Interviewee: Liang Aihua, Researcher, Institute of Chinese Materia Medica, Chinese Academy of Traditional Chinese Medicine
On October 18, aristolochic acid boarded the cover of the authoritative medical journal "Science Translational Medicine" due to gene mutation and induction of liver cancer.
Taiwan Chang Gung Memorial Hospital research team using the international public liver cancer gene information analysis of more than 1,400 cases of liver cancer specimens around the world found that the Asian population of liver cancer and aristolochic acid gene mutations caused by a high incidence of 98 cases of pathological samples of liver cancer in Taiwan , 78% had aristolochic mutagenic characteristics, and 47% of the 89 samples of liver cancer in China were in line with aristolochic acid gene mutation characteristics, while in Europe and the United States, the figure was 1.7% and 4.8% respectively. From this, we speculated that patients may have used Chinese herbal medicine containing aristolochic acid, which may cause hepatitis, cirrhosis and even liver cancer.
Liang Aihua, a researcher at the Institute of Chinese Materia Medica, Chinese Academy of Traditional Chinese Medicine, conducted a toxicological study on Chinese medicines containing aristolochic acid. She told Life Times reporter that aristolochic acid and its lactam are nitro-phenanthrene compounds that exist in many Chinese herbal medicine, such as Guan Mu Tong, Guang Fang Ji, Aoki incense, angel wisteria, Aristolochia, huagongfeng, Zhusha lotus, Daihatsu Aristolochia, Hanzhong Aristolochia, Asarum, etc., used in the past for different purposes, such as heat, Diuretic, swelling, anti-inflammatory, etc .. Some people abroad will be widely used herbal formula for weight loss.At present, Guan Mu Tong, Guang Fang, Aoki high aristolochic acid content of Chinese medicine, the mainland has banned the use of other varieties Are in accordance with the prescription drug management use.Part of proprietary Chinese medicines contain Aristolochia ingredients, such as wheezing capsule, compound snake bile Chuanbei San, cockroach pills, green cough pills, lungs and phlegm pills, oral cough and asthma relief cough Sputum capsules and so on.
The reason for the partial ban is because aristolochic acid has kidney toxicity and is associated with cancer of the urinary system.Liang Aowh explains that aristolochic acid can form an adduct with DNA and lead to changes in DNA that can induce tumors.Her animal experiments Observed in rats given a long-term dose of aristolochic acid dose, medication 4 months to 6 months after (the longest life expectancy of 2 years in rats, the medication period is equivalent to the longevity of rats 1/6 ~ 1 / 4), can cause bladder cancer, kidney cancer, subcutaneous tumors in rats, but in the previous study, rats given aristolochic acid within 6 months, no liver tumors.
According to Liang Aihua, the latest study shows that liver cancer is related to taking traditional Chinese medicines containing aristolochic acid. This conclusion is not objective. "There are many causes of liver cancer, including hepatitis B virus, hepatitis C virus, aflatoxin, other environmental carcinogens Dioxins, nitrosamines, azobenzenes, etc.), cirrhosis caused by other causes, aristolochic acid is just one of many factors. "She believes that the study of Taiwan has the following three issues worth exploring First, it has now been recognized that viral hepatitis is the most common carcinogenic factor of liver cancer, and only 98 of the 98 samples from Taiwan are negative for hepatitis and most of them come from hepatitis-positive patients. Second, In the study of liver cancer sequencing, the sample size, the representativeness of the sample source region and so on are very limited. The types of gene mutations in liver cancer caused by various factors are not completely understood. Many other environmental carcinogenic compounds, such as vinyl chloride , Nitrosamines and other may lead to similar gene mutations? These studies are not sufficient .Third, there is no direct evidence that patients taking aristolochic acid-containing Chinese medicine, but also We have provided evidence that the patient has liver aristolochic acid adduct present.
'These studies on aristolochic acid aim to understand more objectively the toxicity of Chinese herbal medicine and to make it more rational and scientific.' "Mr Leung emphasized that if the content of aristolochic acid is low or the extracted medicines are basically There is no aristolochic acid, these drugs can be used.It must be emphasized that the toxicity of the drug and dosage, the use of time, strict control of dosage and medication time is very important.Some toxic itself contains the use of the medicine should also pay attention to, For example, aconite, Radix Aconitum, Radix commonly used in arthritis and bruises, these drugs contain aconitine ingredients, increase the dose or long-term use, easy to cause poisoning. Eating can hurt the spleen and stomach, causing adverse reactions.Even the low toxicity of traditional Chinese medicine, regardless of disease and physical use, or free to increase the dose, long-term use, will increase the risk of adverse reactions.
