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基于人用经验的证候类中药新药研发策略

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我国药品注册法规一直为证候类中药新药保留位置,但迄今为止尚无证候类中药新药批准上市.该文阐述我国证候类中药新药相关政策法规和相关技术,指出应用中医证候动物模型开展药效学研究和中医证候临床疗效评价标准是证候类中药新药研发的主要技术难点;不是所有的证候都适合开发新药,证候类中药新药适应证应以"恒证"为宜.在"单纯证候""以证统病""证症结合"3种研发模式中,推荐"证症结合"研发模式.临床定位是证候类中药新药的关键环节,鼓励通过开展高质量的人用经验研究,确定证候类中药新药的临床定位,以及目标人群、剂量、疗程、初步的有效性和安全性,申请豁免非临床有效性研究.证候类中药新药临床试验应以目标症状或体征为主要疗效指标,中医证候疗效作为次要疗效指标,临床研究方案设计应贯彻"以患者为中心"理念,引入临床结局评估指标;临床安全性评价要考虑证候传变等特殊情况.随着人用经验技术体系构建与"三结合"中药注册审评证据体系推进,相信未来将开发出一批高质量的证候类中药新药.
Research and development strategy of new traditional Chinese medicine drugs for syndromes based on human use experience
Chinese drug registration laws and regulations have always reserved a place for the new traditional Chinese medicine(TCM)drugs for syndromes,but so far no such new drugs have been approved for registration.This paper expounded on the relevant policies,regulations,and technologies of new TCM drugs for syndromes in China and pointed out that the application of the animal model of TCM syndromes to carry out pharmacodynamics research and clinical efficacy evaluation criteria of TCM syndromes were the main technical difficulties in the research and development of new TCM drugs for syndromes.Not all syndromes are suitable for developing new drugs,and the indications for new TCM drugs should be constant syndromes.Among the three research and development models of simple syndrome,syndrome-unified disease,and combined disease and syndrome,the research and development model of combined disease and syndrome is recommended.Clinical positioning is the key to new TCM drugs for syndromes.It is encouraged to conduct high-quality human use experience studies to determine the clinical positioning of new TCM drugs for syndromes,as well as the target population,dose,course of treatment,and initial therapeutic and safety,and apply for exemption from non-clinical effectiveness studies.Clinical trials of new TCM drugs for syndromes should take the target symptoms or signs as the main efficacy index and the efficacy of TCM syndromes as the secondary efficacy index.Clinical research program design should implement the"patient-centered"concept and introduce clinical outcome evaluation indicators.In the clinical safety evaluation,special conditions such as characteristic syndromes and changes should be considered.With the construction of the human use experience technology system and the promotion of the TCM registration and evaluation evidence system featuring the"combination of TCM theory,human use experience,and clinical trials",it is believed that many high-quality new TCM drugs for syndromes will be developed in the future.

traditional Chinese medicine syndromeshuman use experiencenew traditional Chinese medicine drugs

杨忠奇、何星灵、刘东华、唐雅琴、汤慧敏、凌燕、杜彦萍

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广州中医药大学第一附属医院,广东广州 510407

中医证候 人用经验 中药新药

广东省药品监督管理局科技创新项目国家中医药局新型冠状病毒感染中医药应急专项(第二批)(2023)

2022ZDB062023ZYLCYJ02-17

2024

中国中药杂志
中国药学会

中国中药杂志

CSTPCD北大核心
影响因子:1.718
ISSN:1001-5302
年,卷(期):2024.49(3)
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