the clinical applications and basic research advances of Gegen Qinliantang in treating ulcerative colitis. Modern clinical research has demonstrated that modified Gegen Qinliantang has also been used to treat ulcerative colitis, and it is often used in combination with Western drugs (mesalazine, olsalazine, sulfasalazine, etc.), other Chinese medicine prescriptions (Tongxie Yaofang, Baitouweng Tang, Shaoyaotang, Xianglianwan, etc.), and acupuncture. Such therapties can significantly alleviate symptoms, such as abdominal pain, diarrhea, and mucopurulent bloody stools, lower traditional Chinese medicine symptom scores and Baron score, improve the quality of life and sleep, reduce adverse reactions, and decrease the relapse rate within one year. Pharmacological studies have demonstrated that Gegen Qinliantang can inhibit the secretion of pro-inflammatory cytokines, such as tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and enhance the release of the anti-inflammatory cytokine interleukin-10 (IL-10) to alleviate intestinal inflammation. Additionally, it can modulate cellular signaling pathways and interfere with upstream and downstream connections in the pathways to inhibit oxidative stress response and prevent cell apoptosis. By regulating the balance of T-helper 17 (Th17) and regulatory T (Treg) cells and controlling the normal expression of immunoglobulins, Gegen Qinliantang can restore immune function. Moreover, this prescription can enrich the beneficial microorganisms in the intestine and stimulate intestinal epithelial cell regeneration to protect and repair the intestinal mucosal barrier. The active components in Gegen Qinliantang, such as puerarin, berberine, baicalin, and glycyrrhizin, can exert antibacterial, anti-inflammatory, and metabolic regulatory effects. This review provides a basis for treating ulcerative colitis with Gegen Qinliantang.