| 引用本文: | 丁征,代琦,刘朝晖,杨敏,郑英丽.参松养心胶囊致INR值降低2例及文献回顾[J].中国现代应用药学,2018,35(11):1729-1731. |
| DING Zheng,DAI Qi,LIU Zhaohui,YANG Min,ZHENG Yingli.Shensong Yangxin Capsules Reduced INR in Two Cases and Literature Review[J].Chin J Mod Appl Pharm(中国现代应用药学),2018,35(11):1729-1731. |
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| 参松养心胶囊致INR值降低2例及文献回顾 |
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丁征1, 代琦2, 刘朝晖3, 杨敏1, 郑英丽1
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1.中国医学科学院阜外医院, 药剂科, 北京 100037;2.中国医学科学院阜外医院, 心脏外科, 北京 100037;3.中国医学科学院阜外医院, 心血管病分子诊断中心, 北京 100037
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| 摘要: |
| 目的 探讨参松养心胶囊对华法林抗凝作用的影响、作用机制和处理方法。方法 采用病例回顾方式，1例62岁非瓣膜病房颤女性服用华法林抗凝治疗后INR>2，加用参松养心胶囊4 d后INR降至1.68，停用参松养心胶囊4 d后INR值升至2以上；另1例57岁非瓣膜病房颤男性服用稳定剂量（4.0 mg·d-1）的华法林抗凝治疗，服用参松养心胶囊后INR值降至1.56，后增加华法林剂量至4.5 mg·d-1，INR值升至2以上。结果 患者在稳定的华法林治疗剂量基础上加用参松养心胶囊（含有人参）后，减弱了华法林的抗凝效果。可能的机制是人参轻度诱导了CYP2C9，但是尚不能排除人参的血小板抑制作用等其他可能的机制。结论 服用华法林期间应尽可能避免服用人参等草药，如果坚持加用人参及含人参药物后，建议持续监测INR值，并根据INR值调整剂量。 |
| 关键词: 华法林 参松养心胶囊 人参 相互作用 |
| DOI：10.13748/j.cnki.issn1007-7693.2018.11.030 |
| 分类号:R969.2 |
| 基金项目: |
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| Shensong Yangxin Capsules Reduced INR in Two Cases and Literature Review |
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DING Zheng1, DAI Qi2, LIU Zhaohui3, YANG Min1, ZHENG Yingli1
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1.Department of Pharmacy, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China;2.Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China;3.Molecular Diagnostics of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China
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| Abstract: |
| OBJECTIVE To explore the effect of drugs containing ginseng on warfarin as well as the mechanism of interaction and strategy for the interaction management. METHODS Case review was used, a 62-year-old woman with non-valvular atrial fibrillation initiated warfarin therapy and then the international normalized ratio (INR) achieved therapeutic range. After the addition of Shensongyangxin capsules for 4 d, INR value fell to 1.68. Then the INR value rose abrove 2 after stopping Shensongyangxin capsules for 4 d. Another 57-year-old man with non-valve atrial fibrillation who has been stable on warfarin therapy (4.0 mg·d-1) experienced INR value 1.56, then warfarin dose was adjusted to 4.5 mg·d-1 and the INR value rose abrove 2.0. RESULTS The addition of Shensongyangxin capsules which contains ginseng on stable and therapeutic warfarin might reduce the effect of warfarin. It was possible that ginseng modestly induced CYP2C9, but other potential mechanisms such as the inhibitory on platelets had not been ruled out. CONCLUSION Patients on warfarin therapy shall avoid taking any ginseng products. The patient shall be advised to monitor INR value and adjust the doses based on INR value monitoring if continue taking ginseng. |
| Key words: warfarin, Shensong Yangxin capsules ginseng interaction |
