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אדמונית - Paeonia spp.

עודכן בתאריך 30/07/2025

Peony - Bai shao / Chi shao / Mu dan pi


משפחה בוטנית: אדמוניתיים – Paeoniaceae

חלק הצמח | איכויות | רכיבים פעילים | התוויות | מינונים | רגישות | תופעות לוואי | 

מינון יתר | אזהרות | התוויות נגד | רעילות | אינטראקציות | הריון | הנקה

 

מונוגרף זה מתייחס לשלושת המינים הבאים:

P. lactiflora / Alba (שם עממי: White Peony), המוכר ברפואה הסינית תחת השם Bai shao (כאשר הקליפה קולפה מן השורש);

P. veitchii / Rubra (שם עממי: Red Peony / Veitch's peony), המוכר ברפואה הסינית תחת השם Chi shao (אם כי גם שורש P. lactiflora שאינו מקולף יכול לשמש כחומר גלם לתמצית זו);

P. suffruticosa (שם עממי: Chinese tree peony), המוכר ברפואה הסינית תחת השם Mu dan pi.

שם הסוג הבוטני נגזר משמו של Paeon, רופא האלים במיתולוגיה היוונית, שהיה תלמידו של אסקלפיוס (אל הרפואה). האגדה מספרת שאסקלפיוס קינא בתלמידו, וכדי להציל אותו מחרון אפו, זאוס הפך את פאון לצמח האדמונית.

שם המין lactiflora נובע מצבעם הלבן כחלב של עלי הכותרת; 

המין veitchii נקרא כך על שם משתלת ווייץ׳ (Veitch), ממנה נלקחה דגימה של הצמח.

הצבעים המוזכרים בשמות העממיים של המינים השונים מתייחסים לצבע השורש (עם או ללא קליפת הגזע) ולא לצבעי הפרחים.

אדמונית הינה צמח רב שנתי עשבוני. מוצאם של מיני האדמונית השונים הינו בסין.

מיני האדמונית השונים המוזכרים במונוגרף זה, מותרים לשיווק בישראל.

 

חלק הצמח בשימוש

שורש.

 

איכויות

טמפרטורה: קריר.

לחות: ניטראלי.

טעם: מריר, חמוץ, מתקתק.

 

רכיבים פעילים עיקריים

גליקוזידים מונוטרפניים (החשוב מביניהם הוא paeoniflorin, המהווה 0.05-6.01% מסך הצמח; oxypaeoniflorin, benzoylpaeoniflorin, albiflorin), טריטרפנים, פרואנתוציאנידינים, פלבונואידים, פנולים, טאנינים, פוליסכרידים, סטרולים, סידן (0.5-4%).

 

התוויות

כאבי מחזור (דיסמנוריאה), תסמונת קדם וסתית (PMS), אנדומטריוזיס, אל וסת (אמנוריאה), דימום וסתי מוגבר (מנורגיה), תסמונת גיל המעבר, אבנים בכיס המרה, דלקת בכיס המרה, מיומות, שחלות פוליציסטיות, דלקות כבד, מחלות מעי דלקתיות (IBD), קרוהן, קוליטיס,  כיב פפטי, תסמונת המעי הרגיש (IBS), כאבי ראש, מחלות אוטואימוניות, זאבת (לופוס), פיברומיאלגיה, תסמונת העייפות הכרונית (CFS), מחלת הסעיפים (דיברטיקולוזיס), דיכאון, אנמיה, בעיות פריון, דלקת מפרקים שגרונית (RA).

 

מינונים

תמצית נוזלית בריכוז 1:3, 45% אלכוהול – 10-25 מ״ל ביום.

תמצית יבשה – תלוי בריכוז התמצית. מינון המקביל ל- 3-12 גרם צמח ביום.

מרתח – 3-12 גרם ביום.

בפורמולה – 20-30%.

 

רגישות

לא ידועה רגישות מיוחדת לאדמונית.

 

תופעות לוואי

לא ידועות תופעות לוואי לשימוש באדמונית, למעט  למידע השלם למנויים

 

מינון יתר

לא ידוע על תופעות הנגרמות ממינון יתר של אדמונית.

 

אזהרות וצעדי מנע

יש לנקוט זהירות במתן אדמונית לאנשים הסובלים מ  למידע השלם למנויים

יש לנקוט זהירות במתן אדמונית (Chi shao) לאנשים הסובלים מ  למידע השלם למנויים

 

התוויות נגד

לא ידוע על התוויות נגד.

 

רעילות

לא נצפתה כל רעילות בשימוש באדמונית במינונים הרפואיים המקובלים.

בתנאי מעבדה, תמציות אדמונית  למידע השלם למנויים

מדד רעילותLD50:  למידע השלם למנויים

 

תגובות הדדיות עם תרופות / צמחי מרפא / תוספי תזונה

חילוף חומרים תרופתי | אנטי-פסיכוטיות | מעכבות צימות טסיות | נוגדות קרישה | DMARDs (למחלות אוֹטואימוניות) | סטרואידים |  | NSAIDs | טיפול בשחפת | השריית ביוץ (clomiphene) | התרופה valproate | התרופה Cetirizine (Zyrtec) | התרופה Losartan | התרופה Midazolam |  התרופה Phenytoin | התרופה Carbamazepine  | התרופה Hydroxychloroquin | התרופה Tacrolimus לטיפול במָחלות אוֹטואימוניות | התרופה Tacrolimus להשתלת אברים | אנטיביוטיקה | נוגדות דִיכאון | התרופה Cyclophosphamide 

 

תרופות למחלת הסרְטן

כימותרפיה מסוג Paclitaxel | כימותרפיה מסוג Carboplatin | כימותרפיה מסוג Cisplatin | כימותרפיה מסוג Cyclophosphamide | כימותרפיה מסוג Cytarabine | כימותרפיה מסוג Meloxicam 

 

צמחי מרפא ותוספי תזונה

אנג'לִיקה סינית (Angelִica sinensis) | שוּמר (Foeִniculum vulgare) | שוּש קירח (Gִlycyrrhiza glabra)

 

 

חילוף חומרים תרופתי

במחקרים קליניים(14,52) אדמונית לא השפיעה על למידע השלם למנויים

 

CYP2A6

השְפעתה של אדמונית על למידע השלם למנויים

 

CYP2C9

אדמונית לא צפויה להשפיע על למידע השלם למנויים

 

CYP2C19

השְפעתה של אדמונית על למידע השלם למנויים

 

CYP3A4

השְפעתה של אדמונית על למידע השלם למנויים

 

אנזימי UGT (Glucuronosyltransferase) - UGT1A3, UGT1A4, UGT1A6, UGT1A8, UGT1A9, UGT1A10, UGT2Bִ7 ו-UGT2B15.

אדמונית לא צפויה להשפיע על למידע השלם למנויים

 

P-gp

השְפעתה של אדמונית על למידע השלם למנויים

 

OATP-B

השְפעתה של אדמונית על למידע השלם למנויים

 

ALBUMIN

אדמונית לא צפויה להשפיע על קשירת תרופות למידע השלם למנויים

 

תרופות אנטי-פסיכוטיות (Risperidone, Paliperidone, Sulpiride, Amisulpride, Olanzapine, Ziprasidone ו-Quetiapine)

השילוב אפשרי ואף עשוי להיות מומלץ.

במחקרים קליניים למידע השלם למנויים

 

תרופות מעכבות צימות טסיות

אין מניעה לשלב, אך יש לנקוט זהירות.

על פי סקירות(63,64,65) ומחקרים פרה-קליניים(17,20,66,67,68) תמציות אדמונית ורכיבים מבודדים עיכבו למידע השלם למנויים

 

נוגדי קרישה כגון קומדין (Warfarin)

אין מניעה לשלב, אך יש לנקוט זהירות.
דיווח מקרה(16) תיאר דימום לא תקין לאחר צריכת למידע השלם למנויים

 

DMARDs - תרופות למחלות אוֹטואימוניות (Leflunomide, Methotrexate, Sulfasalazine ו-Iguratimod)

– , , ,

אין מניעה לשלב, והשילוב אף עשוי להיות מומלץ.
סקירות שיטתיות ומטא-אנליזות(28,58-62,186,215-225) מצאו כי השילוב של למידע השלם למנויים

 

סטרואידים

השילוב אפשרי ואף עשוי להיות מומלץ.
על פי סקירות שיטתיות ומטא-אנליזות(58,149,150,174,201), סקירה נוספת(55), מחקרים קליניים(56,151-173,173-182) ומחקרים תצפיתיים(34,213,214,227), השילוב של למידע השלם למנויים

 

NSAIDs
אין מניעה לשלב, והשילוב אף עשוי להיות מומלץ.
על פי מטא-אנליזה(215) וסקירה(226), שילוב של גליקוזידים למידע השלם למנויים

 

טיפול קונבנציונאלי בשחפת

השילוב אפשרי.
סקירה שיטתית ומטא-אנליזה(35) וארבעה מחקרים למידע השלם למנויים

 

התרופה איקקלומין להשריית ביוץ (Clomiphene)

השילוב אפשרי.
סקירה שיטתית ומטא-אנליזה(37) של ארבעה־עשר מחקרים קליניים אקראיים למידע השלם למנויים

 

התרופה חומצה ואלפרואית (Valproate)

אין מניעה לשלב.

סקירה(13) מדווחת על מחקר קליני אקראי פתוח במבנה מוצלב(14) שנערך בקרב למידע השלם למנויים

 

התרופה Cetirizine (Zyrtec)

השילוב אפשרי ואף עשוי להיות מומלץ.
במחקר קליני(57) נמצא כי שילוב של גליקוזידים כוללים למידע השלם למנויים

 

התרופה Losartan

השילוב אפשרי ואף עשוי להיות מומלץ.
במחקר קליני פתוח ואקראי(54), נמצא כי שילוב של גליקוזידים כוללים למידע השלם למנויים

 

התרופה Midazolam

אין מניעה לשלב אך יש לנקוט בזהירות.
במחקרים פרה-קליניים(36,9), נמצא כי למידע השלם למנויים

 

התרופה Phenytoin

אין מניעה לשלב אך יש לנקוט זהירות.
במחקר בבעלי חיים(15) נמצא כי למידע השלם למנויים

 

התרופה Carbamazepine

אין מניעה לשלב אך יש לנקוט זהירות.
במחקר בבעלי חיים(9) נמצא כי שילוב של אדמונית עם למידע השלם למנויים

 

התרופה Hydroxychloroquin

השילוב אפשרי ואף עשוי להיות מומלץ.
סקירה שיטתית(216) שכללה 11 מטא-אנליזות(60, 61, 217–225), אשר סיכמו ממצאים למידע השלם למנויים

 

Tacrolimus לטיפול במחלות אוֹטואימוניות
השילוב אפשרי ואף עשוי להיות מומלץ.
על פי מספר סקירות שיטתיות ומטא-אנליזות(149,150,174) שכללו 30 מחקרים קליניים(151-173,175-182), שילוב של למידע השלם למנויים

 

Tacrolimus להשתלת אברים
השילוב אסור.
נכון להיום, לא בוצעו מחקרים קליניים שבחנו את השילוב בין מיני אדמונית לבין למידע השלם למנויים

 

אנטיביוטיקה

השילוב אינו מומלץ.

נטילת אנטיביוטיקה עלולה למידע השלם למנויים

 

תרופות נוגדות דִיכאון

אין מניעה לשלב.

נטילה משולבת של אדמונית עם תרופות נוגדות דיכאון עשויה לפעול בצורה למידע השלם למנויים

 

התרופה Cyclophosphamide
השילוב אפשרי ואף עשוי להיות מומלץ.
על פי מספר סקירות שיטתיות ומטא-אנליזות (149,150,174) שכללו 30 למידע השלם למנויים

 

כימותרפיה מסוג Paclitaxel

השילוב אפשרי.
במחקר קליני(26) נמצא כי למידע השלם למנויים

 

כימותרפיה מסוג Carboplatin

השילוב אפשרי.
במחקר קליני(26), נמצא כי מתן למידע השלם למנויים

 

כימותרפיה מסוג Cisplatin

אין מניעה לשלב.

במחקרי בעלי חיים(27,53) נטילה משולבת של למידע השלם למנויים

 

כימותרפיה מסוג Cyclosphosphamide

אין מניעה לשלב, והשילוב אף עשוי להיות מומלץ.
מחקר רטרוספקטיבי למידע השלם למנויים

 

כימותרפיה מסוג Cytarabine

אין מניעה לשלב. 
במחקר בבעלי חיים(53), נמצא כי למידע השלם למנויים

 

כימותרפיה מסוג Meloxicam

השילוב אפשרי.
סקירה שיטתית ומטא-אנליזה(58), שדיווחה על למידע השלם למנויים

 

אנג'לִיקה סינית (Angeִlica sinensis)
סקירה שיטתית(38) של מחקרים העוסקים בצמדי צמחים למידע השלם למנויים

 

שוּמר (Foenִiculum vulgare)

אין מניעה לשילוב אדמונית יחד עם שוּמר. מידע מקדמי למידע השלם למנויים

 

שוּש קירח (Gִlycyrrhiza glabra)

נטילה משולבת של אדמונית יחד עם צמח זה אפשרית ואף מומלצת.

במחקרים קליניים(22,23,24,70) וסקירה(25), פורמולה למידע השלם למנויים

פירוט המחקרים:

למידע השלם למנויים

 

 

הריון

מוטב להימנע משימוש באדמונית במהלך ההריון, במיוחד  למידע השלם למנויים

בחלק מהמחקרים שנערכו בבעלי חיים, נצפתה השפעה  למידע השלם למנויים

עם זאת, במחקר קליני לא מבוקר, אדמונית (לצד  למידע השלם למנויים

 

הנקה

חסר מידע בנושא.

 

מקורות

 

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