具有临床影响的草药-药物相互作用：对厄瓜多尔广泛使用药用植物的全球临床证据的系统综述
Herb-drug interactions with clinical impact: A systematic review of global clinical evidence on medicinal plants widely used in Ecuador.
摘要(中文译文)
厄瓜多尔药用植物的广泛使用增加了草药-药物相互作用的风险，其中许多可能危及患者安全。了解具有临床相关性的相互作用对于预防不良事件和指导循证决策至关重要。系统分析厄瓜多尔常用药用植物与常规药物之间相互作用的临床证据，识别其机制和潜在治疗风险。按照PRISMA 2020指南开展系统综述。从主要科学数据库中检索2015年至2025年发表的文章。纳入涉及人类并报告草药-药物相互作用的研究。考虑全球范围内涉及厄瓜多尔常用药用植物的研究。采用预设指标评估方法学质量，并根据Janusmed临床相互作用严重程度量表对相互作用进行分类。在102条记录中，47项研究符合纳入标准。其中，31.9%报告了具有临床相关性的相互作用。最常见的结果为血浆药物水平降低（40%）、出血风险增加（13.3%）、免疫治疗疗效降低（13.3%）以及肝毒性或内分泌效应。最常涉及的植物为Camellia sinensis L.、Hypericum perforatum L.、Borago officinalis和Glycyrrhiza glabra L.。在厄瓜多尔广泛使用的药用植物中，具有临床意义的草药-药物相互作用较为常见，可能影响治疗疗效或增加不良反应。提高医疗专业人员的认识对于改善患者安全和预防有害联合用药至关重要。
Abstract
The widespread use of medicinal plants in Ecuador increases the risk of herb-drug interactions, many of which may compromise patient safety. Understanding clinically relevant interactions is essential for preventing adverse events and guiding evidence-based decision-making. To systematically analyze the clinical evidence on interactions between medicinal plants commonly used in Ecuador and conventional medications, identifying their mechanisms and potential therapeutic risks. A systematic review was conducted following PRISMA 2020 guidelines. Articles published between 2015 and 2025 were retrieved from major scientific databases. Studies involving humans and reporting herb-drug interactions were included. Studies conducted worldwide involving medicinal plants commonly used in Ecuador were considered. Methodological quality was assessed using predefined indicators, and interactions were classified according to the Janusmed clinical interaction severity scale. Out of 102 records, 47 studies met inclusion criteria. Among these, 31.9% reported clinically relevant interactions. The most frequent consequences were reduced plasma drug levels (40%), increased risk of bleeding (13.3%), decreased efficacy of immunotherapy (13.3%), and hepatotoxic or endocrine effects. The most frequently implicated plants were Camellia sinensis L., Hypericum perforatum L., Borago officinalis, and Glycyrrhiza glabra L. Clinically significant herb-drug interactions are common among medicinal plants widely used in Ecuador and may affect therapeutic efficacy or increase adverse effects. Greater awareness among healthcare professionals is essential to improve patient safety and prevent harmful combinations.
如何引用
AMA
Raynier Zambrano-Villacres, Willington Montenegro-Acosta, Dolores Rodriguez-Veintimilla, Elianne Rodriguez-Larraburu, Claudia Espro, Viviana Bressi. Herb-drug interactions with clinical impact: A systematic review of global clinical evidence on medicinal plants widely used in Ecuador.. Journal of ethnopharmacology. 2027; doi:10.1016/j.jep.2026.122220.
APA
Raynier Zambrano-Villacres, Willington Montenegro-Acosta, Dolores Rodriguez-Veintimilla, Elianne Rodriguez-Larraburu, Claudia Espro, Viviana Bressi (2027). Herb-drug interactions with clinical impact: A systematic review of global clinical evidence on medicinal plants widely used in Ecuador.. Journal of ethnopharmacology. https://doi.org/10.1016/j.jep.2026.122220
GB/T 7714
Raynier Zambrano-Villacres, Willington Montenegro-Acosta, Dolores Rodriguez-Veintimilla, Elianne Rodriguez-Larraburu, Claudia Espro, Viviana Bressi. Herb-drug interactions with clinical impact: A systematic review of global clinical evidence on medicinal plants widely used in Ecuador.[J]. Journal of ethnopharmacology, 2027 doi:10.1016/j.jep.2026.122220.
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