Due to the complex composition and difficult qualitative analysis of traditional Chinese medicine, there are still issues of incompatibility between Chinese and Western medicine in integrated treatment. Common incompatibilities between Chinese and Western medicine can be classified into the following categories.
Reduced efficacy or increased toxicity
Chinese herbal medicines such as Siji Qing and Huang Ya Zi have a damaging effect on the liver. When combined with tetracycline, not only does it reduce the efficacy of the former two, but it also increases their toxicity. When combined with pomegranate peel, diyu, hezi, wuzi, and erythromycin, drug-induced hepatitis can occur. Chinese herbal medicines such as Chuan Wu, Cao Wu, Fu Zi, as well as Chinese patent medicines containing these ingredients and alkaloids, such as Xiaohuoluo Dan, Sanqi Tablets, Yuan Hu Zhi Tong Tablets, Huang Lian Su, when used in combination with aminoglycoside drugs, can enhance the toxicity on the auditory nerve.
Compound Danshen Injection combined with anticancer drugs such as cyclophosphamide, fluorouracil, cytarabine, mitomycin, etc., after combination use, not only does it have no inhibitory effect on tumor cells, but it can also promote the metastasis of malignant tumors. Atropine can relieve the inhibitory effect of the vagus nerve on the heart and accelerate heart rate. After being combined with Danshen and its preparations, the antihypertensive effect of Danshen can be blocked by atropine, thus reducing the efficacy of Danshen. The active ingredient in Danshen, tanshinone, can antagonize the effects of androgens. When combined with methyltestosterone, testosterone propionate, and other androgens, it can reduce the activity of androgens and affect their efficacy.
Chinese patent medicines containing ethanol, such as Guogong Jiu, Huoxiang Zhengqi Shui, Fengshi Zhentong Yaojiu, Ren Shen Jiu, when used in combination with phenobarbital, phenytoin sodium, amiodarone, and hypoglycemic western medicine, due to the enzyme-inducing effect of ethanol, increase the activity of liver enzymes, causing accelerated metabolism and shortened half-life of the above-mentioned western medicines in the body, resulting in a significant reduction in efficacy.
Chinese patent medicines containing proteins and their hydrolysates, such as Zhengu Wan, Qingre Jiedu Wan, Niuhuang Jiedu Wan, should not be taken together with berberine, as the protein components can antagonize the antibacterial effect of berberine. Xueyu Tan, Aiye Tan, and Duanwaleng can adsorb a variety of antibiotics, reducing their effective concentration in the gastrointestinal tract. Yinchen can antagonize the anti-infection ability of chloramphenicol.
Chinese patent medicines containing cow bezoar, such as Niuhuang Jiedu Wan, Angong Niuhuang Wan, should not be used in combination with water chloral hydrate, morphine, phenobarbital, and other western medicines, as cow bezoar can enhance the central nervous system depression effects of water chloral hydrate, morphine, phenobarbital, leading to acute poisoning such as coma, respiratory depression, and hypotension.
Chinese patent medicines containing Mahuang, such as Marelin Shigan Pills, Zhike Dingchuan Gao, Fangfeng Tongseng Wan, Xiaoquan Chongji, Tongxuan Lifen Wan, should not be taken together with antihypertensive drugs, as the vasoconstrictive effect of ephedrine in Mahuang can increase blood pressure, counteracting the antihypertensive effect of the antihypertensive drugs, and even causing hypertension. They should also not be used in combination with monoamine oxidase inhibitors such as Litieling, Youshengning, phenethylhydrazine, methylbenzene hydrazine, isoniazid, etc., as monoamine oxidase inhibitors can inhibit the activity of monoamine oxidase and block the inactivation of neurotransmitters stored in the adrenergic nerve terminals, thereby enhancing the pressor effect of ephedrine and its preparations, posing a risk of hypertensive crisis and cerebral hemorrhage. They should also not be used in combination with cardiac glycosides, as ephedrine can stimulate the myocardial β receptors, increase myocardial contractility, thereby enhancing the effects and toxicity of digitalis cardiac glycosides, leading to adverse reactions such as arrhythmias and heart failure.
Chinese medicines containing calcium ions, such as Shigao, Longgu, and Walingzi, should not be used in combination with cardiac glycosides, as cardiac glycosides release calcium ions through the myocardium, and Chinese medicines containing a large amount of calcium ions can enhance the effects and toxicity of cardiac glycosides. Compound Licorice Tablets in combination with cardiac glycosides can easily lead to cardiac intoxication due to the heart's sensitivity to cardiac glycosides.
Gancao, Compound Licorice Tablets, and other licorice preparations should not be used in combination with aspirin and hypoglycemic drugs. When used in combination with aspirin, it can increase gastrointestinal adverse reactions and even induce or aggravate gastrointestinal ulcers. Licorice can antagonize the effects of hypoglycemic drugs such as insulin and glibenclamide.
Jinyinhua, Lianqiao, Huangqin, Yuxingcao, etc., should not be used in combination with lactase, probiotics, and gastric enzyme preparations, as these Chinese medicines can inhibit or reduce the vitality of the latter while combating bacteria.
Chinese medicines such as Taoren, Baiguo, and Xingren should not be used in combination with sedatives and hypnotics such as Diazepam, as it can suppress the respiratory center and impair the liver. Antiepileptic drugs in combination with Cangerzi and Leigongteng can aggravate liver damage. Yuan Hu Zhi Tong Pills, Jiangu Pills, and Dahuoluo Pills should not be used in combination with atropine, ephedrine alkaloids, and other alkaloids to avoid exacerbating their toxic side effects.
Causing changes in acid-base balance
Chinese medicines containing acidic components such as hawthorn, wuzi, wumei, shanzhuyu, and nüzhenzi can acidify urine, affecting the reabsorption and excretion of some western medicines in the renal tubules, such as sodium bicarbonate, magnesium oxide, carbon dioxide
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