背景:传统医学已采用鼻内给药,以促进进入血流和中枢神经系统(CNS)。在现代医学中,鼻腔给药系统是有价值的疾病治疗,因为它们的非侵入性,吸收好,和快速效果。
目的:本研究旨在系统地组织鼻内草药的临床前和临床研究,以突出其在药物开发中的潜力。
方法:在PubMed和WebofScience上进行了直到2023年2月的全面文献搜索。从选定的出版物中,我们提取了关键信息,包括草药材料的类型,目标疾病,鼻内条件,毒性评价方法,主要成果,和行动机制,并对每项研究进行质量评估。
结果:在45项研究中,13个是临床的,32个是临床前的;28个研究使用草药提取物,9种使用过的处方,和8使用天然化合物。目标疾病是鼻窦炎,流感,发烧,中风,偏头痛,失眠,抑郁症,记忆障碍,还有肺癌.小鼠的常见鼻内体积为8-50μl,20-100μl大鼠,和100-500微升的兔子。薄荷油,黑肋,MeliaazedarachL.,樟子树,柴胡,大川熊芳,醒脑静微乳,和人参皂苷Rb1成为快速鼻内治疗的潜在候选药物。体内毒性评估基于死亡率,体重,行为改变,粘膜纤毛活动,组织病理学,和血液测试。大多数鼻内治疗是安全的,除了欧洲仙客来,JasminumSambac,石榴,和紫罗兰色的油,造成轻微的不良影响。在较低的剂量下,鼻内草药治疗通常显示出比口服给药更大的效果。鼻内中药的作用主要涉及调节炎症和神经传递,嗅球和前扣带皮质是相关的大脑区域。
结论:鼻内输送草药有望提高药物输送效果,缩短治疗时间,为开发各种疾病的鼻内治疗提供了潜在的未来前景。
BACKGROUND: Intranasal administration has been adopted in traditional medicine to facilitate access to the bloodstream and central nervous system (CNS). In modern medicine, nasal drug delivery systems are valuable for disease treatment because of their noninvasiveness, good absorption, and fast-acting effects.
OBJECTIVE: This study aimed to systematically organize preclinical and clinical studies on intranasal herbal medicines to highlight their potential in drug development.
METHODS: A comprehensive search for literature until February 2023 was conducted on PubMed and the Web of Science. From the selected publications, we extracted key information, including the types of herbal materials, target diseases, intranasal conditions, methods of toxicity evaluation, main outcomes, and mechanisms of action, and performed quality assessments for each study.
RESULTS: Of the 45 studies, 13 were clinical and 32 were preclinical; 28 studies used herbal extracts, 9 used prescriptions, and 8 used natural compounds. The target diseases were rhinosinusitis, influenza, fever, stroke, migraine, insomnia, depression, memory disorders, and lung cancer. The common intranasal volumes were 8-50 µl in mice, 20-100 µl in rats, and 100-500 µl in rabbits. Peppermint oil, Ribes nigrum folium, Melia azedarach L., Elaeocarpus sylvestris, Radix Bupleuri, Da Chuan Xiong Fang, Xingnaojing microemulsion, and Ginsenoside Rb1 emerged as potential candidates for rapid intranasal therapy. The in vivo toxicity assessments were based on mortality, body weight, behavioral changes, mucociliary activity, histopathology, and blood tests. Most intranasal treatments were safe, except for Cyclamen europaeum, Jasminum sambac, Punica granatum L., and violet oil, which caused mild adverse effects. At lower doses, intranasal herbal treatments often show greater effects than oral administration. The actions of intranasal herbal medicine mainly involve regulating inflammation and neurotransmission, with the olfactory bulb and anterior cingulate cortex to be relevant brain regions.
CONCLUSIONS: Intranasal delivery of herbal materials holds promise for enhancing drug delivery efficacy and reducing treatment duration, offering a potential future perspective for developing intranasal therapies for various diseases.