| Eighteen incompatible herbs is the synonymous with traditional Chinese medicine incompatibility. From Jin and Yuan Dynasties to today, it has almost a thousand years of history. The theory of Eighteen incompatible herbs has Limited on the clinical application of anti-drug, but ancient and modern times has some clinical application to cure some difficult and complicated diseases. So anti-drug whether can be used in the clinic, ancient physicians have different points of view, someone thinks using the anti-drug could increase toxicity and reduce the efficacy; someone thinks using the anti-drug could produce mutual stimulation to cure incurable diseases. So anti-drug whether can be used in clinic is a burning question in the medical field.We all know Chinese medicine theory derived from the clinical, using the clinical applications as the guiding principles, so the eighteen incompatible herbs is a clinic question in final analysis. Although many recent theoretical and experimental study of initial eighteen incompatible herbs is the incompatibility under certain conditions, rather than the absolute incompatibility, but there are certain conditions such uncertainties, we can not rush to conduct clinical trials in the crowd otherwise, it would be contrary to the harm principle in medical ethics. Consequently in the crowd at this stage to carry out the eighteen incompatible herbs conditions for application of clinical trials there is a certain degree of difficulty, not easy to be pursued. So we try to use Evidence-Based Medicine approach to evaluate eighteen incompatible herbs’s clinical application, from the perspective of modern clinical research literature to reveal the clinical applications of eighteen incompatible herbs.Evidence-Based Medicine is a new discipline of clinical medicine developed rapidly in recent years, which has become the new direction of development of international medical research. Evidence-Based Medicine methods which used to evaluate the efficacy and safety of interventions have been generally accepted by the World Health Organization (WHO) and the various countries.【Objective】The topics will systematically accessed on the basis of "gancao" class of the eighteen incompatible herbs, then research the type of clinical research of "gancao" class of anti-drug compatibility of combinations to carry out Evidence-Based Medicine evaluation studies.【Method】 1, Documentation Systems Retrieval2, Access Database creation3, Statistical description and analysis[Contents]1, Analyzing the research literature characteristic of the compatibility of anti drug combination of clinical study types and clinical applications of "gancao" class of eighteen incompatible herbs2, From the perspective of Evidence-Based Medicine to launch systematic review toward eighteen incompatible herbs with "gancao" class anti-drug compatibility combination therapy clinical research3, From the perspective of Evidence-Based Medicine to launch Systematic reviews toward eighteen incompatible herbs with "gancao" class anti-drug compatibility combination therapy clinical research safety of the systematic review4, Towards to "gancao" class of eighteen incompatible herbs, analyzing with the use of the situation of the groups of anti-drugs with the use of clinical literature[Result]1, Documentation Systems Search ResultsSearching the clinical application literature totals up to1191pieces.The document of gancao and haizao using together have1002pieces; gancao and gansui have119pieces; gancao and daji have36pieces; gancao and yuanhua have34pieces.2, Classification of statistical results of the combination of clinical study types of anti-drug compatibilityIn the1191pieces documents, the RCT has129pieces; the CCT has38pieces; the CS has433pieces; the CR has471pieces and the EX has120pieces.3, Database resultsWe establish five databases:RCT database, CCT databsse, CR database, CS database and EX database.The content of the databases contains documents’ basic information:the basic information of document, pathogenetic conditions’ information, therapeutic effect, situation of anti-drug and the data’s extraction.4, Anti-drug literature features4,1Anti-drug compatibility with the clinical treatment of diseasesGancao and haizao clinically use together mainly to cure the surgical diseases. Such as nodules of breast (cystic hyperplasia of breast), simple goiter (thyroid adenoma) and abdominal mass (hysteromyoma). gancao and gansui, gancao and daji, gancao and yuanhua, they all usally be used to cure traditional Chinese internal diseases. Such as drum belly (ascites due to cirrhosis) and phlegm-retention syndrome (pleurisy).4,2Anti-drug compatibility with the clinical doseClinical anti-drugs with the use of gancao used dose of6g and10g; haizao commonly used doses of15g and10g; gansui commonly used dose of5g and1g; daji commonly used dose of3g,15g and30g; yuanhua commonly used doses of10g and30g.4,3Anti-drug compatibility with the use of ratioGancao and haizao often compatibility use the ratio of1:2; clinically gancao and gansui, gancao and daji, gancao and yuanhuare often compatibility use the ratio of1:1.4,4the anti-drug compatibility with the clinical drug formulations and routes of administrationGancao and haizao on the clinical use often made "soups oral, within the service-based; The remaining three groups clinical with the use often made " soups" oral, topical dip made of the proportion of "paste" the use of topical oral and topical clinical considerable.4,5Cooked up by the anti-drug compatibility with the use of clinical drug useThe gancao and haizao often use the Crude medicine, and the remaining three groups of use the Vinegar processed medicine.4,6documented anti-drug quality evaluation of the clinical literatureFrom the published literature of the unit, the quality of journals, published the era of tripartite face of literature quality evaluation shows that the quality of the literature we retrieved or high.5, Compatibility of anti-drug combination of efficacy evaluation resultsClinical "gancao" class group of anti-drug with the quantitative analysis mentioned in the literature with an effective rate of treatment of diseases in more than80%.6, Compatibility of anti-drug combination of safety evaluation and studyGancao and haizao with the use of literature, only40clearly pointed out that they can use effectively and safely; gancao and gansui with the use of literature, only2clearly pointed out that they can use effectively and safely; gancao and daji with the use of literature, only2clearly pointed out that they can use effectively; gancao and yuanhuare with the use of literature, only1clearly pointed out that they can use effectively and safely.7, the situation of groups of anti-drug combination useageIn the literature retrieved, gancao, gansui, daji, and yuanhua four drugs jointly with the use of the most widely used; Followed by gancao, gansui and daji with the use usefulness, gancao, gansui, daji, yuanhua and haizao five drugs often used in the joint elimination of nuclear extract, the treatment of orthopedic diseases.【conclusion】1, In the anti-drug groups of contracts of "gancao" class, gancao and haizao together used mostly widly, followed by gancao and gansui, gancao and daji, gancao and yuanhua.2, From types of clinical research, the CS and CR documented the most, followed by the RCT and CCT literature.3, From the anti-drug use, both in terms of clinical safety and efficacy, we know, in clinical, Anti-drug compatibility portfolio in the clinical application is a certain basis, it is feasible and effective.4, Clinical anti-drug use, but need to be carried out "under certain conditions, a certain range.4.1Gancao and haizao using together mainly applies to the treatment of surgical diseases, for instance Breast cystic hyperplasia, Hyperthyroidism, Uterine fibroids and so on. Licorice seaweed with the use of licorice dose more than10g following and Algae and more than15g application of appropriate; The licorice algae often a1:2ratio with the use of compatibility using; Licorice seaweed with the use of both in raw product is better; Treatment of diseases made of the decoction, taken orally.4.2Gancao and gansui, gancao and daji, gancao and yuanhua the mainly applicable to treatment of internal diseases, for instance Ascites due to cirrhosis and Pleurisy. Gancao and gansui with the use of both applications dose more than lOg less. Gancao and daji with the use of5g,10g medicine in gancao, daji multi-3g,15g and30g; gancao and yuanhua with the use of both applications are multi-dose medicine,10g,30g. Three groups of anti-drugs are often1:1ratio compatibility; gancao and more to the raw product is better, gansui. daji and yuanhua vinegar Sunburn; in clinical medicine dosage form and route of administration, and more made of the decoction, oral and topical immersion.4.3In the orthopedic, Four groups of anti-drug combination used to treat traditional Chinese medicine attached necrosis syndrome.4.4gancao and haizao, gancao and daji this two groups can use to cure Gynecology infertility, although the mechanism of action is different, but can be the treatment of infertility caused by tubal obstruction or inflammation. The gancao and yuanhua gave birth to the next child, for early termination of pregnancy or treatment of the cause of hemorrhage after termination of pregnancy card.5, Groups of anti-drug combination with the use of the treatment of orthopedic or surgical infection diseases such as chronic suppurative osteomyelitis, chronic knee synovitis, soft tissue contusion, More than made into paste, powder, lotion for external use, a significant cream application to the elimination of nuclear.6, After finishing the analysis of literature found that the existing published eightteen anti-literature, and even Chinese medicine literature in the field of literature quality to be improved in many respects is not precise enough and need further improvement. Such as Chinese medicine medicine concocted medicine, adverse reactions after treatment, the treatment of diseases, disease name standardization situation, some articles did not explicitly mention or non-standard positioning, so many of the problems difficult to trace. For certain drugs, further research is very unfavorable from the perspective of evidence-based medicine, it is recommended that future researchers to rigorous attitude to quality literature. |
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