摘要
通过对中药毒性发生的因素进行分析,探究中药毒性与体质的关系,为防范中药毒性的发生提供新思路。归纳中药毒性发生的原因,并分析发生于中药毒性背后的体质与其的关系,同时也要考虑以下方面,(1)使用中药的主要原因是疾病,是人的病理状态,病理状态对相应中药的需求可能会多,而中医治病历来有"有病病受之,无病人受之",这也是药证对应的重要体现,正常动物怎样反应病理状态下的毒性;(2)病理状态的人、特别是病程较长时,其肝肾功能可能已有异常,如何区分因肝肾功能低下时中药毒性发生的原因;(3)长期的疾病状态也会导致机体肠道菌群的紊乱,肠道菌群与中药的相互作用而受到的影响如何在中药毒性发生中体现;(4)情绪及心理因素虽在中药毒性发生中所占比重小,但也有影响,疗效与预期相关,毒性与背景也有关;(5)人与动物虽然有高度相似性,但还是有种属的差异(如巴豆又称肥鼠子),人的临床毒性如何与动物的研究毒性相统一。目前中药毒性更多关注的是中药本身的因素(品种、质量、炮制等)、中药应用的因素(配伍、药证对应、剂量、疗程等),但这是中药毒性产生的外因;机体的生理状况、病理状态、肠道菌群、情绪及心理因素等是内因。机体体质因素则是中药毒性产生的内因,外因要通过内因发挥作用。同时人与动物存在本质的差异,动物的毒理实验仅供临床做参考。通过剖析中药毒性发生与机体体质因素相关理念,相应地推动中药毒性作用的现代研究,也完善传统中药毒性理论,为中药在临床的安全、合理应用提供科学依据;当然还应加强病理状态下动物模型的研究来推进中药毒性研究,从而加深人们对中药毒性的认识和理解。
Through analysis of factors affecting toxicity of traditional Chinese medicine( TCM),relationship between toxicity of TCM and physical constitution was explored,which provided a new idea for preventing occurrence of toxicity of TCM. Efforts were made to summarize causes of toxicity of TCM,and analyze relationship between physical constitution and toxicity of TCM. following aspects were taken into account:(1)main reason for people to use TCM is disease,which is pathological state of human beings. The pathological state may have more demands for corresponding TCM. The TCM rule of 'disease-based treatment ' is an important manifestation for correlating drugs with syndromes. Then how can normal animals reflect human toxicity under pathological conditions.(2) People with pathological conditions,especially with a long disease course,may have abnormal liver and kidney functions. Then how to distinguish cause of toxicity of TCM in liver and kidney dysfunctions.(3)The long-term disease state can also lead to disorder of intestinal flora of body. Then how is impact of interaction between intestinal flora and TCM reflected in toxicity of TCM.(4) Although emotional and psychological factors account for a small proportion of toxicity of TCM,it still has an effect.(5)Although humans and animals have a high degree of similarity,there are still species differences( such as croton). Then how is human clinical toxicity consistent with animal research toxicity. The efficacy is related to expectation,while toxicity is related to background. At present,toxicity of TCM is more caused by factors of TCM( such as variety,quality,processing),and factors of TCM application( like compatibility, drug correspondence, dosage, course of treatment),which are external causes of toxicity of TCM. physiological condition,pathological state,emotional and psychological factors,and intestinal flora of body are internal factors. The physical constitution factors are internal factors of toxicity of TCM,and external factors play a role based on internal factors. At the same time,there are essential differences between humans and animals. Animal toxicological experiments are only for clinical reference.By analyzing concepts related to toxicity of TCM and physical constitution factors,modern researches on toxic effects of TCM are also promoted accordingly,and TCM toxicity theory is also improved,which provides a scientific basis for safe and rational application of TCM in clinical practice. Of course,research on animal models under pathological conditions shall be strengthened to promote study of toxicity of TCMs,so as to deepen people’s understanding of toxicity of TCMs.
作者
李艳
项丽玲
郭晖
姜权
苗明三
LI Yan;XIANG Li-ling;GUO Hui;JIANG Quan;MIAO Ming-san(Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China;Henan University of Chinese Medicine,Zhengzhou 450046,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2019年第6期189-195,共7页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家"重大新药创制"科技重大专项(2017ZX09301071)
河南省中原学者科学家工作室项目(162101510003)
国家国际合作基地项目[国科外函(2016)65号]
河南省科技攻关计划项目(162102310181)
河南省产学研项目(172107000012)
关键词
中药毒性
机体因素
病理状态
动物模型
traditional Chinese medicine toxicity
organism factors
pathological state
animal model
