{ "herb_drug_interactions": [ { "id": "dan-shen-anticoagulants", "herb_keys": [ "dan_shen" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin", "rivaroxaban", "apixaban", "dabigatran" ], "severity": "major", "mechanism_zh": "丹参所含丹参酮、丹酚酸等成分可抑制血小板聚集，并经报道增加华法林的抗凝作用，可致 INR 升高及出血。", "mechanism_en": "Salvia miltiorrhiza contains tanshinones and salvianolic acids that inhibit platelet aggregation, and is reported to potentiate warfarin's anticoagulant effect, raising INR and increasing bleeding risk.", "clinical_recommendation_zh": "服用华法林或新型口服抗凝药者忌用丹参。如必须合用，须在医师监测 INR 及出凝血指标下进行。", "clinical_recommendation_en": "Avoid Dan Shen in patients on warfarin or DOACs. If combination is unavoidable, INR and coagulation must be closely monitored by the prescribing physician.", "sources": [ "Brinker 4th ed., p. 196", "Chen & Chen, p. 631" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "dang-gui-anticoagulants", "herb_keys": [ "dang_gui" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin", "heparin", "rivaroxaban" ], "severity": "major", "mechanism_zh": "当归含香豆素类成分，理论上可加强华法林之抗凝作用。已有当归与华法林合用致 INR 升高、出血之报道。", "mechanism_en": "Angelica sinensis contains coumarin derivatives that may potentiate the anticoagulant effect of warfarin. Case reports document elevated INR and bleeding when Dang Gui is combined with warfarin.", "clinical_recommendation_zh": "服用抗凝药者忌用当归及含当归之复方（四物汤、八珍汤、十全大补汤等）。", "clinical_recommendation_en": "Avoid Dang Gui — and any formula containing it (Si Wu Tang, Ba Zhen Tang, Shi Quan Da Bu Tang) — in patients on anticoagulants.", "sources": [ "Brinker 4th ed., p. 31", "Chen & Chen, p. 909" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "hong-hua-anticoagulants", "herb_keys": [ "hong_hua" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin", "rivaroxaban", "aspirin", "clopidogrel" ], "severity": "major", "mechanism_zh": "红花有抗血小板与抗凝血作用，与华法林、阿司匹林、氯吡格雷合用增加出血风险。", "mechanism_en": "Carthamus tinctorius (safflower) has documented antiplatelet and anticoagulant activity; combination with warfarin, aspirin, or clopidogrel increases bleeding risk.", "clinical_recommendation_zh": "服用抗凝药或抗血小板药者忌用红花及含红花之活血化瘀方剂（桃红四物汤等）。", "clinical_recommendation_en": "Avoid Hong Hua — and any blood-invigorating formula containing it (Tao Hong Si Wu Tang, etc.) — in patients on anticoagulants or antiplatelet agents.", "sources": [ "Brinker 4th ed., p. 89", "Chen & Chen, p. 661" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "tao-ren-anticoagulants", "herb_keys": [ "tao_ren" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin", "aspirin", "clopidogrel" ], "severity": "moderate", "mechanism_zh": "桃仁含苦杏仁苷类成分，并具活血化瘀作用，理论上与抗凝药、抗血小板药合用增加出血风险。", "mechanism_en": "Persicae semen contains amygdalin and exhibits blood-invigorating activity; theoretical interaction with anticoagulants and antiplatelet agents may increase bleeding risk.", "clinical_recommendation_zh": "服用抗凝药或抗血小板药者慎用桃仁。", "clinical_recommendation_en": "Use Tao Ren with caution in patients on anticoagulant or antiplatelet therapy.", "sources": [ "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "bensky_mm_3e" ] }, { "id": "ma-huang-mao-inhibitors", "herb_keys": [ "ma_huang" ], "drug_class": "MAO inhibitors", "drug_class_zh": "单胺氧化酶抑制剂", "drug_examples": [ "phenelzine", "tranylcypromine", "selegiline", "moclobemide" ], "severity": "major", "mechanism_zh": "麻黄含麻黄碱（ephedrine），为间接拟交感胺。与单胺氧化酶抑制剂合用可致严重高血压危象。", "mechanism_en": "Ephedra sinica contains ephedrine, an indirect-acting sympathomimetic. Co-administration with MAO inhibitors can precipitate hypertensive crisis.", "clinical_recommendation_zh": "服用 MAOI 者绝对禁用麻黄。即便停药后亦须等待至少 2 周方可使用。", "clinical_recommendation_en": "Absolutely contraindicated in patients on MAO inhibitors. Wait at least 2 weeks after discontinuation of the MAOI before using Ma Huang.", "sources": [ "Brinker 4th ed., p. 70", "Chen & Chen, p. 39" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "ma-huang-sympathomimetics", "herb_keys": [ "ma_huang" ], "drug_class": "sympathomimetics & stimulants", "drug_class_zh": "拟交感药及兴奋剂", "drug_examples": [ "pseudoephedrine", "phenylephrine", "amphetamines", "caffeine (high dose)" ], "severity": "major", "mechanism_zh": "麻黄之拟交感作用与其他拟交感药合用，致心动过速、高血压、心律失常之风险显著增加。", "mechanism_en": "Ma Huang's sympathomimetic activity adds to that of other adrenergic drugs, significantly increasing the risk of tachycardia, hypertension, and arrhythmia.", "clinical_recommendation_zh": "服用拟交感药者禁用麻黄。", "clinical_recommendation_en": "Avoid Ma Huang in patients taking sympathomimetic medications.", "sources": [ "Brinker 4th ed., p. 71" ], "source_keys": [ "brinker_4e" ] }, { "id": "ma-huang-cardiac-glycosides", "herb_keys": [ "ma_huang" ], "drug_class": "cardiac glycosides", "drug_class_zh": "强心苷", "drug_examples": [ "digoxin" ], "severity": "major", "mechanism_zh": "麻黄碱可增加心肌兴奋性，与地高辛合用可诱发室性心律失常。", "mechanism_en": "Ephedrine increases myocardial excitability; combination with digoxin may precipitate ventricular arrhythmias.", "clinical_recommendation_zh": "服用地高辛者禁用麻黄。", "clinical_recommendation_en": "Avoid Ma Huang in patients taking digoxin.", "sources": [ "Brinker 4th ed., p. 71" ], "source_keys": [ "brinker_4e" ] }, { "id": "gan-cao-diuretics", "herb_keys": [ "gan_cao" ], "drug_class": "potassium-wasting diuretics", "drug_class_zh": "排钾利尿剂", "drug_examples": [ "hydrochlorothiazide", "furosemide", "bumetanide" ], "severity": "major", "mechanism_zh": "甘草所含甘草甜素可抑制 11-β-羟类固醇脱氢酶 2，致皮质醇蓄积，引起假性醛固酮增多症（钠水潴留、低钾、高血压）。与排钾利尿剂合用使低血钾风险显著加剧。", "mechanism_en": "Glycyrrhizin in licorice inhibits 11-β-hydroxysteroid dehydrogenase type 2, leading to cortisol accumulation and pseudoaldosteronism (sodium retention, hypokalemia, hypertension). Combination with potassium-wasting diuretics dramatically increases the risk of severe hypokalemia.", "clinical_recommendation_zh": "服用排钾利尿剂者长期或大量用甘草需慎，并监测血钾。短期、低剂量（如调和诸药 3g 以下）一般尚可。", "clinical_recommendation_en": "Patients on potassium-wasting diuretics should avoid long-term or high-dose Gan Cao and have serum potassium monitored. Short-term, low-dose use (≤3 g for harmonization) is generally safer.", "sources": [ "Brinker 4th ed., p. 144", "Chen & Chen, p. 877" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "gan-cao-digoxin", "herb_keys": [ "gan_cao" ], "drug_class": "cardiac glycosides", "drug_class_zh": "强心苷", "drug_examples": [ "digoxin" ], "severity": "major", "mechanism_zh": "甘草所致低血钾增强地高辛之毒性，可致地高辛中毒（恶心、心律失常、视觉异常）。", "mechanism_en": "Hypokalemia induced by licorice potentiates digoxin toxicity, manifesting as nausea, arrhythmia, and visual disturbance.", "clinical_recommendation_zh": "服用地高辛者长期用甘草需慎，并监测血钾与地高辛血药浓度。", "clinical_recommendation_en": "Patients on digoxin should use Gan Cao cautiously, with monitoring of serum potassium and digoxin levels.", "sources": [ "Brinker 4th ed., p. 144" ], "source_keys": [ "brinker_4e" ] }, { "id": "gan-cao-corticosteroids", "herb_keys": [ "gan_cao" ], "drug_class": "corticosteroids", "drug_class_zh": "皮质类固醇", "drug_examples": [ "prednisone", "dexamethasone", "hydrocortisone" ], "severity": "moderate", "mechanism_zh": "甘草甜素可延缓皮质醇代谢，与外源性皮质类固醇合用使皮质醇负担及副作用增加。", "mechanism_en": "Glycyrrhizin slows cortisol metabolism; combination with exogenous corticosteroids increases the cortisol burden and the risk of corticosteroid side effects.", "clinical_recommendation_zh": "长期使用皮质类固醇者，长期合用甘草需谨慎。", "clinical_recommendation_en": "Long-term combination of Gan Cao and systemic corticosteroids requires monitoring.", "sources": [ "Brinker 4th ed., p. 145" ], "source_keys": [ "brinker_4e" ] }, { "id": "huang-qi-immunosuppressants", "herb_keys": [ "huang_qi" ], "drug_class": "immunosuppressants", "drug_class_zh": "免疫抑制剂", "drug_examples": [ "cyclosporine", "tacrolimus", "azathioprine" ], "severity": "moderate", "mechanism_zh": "黄芪有显著之免疫增强作用，理论上与免疫抑制剂之作用相对抗，可削弱后者之疗效（尤其器官移植与自身免疫病）。", "mechanism_en": "Astragalus has documented immunostimulant activity that may theoretically antagonize immunosuppressive therapy, particularly in organ transplant recipients and autoimmune disease.", "clinical_recommendation_zh": "器官移植术后及自身免疫病服用免疫抑制剂者，慎用黄芪。", "clinical_recommendation_en": "Use Huang Qi with caution in transplant recipients and patients on immunosuppressive therapy for autoimmune disease.", "sources": [ "Chen & Chen, p. 854", "Brinker 4th ed., p. 11" ], "source_keys": [ "chen_chen_cmm", "brinker_4e" ] }, { "id": "ren-shen-anticoagulants", "herb_keys": [ "ren_shen" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin" ], "severity": "moderate", "mechanism_zh": "人参与华法林之相互作用文献存争议：有报道显示人参可降低华法林之 INR（即拮抗其作用）。机制可能涉及肝酶诱导。", "mechanism_en": "Reports on Panax ginseng × warfarin are mixed; some studies show ginseng reduces warfarin's INR (antagonism), possibly via hepatic enzyme induction.", "clinical_recommendation_zh": "服用华法林者使用人参须监测 INR。", "clinical_recommendation_en": "Patients on warfarin who use Ren Shen should have INR monitored.", "sources": [ "Brinker 4th ed., p. 110", "Chen & Chen, p. 845" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "ren-shen-hypoglycemics", "herb_keys": [ "ren_shen" ], "drug_class": "antidiabetic agents", "drug_class_zh": "降糖药", "drug_examples": [ "insulin", "metformin", "glipizide", "glyburide" ], "severity": "moderate", "mechanism_zh": "人参有降低血糖之作用，与降糖药合用可致低血糖。", "mechanism_en": "Ginseng has hypoglycemic activity; combination with antidiabetic drugs may cause hypoglycemia.", "clinical_recommendation_zh": "糖尿病患者服降糖药同时使用人参须监测血糖。", "clinical_recommendation_en": "Diabetic patients on antidiabetic medication who use Ren Shen should monitor blood glucose closely.", "sources": [ "Brinker 4th ed., p. 110" ], "source_keys": [ "brinker_4e" ] }, { "id": "huang-qin-cyp450", "herb_keys": [ "huang_qin" ], "drug_class": "CYP3A4 substrates", "drug_class_zh": "CYP3A4 代谢底物", "drug_examples": [ "statins", "calcium channel blockers", "many oral anticancer agents" ], "severity": "theoretical", "mechanism_zh": "黄芩中黄酮类成分（黄芩苷等）于体外可调节 CYP450 同工酶活性，理论上影响经此通路代谢之药物之血药浓度。", "mechanism_en": "Scutellaria flavonoids (notably baicalin) modulate CYP450 isoforms in vitro, theoretically altering serum levels of drugs metabolized via these pathways.", "clinical_recommendation_zh": "长期合用窄治疗指数药物（如他汀类、抗癌药）时需考量。", "clinical_recommendation_en": "Consider this interaction in long-term combination with narrow-therapeutic-index drugs (statins, oral oncologics).", "sources": [ "Chen & Chen, p. 192" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "chai-hu-cyp450", "herb_keys": [ "chai_hu" ], "drug_class": "CYP3A4 substrates", "drug_class_zh": "CYP3A4 代谢底物", "drug_examples": [ "statins", "midazolam", "cyclosporine" ], "severity": "theoretical", "mechanism_zh": "柴胡所含柴胡皂苷于动物模型中可调节 CYP3A 酶活性，理论上影响共服药物之血药浓度。", "mechanism_en": "Saikosaponins in Bupleurum modulate CYP3A activity in animal models, theoretically affecting serum levels of co-administered substrate drugs.", "clinical_recommendation_zh": "长期合用经 CYP3A4 代谢之窄治疗指数药物时需考量。", "clinical_recommendation_en": "Consider when co-administering long-term with narrow-therapeutic-index CYP3A4 substrates.", "sources": [ "Chen & Chen, p. 71" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "fu-zi-cardiac", "herb_keys": [ "fu_zi" ], "drug_class": "cardiac & antiarrhythmic drugs", "drug_class_zh": "心脏药及抗心律失常药", "drug_examples": [ "digoxin", "beta-blockers", "antiarrhythmics" ], "severity": "major", "mechanism_zh": "附子（生品）含乌头碱类生物碱，具显著心毒性，可致心律失常、心力衰竭。即便经炮制后毒性大减，仍须避免与心脏药同用。", "mechanism_en": "Aconitum carmichaelii contains aconitine alkaloids with marked cardiotoxicity; even prepared (paozhi) preparations should not be combined with cardiac or antiarrhythmic medications.", "clinical_recommendation_zh": "心脏病患者及服用心脏药物者禁用附子。仅可由有经验之中医师严格炮制并控制剂量后使用。", "clinical_recommendation_en": "Contraindicated in patients with cardiac disease or on cardiac medication. Use only when properly prepared (paozhi), at controlled dosage, by an experienced TCM practitioner.", "sources": [ "Brinker 4th ed., p. 5", "Chen & Chen, p. 481" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "wu-wei-zi-cyp450", "herb_keys": [ "wu_wei_zi" ], "drug_class": "CYP3A4 substrates", "drug_class_zh": "CYP3A4 代谢底物", "drug_examples": [ "tacrolimus", "midazolam", "warfarin" ], "severity": "moderate", "mechanism_zh": "五味子之木脂素类成分可显著抑制 CYP3A4，使经此酶代谢之药物血药浓度升高。已有五味子提高他克莫司血药浓度之报告。", "mechanism_en": "Schisandra lignans are documented CYP3A4 inhibitors; co-administration significantly raises blood levels of CYP3A4 substrates. Case reports document increased tacrolimus levels with Wu Wei Zi.", "clinical_recommendation_zh": "服用他克莫司、咪达唑仑、华法林之窄治疗指数药者使用五味子须监测血药浓度。", "clinical_recommendation_en": "Patients on tacrolimus, midazolam, warfarin, or other narrow-therapeutic-index CYP3A4 substrates require monitoring when combined with Wu Wei Zi.", "sources": [ "Chen & Chen, p. 882", "Brinker 4th ed., p. 188" ], "source_keys": [ "chen_chen_cmm", "brinker_4e" ] }, { "id": "da-huang-diuretics-laxatives", "herb_keys": [ "da_huang" ], "drug_class": "potassium-affecting drugs", "drug_class_zh": "影响钾离子之药物", "drug_examples": [ "digoxin", "thiazide diuretics", "loop diuretics", "corticosteroids" ], "severity": "moderate", "mechanism_zh": "大黄所含蒽醌类泻下成分长期使用可致低钾血症，与排钾药物及强心苷合用风险叠加。", "mechanism_en": "Anthraquinone laxatives in Da Huang can cause hypokalemia with prolonged use; combination with potassium-wasting drugs and cardiac glycosides is additive.", "clinical_recommendation_zh": "长期服用大黄者监测血钾。短期攻下用药一般无虞。", "clinical_recommendation_en": "Monitor serum potassium with prolonged Da Huang use. Short-term purgative use is generally safe.", "sources": [ "Brinker 4th ed., p. 134", "Chen & Chen, p. 119" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "ban-xia-sedatives", "herb_keys": [ "ban_xia" ], "drug_class": "sedatives & hypnotics", "drug_class_zh": "镇静催眠药", "drug_examples": [ "benzodiazepines", "zolpidem", "eszopiclone", "barbiturates" ], "severity": "moderate", "mechanism_zh": "半夏具中枢抑制作用，与苯二氮卓类、巴比妥类等镇静催眠药合用可致过度镇静、嗜睡。", "mechanism_en": "Pinellia ternata has CNS-depressant activity; combination with benzodiazepines, barbiturates, or other sedative-hypnotics may cause excessive sedation and somnolence.", "clinical_recommendation_zh": "服用镇静催眠药者使用半夏须谨慎，注意嗜睡及呼吸抑制。", "clinical_recommendation_en": "Use Ban Xia cautiously in patients on sedative-hypnotics; monitor for excessive drowsiness and respiratory depression.", "sources": [ "Chen & Chen, p. 400", "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "chen_chen_cmm", "bensky_mm_3e" ] }, { "id": "sheng-di-huang-anticoagulants", "herb_keys": [ "sheng_di_huang" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin", "rivaroxaban", "apixaban" ], "severity": "moderate", "mechanism_zh": "生地黄有凉血活血之效，可影响血小板功能，理论上与抗凝药合用增加出血风险。", "mechanism_en": "Rehmannia glutinosa (raw) cools and invigorates blood, may affect platelet function, and theoretically increases bleeding risk when combined with anticoagulants.", "clinical_recommendation_zh": "服用抗凝药者使用生地黄须监测凝血功能。", "clinical_recommendation_en": "Monitor coagulation parameters when Sheng Di Huang is used in patients on anticoagulant therapy.", "sources": [ "Chen & Chen, p. 700", "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "chen_chen_cmm", "bensky_mm_3e" ] }, { "id": "huang-lian-antidiabetics", "herb_keys": [ "huang_lian" ], "drug_class": "antidiabetic agents", "drug_class_zh": "降糖药", "drug_examples": [ "metformin", "glipizide", "glyburide", "insulin" ], "severity": "moderate", "mechanism_zh": "黄连所含小檗碱（berberine）具显著降血糖作用，与降糖药合用可致低血糖。", "mechanism_en": "Coptis chinensis contains berberine, which has well-documented hypoglycemic activity; combination with antidiabetic agents increases the risk of hypoglycemia.", "clinical_recommendation_zh": "糖尿病患者服用降糖药期间使用黄连须密切监测血糖，必要时调整降糖药剂量。", "clinical_recommendation_en": "Monitor blood glucose closely when Huang Lian is combined with antidiabetic medications; dose adjustment of the antidiabetic may be required.", "sources": [ "Chen & Chen, p. 177", "Brinker 4th ed., p. 53" ], "source_keys": [ "chen_chen_cmm", "brinker_4e" ] }, { "id": "shan-zha-antihypertensives", "herb_keys": [ "shan_zha" ], "drug_class": "antihypertensives", "drug_class_zh": "降压药", "drug_examples": [ "ACE inhibitors", "ARBs", "amlodipine", "metoprolol" ], "severity": "moderate", "mechanism_zh": "山楂含黄酮类及原花青素，有扩张血管、降低血压之作用，与降压药合用可致血压过低。", "mechanism_en": "Crataegus pinnatifida contains flavonoids and proanthocyanidins with vasodilatory and hypotensive effects; combination with antihypertensives may cause excessive blood pressure reduction.", "clinical_recommendation_zh": "服用降压药者使用山楂须注意血压变化，防止低血压。", "clinical_recommendation_en": "Monitor blood pressure when Shan Zha is used alongside antihypertensive medications to avoid excessive hypotension.", "sources": [ "Chen & Chen, p. 469", "Brinker 4th ed., p. 55" ], "source_keys": [ "chen_chen_cmm", "brinker_4e" ] }, { "id": "gou-qi-zi-anticoagulants", "herb_keys": [ "gou_qi_zi" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin", "rivaroxaban" ], "severity": "moderate", "mechanism_zh": "枸杞子有报道可增强华法林之抗凝作用，致 INR 升高及出血。机制可能涉及 CYP2C9 抑制。", "mechanism_en": "Lycium barbarum has been reported to potentiate warfarin's anticoagulant effect, raising INR and increasing bleeding risk, possibly via CYP2C9 inhibition.", "clinical_recommendation_zh": "服用华法林者使用枸杞子须监测 INR。", "clinical_recommendation_en": "Patients on warfarin should have INR monitored when taking Gou Qi Zi.", "sources": [ "Brinker 4th ed., p. 151" ], "source_keys": [ "brinker_4e" ] }, { "id": "he-shou-wu-hepatotoxic-drugs", "herb_keys": [ "he_shou_wu" ], "drug_class": "hepatotoxic drugs", "drug_class_zh": "肝毒性药物", "drug_examples": [ "acetaminophen (high dose)", "methotrexate", "statins", "isoniazid" ], "severity": "major", "mechanism_zh": "何首乌含蒽醌类成分，已有大量肝毒性报告（包括致死病例）。与其他肝毒性药物合用使肝损伤风险叠加。", "mechanism_en": "Polygonum multiflorum contains anthraquinones and has extensive documentation of hepatotoxicity, including fatal cases. Combination with other hepatotoxic drugs compounds the risk of liver injury.", "clinical_recommendation_zh": "服用肝毒性药物者禁用何首乌。即便单独使用亦须监测肝功能。", "clinical_recommendation_en": "Avoid He Shou Wu in patients taking hepatotoxic medications. Even when used alone, liver function monitoring is advised.", "sources": [ "Brinker 4th ed., p. 133", "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "brinker_4e", "bensky_mm_3e" ] }, { "id": "ge-gen-antidiabetics", "herb_keys": [ "ge_gen" ], "drug_class": "antidiabetic agents", "drug_class_zh": "降糖药", "drug_examples": [ "metformin", "glipizide", "insulin" ], "severity": "moderate", "mechanism_zh": "葛根所含葛根素（puerarin）等异黄酮类成分有降血糖作用，与降糖药合用可增加低血糖风险。", "mechanism_en": "Pueraria lobata contains puerarin and other isoflavones with hypoglycemic activity; combination with antidiabetic agents may increase the risk of hypoglycemia.", "clinical_recommendation_zh": "糖尿病患者服用降糖药期间使用葛根须监测血糖。", "clinical_recommendation_en": "Monitor blood glucose when Ge Gen is combined with antidiabetic medications.", "sources": [ "Chen & Chen, p. 58", "Brinker 4th ed., p. 132" ], "source_keys": [ "chen_chen_cmm", "brinker_4e" ] }, { "id": "san-qi-anticoagulants", "herb_keys": [ "san_qi" ], "drug_class": "anticoagulants & antiplatelet agents", "drug_class_zh": "抗凝血药及抗血小板药", "drug_examples": [ "warfarin", "aspirin", "clopidogrel", "rivaroxaban" ], "severity": "major", "mechanism_zh": "三七含三七皂苷，具显著抗血小板及抗凝血活性。与华法林、阿司匹林等合用显著增加出血风险。", "mechanism_en": "Panax notoginseng contains notoginsenosides with significant antiplatelet and anticoagulant activity; combination with warfarin, aspirin, or clopidogrel significantly increases bleeding risk.", "clinical_recommendation_zh": "服用抗凝药或抗血小板药者禁用三七。术前至少 2 周停用。", "clinical_recommendation_en": "Avoid San Qi in patients on anticoagulants or antiplatelet agents. Discontinue at least 2 weeks before surgery.", "sources": [ "Brinker 4th ed., p. 107", "Chen & Chen, p. 651" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "rou-gui-anticoagulants", "herb_keys": [ "rou_gui" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin", "rivaroxaban", "aspirin" ], "severity": "moderate", "mechanism_zh": "肉桂含香豆素类成分，有报道可增强华法林之抗凝效果。大剂量肉桂可抑制血小板聚集。", "mechanism_en": "Cinnamomum cassia contains coumarins that may potentiate warfarin's anticoagulant effect. High-dose cinnamon bark has been reported to inhibit platelet aggregation.", "clinical_recommendation_zh": "服用华法林者大剂量使用肉桂须监测 INR。常规调味量一般无虞。", "clinical_recommendation_en": "Monitor INR when high-dose Rou Gui is combined with warfarin. Culinary doses are generally safe.", "sources": [ "Brinker 4th ed., p. 46", "Chen & Chen, p. 489" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "du-zhong-antihypertensives", "herb_keys": [ "du_zhong" ], "drug_class": "antihypertensives", "drug_class_zh": "降压药", "drug_examples": [ "ACE inhibitors", "ARBs", "calcium channel blockers", "beta-blockers" ], "severity": "moderate", "mechanism_zh": "杜仲含杜仲胶及环烯醚萜苷类成分，有降压作用。与降压药合用可致血压过低。", "mechanism_en": "Eucommia ulmoides bark has documented hypotensive activity via its iridoid glycosides; combination with antihypertensives may cause excessive blood pressure lowering.", "clinical_recommendation_zh": "服用降压药者使用杜仲须注意血压变化。", "clinical_recommendation_en": "Monitor blood pressure when Du Zhong is used alongside antihypertensive therapy.", "sources": [ "Chen & Chen, p. 795", "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "chen_chen_cmm", "bensky_mm_3e" ] }, { "id": "yi-mu-cao-anticoagulants", "herb_keys": [ "yi_mu_cao" ], "drug_class": "anticoagulants & antiplatelet agents", "drug_class_zh": "抗凝血药及抗血小板药", "drug_examples": [ "warfarin", "aspirin", "clopidogrel" ], "severity": "moderate", "mechanism_zh": "益母草有活血化瘀作用，含益母草碱等生物碱，可抑制血小板聚集。与抗凝药合用增加出血风险。", "mechanism_en": "Leonurus japonicus has blood-invigorating activity and contains leonurine, which inhibits platelet aggregation; combination with anticoagulants increases bleeding risk.", "clinical_recommendation_zh": "服用抗凝药或抗血小板药者慎用益母草。", "clinical_recommendation_en": "Use Yi Mu Cao cautiously in patients on anticoagulant or antiplatelet therapy.", "sources": [ "Chen & Chen, p. 669", "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "chen_chen_cmm", "bensky_mm_3e" ] }, { "id": "chuan-xiong-anticoagulants", "herb_keys": [ "chuan_xiong" ], "drug_class": "anticoagulants & antiplatelet agents", "drug_class_zh": "抗凝血药及抗血小板药", "drug_examples": [ "warfarin", "aspirin", "clopidogrel", "heparin" ], "severity": "moderate", "mechanism_zh": "川芎含川芎嗪（tetramethylpyrazine）等活血成分，可抑制血小板聚集、扩张血管。与抗凝药合用增加出血风险。", "mechanism_en": "Ligusticum chuanxiong contains tetramethylpyrazine (ligustrazine) with documented antiplatelet and vasodilatory activity; combination with anticoagulants increases bleeding risk.", "clinical_recommendation_zh": "服用抗凝药或抗血小板药者慎用川芎及含川芎之复方。", "clinical_recommendation_en": "Use Chuan Xiong and formulas containing it cautiously in patients on anticoagulant or antiplatelet therapy.", "sources": [ "Brinker 4th ed., p. 84", "Chen & Chen, p. 645" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "tian-ma-antihypertensives", "herb_keys": [ "tian_ma" ], "drug_class": "antihypertensives", "drug_class_zh": "降压药", "drug_examples": [ "ACE inhibitors", "ARBs", "amlodipine", "nifedipine" ], "severity": "moderate", "mechanism_zh": "天麻含天麻素（gastrodin），有降血压及扩张血管作用。与降压药合用可致血压过低。", "mechanism_en": "Gastrodia elata contains gastrodin with documented hypotensive and vasodilatory effects; combination with antihypertensives may cause excessive blood pressure reduction.", "clinical_recommendation_zh": "服用降压药者使用天麻须密切监测血压。", "clinical_recommendation_en": "Monitor blood pressure closely when Tian Ma is combined with antihypertensive medications.", "sources": [ "Chen & Chen, p. 748", "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "chen_chen_cmm", "bensky_mm_3e" ] }, { "id": "suan-zao-ren-sedatives", "herb_keys": [ "suan_zao_ren" ], "drug_class": "sedatives & hypnotics", "drug_class_zh": "镇静催眠药", "drug_examples": [ "benzodiazepines", "zolpidem", "eszopiclone", "barbiturates" ], "severity": "moderate", "mechanism_zh": "酸枣仁含酸枣仁皂苷及黄酮类，具显著镇静催眠作用。与苯二氮卓类等镇静催眠药合用可致过度镇静。", "mechanism_en": "Ziziphus jujuba var. spinosa contains jujubosides and flavonoids with significant sedative-hypnotic activity; combination with benzodiazepines or other sedatives may cause excessive sedation.", "clinical_recommendation_zh": "服用镇静催眠药者使用酸枣仁须注意过度嗜睡。", "clinical_recommendation_en": "Use Suan Zao Ren cautiously in patients on sedative-hypnotic medications; monitor for excessive drowsiness.", "sources": [ "Chen & Chen, p. 739", "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "chen_chen_cmm", "bensky_mm_3e" ] }, { "id": "bo-he-cyp-substrates", "herb_keys": [ "bo_he" ], "drug_class": "CYP1A2 & CYP2A6 substrates", "drug_class_zh": "CYP1A2 及 CYP2A6 代谢底物", "drug_examples": [ "theophylline", "clozapine", "duloxetine", "cyclosporine" ], "severity": "theoretical", "mechanism_zh": "薄荷含薄荷醇（menthol），体外研究显示可抑制 CYP1A2 及 CYP2A6 酶活性，理论上影响经此通路代谢之药物之血药浓度。", "mechanism_en": "Mentha haplocalyx contains menthol, which inhibits CYP1A2 and CYP2A6 in vitro, theoretically altering serum levels of drugs metabolized by these pathways.", "clinical_recommendation_zh": "长期大量使用薄荷并同服窄治疗指数之 CYP1A2 底物（茶碱、氯氮平等）时需考量。", "clinical_recommendation_en": "Consider this interaction when long-term, high-dose Bo He is combined with narrow-therapeutic-index CYP1A2 substrates (theophylline, clozapine).", "sources": [ "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "bensky_mm_3e" ] }, { "id": "gan-cao-antihypertensives", "herb_keys": [ "gan_cao" ], "drug_class": "antihypertensives", "drug_class_zh": "降压药", "drug_examples": [ "ACE inhibitors", "ARBs", "amlodipine", "hydrochlorothiazide" ], "severity": "major", "mechanism_zh": "甘草所致假性醛固酮增多症可致钠水潴留、高血压，直接对抗降压药之效果。长期用量超过 3g/日时此风险显著。", "mechanism_en": "Glycyrrhizin-induced pseudoaldosteronism causes sodium and water retention with resultant hypertension, directly antagonizing the effect of antihypertensive drugs. Risk is significant with chronic intake exceeding 3 g/day.", "clinical_recommendation_zh": "高血压患者服用降压药者避免长期、大量使用甘草。须监测血压和血钾。", "clinical_recommendation_en": "Avoid long-term or high-dose Gan Cao in patients on antihypertensives. Monitor blood pressure and serum potassium.", "sources": [ "Brinker 4th ed., p. 144", "Chen & Chen, p. 877" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "ren-shen-immunosuppressants", "herb_keys": [ "ren_shen" ], "drug_class": "immunosuppressants", "drug_class_zh": "免疫抑制剂", "drug_examples": [ "cyclosporine", "tacrolimus", "azathioprine", "mycophenolate" ], "severity": "moderate", "mechanism_zh": "人参具免疫调节作用，含多种人参皂苷可增强免疫功能，理论上可对抗免疫抑制剂之效果。", "mechanism_en": "Panax ginseng has immunomodulatory activity via ginsenosides; its immune-enhancing effects may theoretically antagonize immunosuppressive therapy.", "clinical_recommendation_zh": "器官移植及自身免疫病服用免疫抑制剂者慎用人参。", "clinical_recommendation_en": "Use Ren Shen cautiously in organ transplant recipients and patients on immunosuppressive therapy for autoimmune conditions.", "sources": [ "Brinker 4th ed., p. 110", "Chen & Chen, p. 845" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "ma-huang-antihypertensives", "herb_keys": [ "ma_huang" ], "drug_class": "antihypertensives", "drug_class_zh": "降压药", "drug_examples": [ "ACE inhibitors", "ARBs", "beta-blockers", "calcium channel blockers" ], "severity": "major", "mechanism_zh": "麻黄含麻黄碱，具升压及增加心率之作用，直接对抗降压药之效果。可致血压控制不良及高血压危象。", "mechanism_en": "Ephedrine in Ma Huang raises blood pressure and heart rate, directly antagonizing antihypertensive therapy and potentially causing hypertensive crisis.", "clinical_recommendation_zh": "高血压患者及服用降压药者禁用麻黄。", "clinical_recommendation_en": "Avoid Ma Huang in hypertensive patients and those on antihypertensive medications.", "sources": [ "Brinker 4th ed., p. 70", "Chen & Chen, p. 39" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "fu-zi-anesthetics", "herb_keys": [ "fu_zi" ], "drug_class": "anesthetic agents", "drug_class_zh": "麻醉药", "drug_examples": [ "sevoflurane", "isoflurane", "propofol", "ketamine" ], "severity": "major", "mechanism_zh": "附子含乌头碱类生物碱，具心毒性及心律失常风险。全身麻醉亦可诱发心律失常，两者合用风险叠加。术前至少 2 周须停用。", "mechanism_en": "Aconitine alkaloids in Fu Zi carry arrhythmogenic risk; general anesthetics also sensitize the myocardium to arrhythmias, creating additive risk. Discontinue at least 2 weeks before surgery.", "clinical_recommendation_zh": "拟行全身麻醉者术前至少 2 周停用附子。", "clinical_recommendation_en": "Discontinue Fu Zi at least 2 weeks prior to general anesthesia.", "sources": [ "Brinker 4th ed., p. 5", "Chen & Chen, p. 481" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "da-huang-anticoagulants", "herb_keys": [ "da_huang" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin", "rivaroxaban", "apixaban" ], "severity": "moderate", "mechanism_zh": "大黄含蒽醌类成分，长期使用致低钾血症可间接影响凝血功能。此外大黄有轻度活血化瘀作用，与抗凝药合用理论上增加出血风险。", "mechanism_en": "Anthraquinones in Da Huang may indirectly affect coagulation via chronic hypokalemia. Additionally, rhubarb has mild blood-invigorating properties that theoretically increase bleeding risk with anticoagulants.", "clinical_recommendation_zh": "服用抗凝药者长期使用大黄须慎。短期攻下用药一般影响不大。", "clinical_recommendation_en": "Caution with prolonged Da Huang use in patients on anticoagulants. Short-term purgative use is generally acceptable.", "sources": [ "Brinker 4th ed., p. 134", "Chen & Chen, p. 119" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "huang-qi-antidiabetics", "herb_keys": [ "huang_qi" ], "drug_class": "antidiabetic agents", "drug_class_zh": "降糖药", "drug_examples": [ "metformin", "insulin", "glipizide", "glyburide" ], "severity": "moderate", "mechanism_zh": "黄芪含黄芪多糖等成分，有降低血糖作用。与降糖药合用可增加低血糖风险。", "mechanism_en": "Astragalus membranaceus contains polysaccharides with hypoglycemic activity; combination with antidiabetic agents may increase the risk of hypoglycemia.", "clinical_recommendation_zh": "糖尿病患者服用降糖药期间使用黄芪须监测血糖。", "clinical_recommendation_en": "Monitor blood glucose when Huang Qi is combined with antidiabetic medications.", "sources": [ "Chen & Chen, p. 854", "Brinker 4th ed., p. 11" ], "source_keys": [ "chen_chen_cmm", "brinker_4e" ] }, { "id": "ban-xia-antiarrhythmics", "herb_keys": [ "ban_xia" ], "drug_class": "antiarrhythmic drugs", "drug_class_zh": "抗心律失常药", "drug_examples": [ "amiodarone", "sotalol", "flecainide" ], "severity": "theoretical", "mechanism_zh": "半夏含生物碱类成分，体外研究显示可影响心肌细胞离子通道。理论上与抗心律失常药合用须考量。", "mechanism_en": "Pinellia alkaloids affect cardiac ion channels in vitro; theoretical interaction with antiarrhythmics warrants consideration.", "clinical_recommendation_zh": "服用抗心律失常药者使用半夏须谨慎。", "clinical_recommendation_en": "Use Ban Xia cautiously in patients on antiarrhythmic medications.", "sources": [ "Chen & Chen, p. 400" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "huang-lian-cyp-substrates", "herb_keys": [ "huang_lian" ], "drug_class": "CYP3A4 & CYP2D6 substrates", "drug_class_zh": "CYP3A4 及 CYP2D6 代谢底物", "drug_examples": [ "cyclosporine", "statins", "codeine", "dextromethorphan" ], "severity": "moderate", "mechanism_zh": "黄连所含小檗碱可抑制 CYP3A4 及 CYP2D6 酶活性，使经此通路代谢之药物血药浓度升高。", "mechanism_en": "Berberine in Coptis chinensis inhibits CYP3A4 and CYP2D6, potentially raising serum levels of drugs metabolized via these pathways.", "clinical_recommendation_zh": "合用经 CYP3A4 或 CYP2D6 代谢之窄治疗指数药物时须考量，必要时监测血药浓度。", "clinical_recommendation_en": "Monitor serum levels of narrow-therapeutic-index CYP3A4 and CYP2D6 substrates when combined with Huang Lian.", "sources": [ "Chen & Chen, p. 177" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "gou-qi-zi-antidiabetics", "herb_keys": [ "gou_qi_zi" ], "drug_class": "antidiabetic agents", "drug_class_zh": "降糖药", "drug_examples": [ "metformin", "insulin", "glipizide" ], "severity": "theoretical", "mechanism_zh": "枸杞子含枸杞多糖，有轻度降血糖作用。与降糖药合用理论上增加低血糖风险。", "mechanism_en": "Lycium barbarum polysaccharides have mild hypoglycemic activity; theoretical additive effect with antidiabetic agents.", "clinical_recommendation_zh": "糖尿病患者服用降糖药期间大量使用枸杞子须注意血糖。", "clinical_recommendation_en": "Monitor blood glucose when large doses of Gou Qi Zi are combined with antidiabetic medications.", "sources": [ "Chen & Chen, p. 817", "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "chen_chen_cmm", "bensky_mm_3e" ] }, { "id": "he-shou-wu-anticoagulants", "herb_keys": [ "he_shou_wu" ], "drug_class": "anticoagulants", "drug_class_zh": "抗凝血药", "drug_examples": [ "warfarin", "rivaroxaban" ], "severity": "moderate", "mechanism_zh": "何首乌之肝毒性可影响肝脏合成凝血因子之功能，理论上改变抗凝药之效果。此外肝损伤本身即增加出血风险。", "mechanism_en": "He Shou Wu hepatotoxicity may impair hepatic synthesis of clotting factors, theoretically altering anticoagulant drug efficacy. Liver injury itself also increases bleeding risk.", "clinical_recommendation_zh": "服用抗凝药者避免使用何首乌。", "clinical_recommendation_en": "Avoid He Shou Wu in patients on anticoagulant therapy.", "sources": [ "Brinker 4th ed., p. 133" ], "source_keys": [ "brinker_4e" ] }, { "id": "ge-gen-antihypertensives", "herb_keys": [ "ge_gen" ], "drug_class": "antihypertensives", "drug_class_zh": "降压药", "drug_examples": [ "ACE inhibitors", "ARBs", "calcium channel blockers" ], "severity": "theoretical", "mechanism_zh": "葛根所含葛根素有扩张冠状动脉及外周血管之作用，理论上与降压药合用可致血压过低。", "mechanism_en": "Puerarin in Ge Gen has coronary and peripheral vasodilatory effects; theoretical additive hypotension when combined with antihypertensives.", "clinical_recommendation_zh": "服用降压药者使用葛根须注意血压变化。", "clinical_recommendation_en": "Monitor blood pressure when Ge Gen is used in patients on antihypertensive therapy.", "sources": [ "Chen & Chen, p. 58" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "san-qi-antidiabetics", "herb_keys": [ "san_qi" ], "drug_class": "antidiabetic agents", "drug_class_zh": "降糖药", "drug_examples": [ "metformin", "insulin", "glipizide" ], "severity": "theoretical", "mechanism_zh": "三七皂苷有轻度降血糖作用，理论上与降糖药合用增加低血糖风险。", "mechanism_en": "Notoginsenosides in San Qi have mild hypoglycemic activity; theoretical additive effect with antidiabetic agents.", "clinical_recommendation_zh": "糖尿病患者服用降糖药期间使用三七须注意血糖变化。", "clinical_recommendation_en": "Monitor blood glucose when San Qi is combined with antidiabetic medications.", "sources": [ "Chen & Chen, p. 651" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "rou-gui-antidiabetics", "herb_keys": [ "rou_gui" ], "drug_class": "antidiabetic agents", "drug_class_zh": "降糖药", "drug_examples": [ "metformin", "insulin", "glipizide" ], "severity": "theoretical", "mechanism_zh": "肉桂有改善胰岛素敏感性及降血糖之作用。与降糖药合用理论上增加低血糖风险。", "mechanism_en": "Cinnamomum cassia improves insulin sensitivity and has hypoglycemic properties; theoretical additive effect with antidiabetic agents.", "clinical_recommendation_zh": "糖尿病患者服用降糖药期间大量使用肉桂须注意血糖。", "clinical_recommendation_en": "Monitor blood glucose when high-dose Rou Gui is combined with antidiabetic medications.", "sources": [ "Brinker 4th ed., p. 46" ], "source_keys": [ "brinker_4e" ] }, { "id": "du-zhong-antidiabetics", "herb_keys": [ "du_zhong" ], "drug_class": "antidiabetic agents", "drug_class_zh": "降糖药", "drug_examples": [ "metformin", "insulin", "glipizide" ], "severity": "theoretical", "mechanism_zh": "杜仲有轻度降血糖作用，理论上与降糖药合用增加低血糖风险。", "mechanism_en": "Eucommia ulmoides has mild hypoglycemic activity; theoretical additive effect with antidiabetic agents.", "clinical_recommendation_zh": "糖尿病患者服用降糖药期间使用杜仲须注意血糖。", "clinical_recommendation_en": "Monitor blood glucose when Du Zhong is combined with antidiabetic medications.", "sources": [ "Chen & Chen, p. 795" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "chuan-xiong-antihypertensives", "herb_keys": [ "chuan_xiong" ], "drug_class": "antihypertensives", "drug_class_zh": "降压药", "drug_examples": [ "ACE inhibitors", "ARBs", "calcium channel blockers" ], "severity": "moderate", "mechanism_zh": "川芎含川芎嗪，有扩张血管、降低血压之作用。与降压药合用可致血压过低。", "mechanism_en": "Tetramethylpyrazine (ligustrazine) in Chuan Xiong has vasodilatory and hypotensive effects; combination with antihypertensives may cause excessive blood pressure reduction.", "clinical_recommendation_zh": "服用降压药者使用川芎须注意血压变化。", "clinical_recommendation_en": "Monitor blood pressure when Chuan Xiong is used alongside antihypertensive therapy.", "sources": [ "Brinker 4th ed., p. 84", "Chen & Chen, p. 645" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] }, { "id": "tian-ma-sedatives", "herb_keys": [ "tian_ma" ], "drug_class": "sedatives & hypnotics", "drug_class_zh": "镇静催眠药", "drug_examples": [ "benzodiazepines", "zolpidem", "barbiturates" ], "severity": "moderate", "mechanism_zh": "天麻含天麻素，有镇静、抗惊厥作用。与镇静催眠药合用可致过度镇静。", "mechanism_en": "Gastrodin in Tian Ma has sedative and anticonvulsant properties; combination with sedative-hypnotics may cause excessive sedation.", "clinical_recommendation_zh": "服用镇静催眠药者使用天麻须注意过度嗜睡。", "clinical_recommendation_en": "Use Tian Ma cautiously in patients on sedative-hypnotic medications; monitor for excessive drowsiness.", "sources": [ "Chen & Chen, p. 748" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "suan-zao-ren-antiepileptics", "herb_keys": [ "suan_zao_ren" ], "drug_class": "antiepileptic drugs", "drug_class_zh": "抗癫痫药", "drug_examples": [ "phenobarbital", "carbamazepine", "valproic acid", "gabapentin" ], "severity": "theoretical", "mechanism_zh": "酸枣仁有镇静及抗惊厥作用，理论上与抗癫痫药合用可产生协同镇静效应。", "mechanism_en": "Ziziphus spinosa has sedative and anticonvulsant activity; theoretical synergistic sedation with antiepileptic drugs.", "clinical_recommendation_zh": "服用抗癫痫药者使用酸枣仁须注意过度镇静。", "clinical_recommendation_en": "Monitor for excessive sedation when Suan Zao Ren is combined with antiepileptic medications.", "sources": [ "Chen & Chen, p. 739" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "bo-he-cyclosporine", "herb_keys": [ "bo_he" ], "drug_class": "immunosuppressants (cyclosporine)", "drug_class_zh": "免疫抑制剂（环孢素）", "drug_examples": [ "cyclosporine" ], "severity": "moderate", "mechanism_zh": "薄荷含薄荷醇，可抑制 CYP3A4，影响环孢素之代谢，致血药浓度升高。", "mechanism_en": "Menthol in Bo He inhibits CYP3A4, potentially reducing cyclosporine metabolism and raising its serum levels.", "clinical_recommendation_zh": "使用环孢素之移植患者避免大量使用薄荷。", "clinical_recommendation_en": "Avoid high-dose Bo He in transplant patients on cyclosporine; monitor cyclosporine levels if combination is necessary.", "sources": [ "Bensky et al. Materia Medica 3rd ed., safety appendix" ], "source_keys": [ "bensky_mm_3e" ] }, { "id": "yi-mu-cao-antihypertensives", "herb_keys": [ "yi_mu_cao" ], "drug_class": "antihypertensives", "drug_class_zh": "降压药", "drug_examples": [ "ACE inhibitors", "ARBs", "calcium channel blockers" ], "severity": "theoretical", "mechanism_zh": "益母草含益母草碱，有扩张血管、利尿、降压作用。与降压药合用理论上可致血压过低。", "mechanism_en": "Leonurine in Yi Mu Cao has vasodilatory, diuretic, and hypotensive effects; theoretical additive hypotension with antihypertensives.", "clinical_recommendation_zh": "服用降压药者使用益母草须注意血压变化。", "clinical_recommendation_en": "Monitor blood pressure when Yi Mu Cao is used alongside antihypertensive therapy.", "sources": [ "Chen & Chen, p. 669" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "sheng-di-huang-antidiabetics", "herb_keys": [ "sheng_di_huang" ], "drug_class": "antidiabetic agents", "drug_class_zh": "降糖药", "drug_examples": [ "metformin", "insulin", "glipizide" ], "severity": "theoretical", "mechanism_zh": "生地黄含梓醇等环烯醚萜苷，有轻度降血糖作用。理论上与降糖药合用增加低血糖风险。", "mechanism_en": "Rehmannia glutinosa contains catalpol and other iridoid glycosides with mild hypoglycemic activity; theoretical additive effect with antidiabetic agents.", "clinical_recommendation_zh": "糖尿病患者服用降糖药期间使用生地黄须注意血糖变化。", "clinical_recommendation_en": "Monitor blood glucose when Sheng Di Huang is combined with antidiabetic medications.", "sources": [ "Chen & Chen, p. 700" ], "source_keys": [ "chen_chen_cmm" ] }, { "id": "shan-zha-cardiac-glycosides", "herb_keys": [ "shan_zha" ], "drug_class": "cardiac glycosides", "drug_class_zh": "强心苷", "drug_examples": [ "digoxin" ], "severity": "moderate", "mechanism_zh": "山楂含黄酮类成分，有正性肌力作用，与地高辛合用可增强强心效果，致地高辛毒性风险增加。", "mechanism_en": "Crataegus flavonoids have positive inotropic activity; combination with digoxin may potentiate its effects and increase toxicity risk.", "clinical_recommendation_zh": "服用地高辛者使用山楂须监测地高辛血药浓度。", "clinical_recommendation_en": "Monitor digoxin levels when Shan Zha is combined with cardiac glycoside therapy.", "sources": [ "Brinker 4th ed., p. 55" ], "source_keys": [ "brinker_4e" ] }, { "id": "gan-cao-oral-contraceptives", "herb_keys": [ "gan_cao" ], "drug_class": "oral contraceptives & hormone therapy", "drug_class_zh": "口服避孕药及激素治疗", "drug_examples": [ "ethinyl estradiol", "norethindrone", "conjugated estrogens" ], "severity": "moderate", "mechanism_zh": "甘草甜素可抑制类固醇代谢，与外源性雌激素合用可加剧雌激素之副作用（水肿、高血压、血栓风险）。", "mechanism_en": "Glycyrrhizin inhibits steroid metabolism; combination with exogenous estrogens may potentiate estrogen-related side effects (edema, hypertension, thrombotic risk).", "clinical_recommendation_zh": "服用口服避孕药或激素替代治疗者避免长期大量使用甘草。", "clinical_recommendation_en": "Avoid long-term, high-dose Gan Cao in patients on oral contraceptives or hormone replacement therapy.", "sources": [ "Brinker 4th ed., p. 145" ], "source_keys": [ "brinker_4e" ] }, { "id": "ren-shen-anticoagulants-nsaids", "herb_keys": [ "ren_shen" ], "drug_class": "NSAIDs", "drug_class_zh": "非甾体抗炎药", "drug_examples": [ "ibuprofen", "naproxen", "diclofenac", "aspirin" ], "severity": "moderate", "mechanism_zh": "人参具抗血小板活性，与非甾体抗炎药（尤其阿司匹林）合用可增加出血风险。已有合用致出血之个案报道。", "mechanism_en": "Panax ginseng has antiplatelet activity; combination with NSAIDs (especially aspirin) may increase bleeding risk. Case reports of bleeding with concurrent use exist.", "clinical_recommendation_zh": "长期服用 NSAIDs 者使用人参须注意出血征象。", "clinical_recommendation_en": "Monitor for signs of bleeding when Ren Shen is used in patients on long-term NSAID therapy.", "sources": [ "Brinker 4th ed., p. 110", "Chen & Chen, p. 845" ], "source_keys": [ "brinker_4e", "chen_chen_cmm" ] } ] }