中国中药杂志

2019, v.44(24) 5336-5344

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苍耳子安全问题探讨与合理用药思考
Discussion on safety of Xanthii Fructus and consideration on its rational use

聂安政;高梅梅;贾文瑞;朱春胜;张晓川;周政;张冰;
NIE An-zheng;GAO Mei-mei;JIA Wen-rui;ZHU Chun-sheng;ZHANG Xiao-chuan;ZHOU Zheng;ZHANG Bing;the First Affiliated Hospital of Zhengzhou University;Beijing University of Chinese Medicine;

摘要(Abstract):

苍耳子为历代中医治疗鼻渊头痛之要药,至今已有1 800多年药用历史,药材资源丰富,临床应用广泛。现代药理学研究发现,苍耳子具有抗炎镇痛、抗肿瘤、抗菌、降血糖、抗过敏、调节免疫等药理作用,临床常用于治疗风湿性关节炎、慢性鼻炎、急性鼻炎、过敏性鼻炎、皮肤病等与免疫异常相关的疾病,具有较高的药用价值,同时毒理学研究发现苍耳子具有肝脏毒性、肾脏毒性、胃肠道毒性等不良反应,尤其是肝损伤。因苍耳子毒效并存,临床常因不合理应用导致一系列的安全问题,该文结合文献报道归纳苍耳子不良反应特点,从炮制、剂量、疗程与误食的角度剖析苍耳子产生毒性反应的根本原因,并以活性成分与毒性成分为切入点探讨苍耳子发挥药效及产生毒性的化学实质,从严格炮制、合理配伍、药有禁忌、严控量程、用药告知等方面对如何促进苍耳子临床合理应用提出探索性的思考,以期为苍耳子的合理用药提供参考。
Xanthii Fructus is a traditional Chinese medicine for the treatment of sinusitis and headache,rich in medicinal materials and is widely used for more than 1 800 years. Modern pharmacological studies have showed that Xanthii Fructus has anti-inflammatory,analgesic,anti-tumor,anti-bacterial,hypoglycemic,anti-allergic,immunomodulatory and other pharmacological effects,which can be commonly used in the treatment of diseases relating to immune abnormalities,such as rheumatoid arthritis,acute and chronic rhinitis,allergic rhinitis,and skin diseases,with a high medicinal value. Toxicological studies have shown that Xanthii Fructus poisoning can cause substantial damage to organs,such as the liver,kidney,and gastrointestinal tract,especially to liver. Because of the coexisting of its efficacy and toxicity,Xanthii Fructus often leads to a series of safety problems in the clinical application process. This study attempts to summarize its characteristics of adverse reactions,analyze the root cause of the toxicity of Xanthii Fructus from such aspects as processing,dose,course of treatment and eating by mistake,discuss the substance of its efficacy/toxicity from chemical compositions,and put forward exploratory thinking about how to promote its clinical rational application from the aspects such as strict processing,reasonable compatibility,medication information,contraindication,strict control of the dose,and course of treatment,so as to promote the safe and reasonable application of Xanthii Fructus.

关键词(KeyWords): 苍耳子;安全问题;合理用药;毒效并存;毒性反应
Xanthii Fructus;security issues;rational use of drugs;coexisting of efficacy and poison;toxic reaction

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81673618);; 中华医学会临床药学分会-吴阶平基金会青年基金项目(LCYX-Q025)

作者(Author): 聂安政;高梅梅;贾文瑞;朱春胜;张晓川;周政;张冰;
NIE An-zheng;GAO Mei-mei;JIA Wen-rui;ZHU Chun-sheng;ZHANG Xiao-chuan;ZHOU Zheng;ZHANG Bing;the First Affiliated Hospital of Zhengzhou University;Beijing University of Chinese Medicine;

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