摘要
雷公藤具有清热解毒、祛风除湿、消肿止痛、杀虫止痒的功用,现代药理研究亦表明其具有抗炎、镇痛、抗肿瘤及免疫调节等作用,临床主要用于治疗免疫性疾病、肾脏性疾病、皮肤性疾病等,对治疗类风湿性关节炎疗效尤为显著。但因其具有严重的毒副反应,尤其是肝肾毒性,限制了雷公藤的临床安全应用,成为了迫切需要解决的难题。虽然目前存在的减毒方式众多,包括传统的净制减毒、炮制减毒、配伍减毒和现代的制剂减毒、结构修饰减毒、生物技术减毒以及其相互间的联合应用等,但并没有本质上解决雷公藤的安全问题。在古代医药文献中药物的毒性常指这种药物的偏性,在中医药理论看来,作为药物都有毒性,关键是正确使用。中药的配伍使用是中医药文化的重要组成部分,从春秋战国时期的配伍雏形,到《黄帝内经》中已有君臣佐使配伍用药的方剂,再到《神农本草经》中配伍理论的形成,到最后《伤寒论》经典名方的传世,记录了中药配伍应用的发展,也记录了中药配伍使用的重要意义,随着中药事业逐渐走向现代化和国际化,中药配伍又有了进一步的发展,开始迈向质量可控、机制清楚的组分配伍,故本文以雷公藤配伍减毒为中心,以配伍形式的发展为主线,对雷公藤配伍减毒进行综述,为雷公藤减毒增效研究提供思路,促进其合理开发和临床安全应用,也为其他有毒中药的合理应用提供参考。
Tripterygii Radix et Rhizoma（TWHF） shows multiple pharmacological activities including heat-clearing and detoxifying,eliminating wind and dampness,detumescence and pain relief,killing parasites and relieving itch.The modern pharmacological researches also prove that it has anti-inflammatory,analgesic,antitumor,immune regulation and other effects.Based on this evidence,TWHF has been applied clinically for many disorders including immune diseases,renal disease and dermatosis disease,especially for the rheumatoid arthritis.However,its severe toxic and side effects,expecially hepatotoxicity and nephrotoxicity,prevent it from being widely used in clinical practice.Therefore,the reduction of toxicity has become a hot research topic in recent years.There are multitudinous ways for detoxicity,including the traditional cleansing method,processing method,compatibility method as well as the modern preparation method,structural modification method,biological technology method and their combined use,but all of these can＇t solve its safety problem essentially.In the ancient medical literature,the drug toxicity often referred to the bias of this drug.In the view of the theory of traditional Chinese medicine（TCM）,all of the drugs have toxicity,and the key is their correct use.The compatibility of TCM is an important part of Chinese medicine culture.From the embryonic form of compatibility in Spring and Autumn and Warring States period to the prescriptions with compatibility between monarch and ministerial drugs in Huangdi Neijin,formation of compatibility theory in Sheng Nong＇s Herbal Classic and spreading of classic formulations in Treatise on Febrile Diseases,the development and significance of compatibility application of TCM was recorded.With the gradual development of TCM towards modernization and internationalization,the compatibility of TCM has been further developed with quality control and clear mechanism.In this study,with TWHF detoxicity by compatibility as the center,and based on the changes of its form,the current situation and dilemma of reducing toxicity of TWHF were analyzed to provide ideas for toxicity reducing and efficacy enhancing of T.wilfordii,promote its rational development and safe clinical application,and provide a reference for the rational use of other toxic Chinese medicines.
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2018年第4期229-234,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(81460607)
关键词
雷公藤
减毒
复方配伍
组分配伍
Tripterygii Radix et Rhizoma
detoxicity
compatibility
component compatibility
