臨床常用安胎中藥機轉與安全性探討

Review: The Mechanism and Safety Evaluation of Chinese Herbal Medicines Clinically Used for Tocolysis

胎漏、胎動不安、滑胎等症狀，屬於先兆性流產或習慣性流產之範疇，為婦科常見症狀，安胎為其治療原則。本文整理臨床常見用以安胎之中藥，包括清熱類的黃芩、健脾類的白朮、補血類的阿膠、補肝腎類的續斷、菟絲子、桑寄生、杜仲等。其安胎機轉包括：增加黃體素含量、抑制子宮平滑肌收縮、清除自由基、抗氧化、抑制母體對胚胎的免疫排斥、強化造血機能、抑制子宮出血、預防妊娠高血壓、增加鋅含量、促進葉酸吸收與代謝、增加維生素E含量等。在妊娠期中藥安全性方面，近代研究發現，常用安胎中藥在高劑量下，反而可能抑制胚胎成長發育或具有致畸性，足供中醫師用藥參考。

Threatened abortion and habitual abortion are common symptoms in miscarriage. Tocolysis is the principle of the treatment. In this paper, we review mechanisms of some traditional Chinese medicine, such as skullcap, Atractylodes, donkey-hide gelatin, teasel, dodder, mistletoe, Eucommia, commonly used in treating miscarriage, including raising the progesterone level to inhibit uterine smooth muscle contraction and abnormal bleeding, scavenging free radical as antioxidant, inhibiting maternal immune rejection to the embryo, preventing pregnancy-induced hypertension, enhancing hematopoietic function, supplying zinc to promote the absorption and metabolism of folic acid, maintaining vitamin E level, etc. Studying the safety of the traditional Chinese medicine intake during pregnancy, research papers show that overdose can inhibit the growth and development of the embryo and may induce teratogenicity.