摘要
中药安全性关系到人民群众健康和生命安全,保证中医临床安全用药是医药卫生领域的重大需求。近年来,中医药临床循证证据逐年增多,中医药的疗效越来越受到国际认可。然而,伴生的、不可忽视的中药的安全性问题仍饱受质疑,特别是“毒性”中药材的应用更是备受关注,中药安全性问题已严重制约中医药的现代化和国际化。含砷中药复方是“毒性”中药材应用的典范,以复方黄黛片和牛黄解毒片为代表的方剂在临床应用具有很好的疗效,虽偶有不良反应事件报导,但总体安全性较好,临床风险较小。然而因毒性机制不明以及减毒配伍研究的缺乏,由砷引发的安全性隐忧一直制约着含砷中药的推广和应用。减毒配伍研究一直是中医药领域关注的前沿科学问题之一,是保障中药安全性的关键环节。基于此,本文以含砷中药复方为例,对含砷中药复方减毒配伍研究进展进行综述,围绕砷体内代谢效应结局、砷甲基化代谢中砷甲基转移酶(As3MT)调控的甲基供体平衡稳态在砷制剂体内命运中的作用进行探讨,为含砷中药复方临床安全合理应用提供理论指导,也为该类制剂的减毒配伍研究提供新的思路和方法。
The safety of traditional Chinese medicine(TCM)is closely related to the health and life safety of the people,and ensuring the safe use of TCM in clinical practice is a major demand in the field of medicine and health.In recent years,the number of clinical evidence-based evidence for TCM has increased year by year,and the efficacy of TCM has increasingly been recognized internationally.However,the accompanying and unavoidable safety issues of TCM are still subject to doubt,especially the application of“toxic”TCM materials,which has attracted much attention.The safety issues of TCM have seriously restricted the modernization and internationalization of TCM.Arsenic-containing TCM compounds are a model of“toxic”TCM.The formulas represented by Realgar-Indigo naturalis formula and Niuhuang Jiedu Tablets have good efficacy in clinical application.Although there are occasional reports of adverse reactions,the overall safety is good,and the clinical risk is small.However,due to the unknown toxicity mechanism and the lack of research on toxicity reduction and compatibility,safety concerns caused by arsenic have been restricting the popularization and application of arsenic-containing TCM.The research on toxicity reduction and compatibility has always been one of the frontier scientific issues in the field of TCM and a key link to ensure the safety of TCM.Based on this,taking arsenic-containing TCM compound as an example,this article summarized the research progress on toxicity reduction and compatibility of arsenic-containing TCM compound and outcomes surrounding the metabolic effects of arsenic in vivo and explored the role of arsenic methyltransferase(As3MT)-regulated steady methyl donor balance state in the fate of arsenic preparations in vivo,which could provide theoretical guidance for the safe and reasonable clinical application of arsenic-containing TCM compound and provided new ideas and methods for the research on toxicity reduction and compatibility of this type of preparation.
作者
曾慧敏
江珍红
史云霞
杨建豪
黄凯峰
李妙琳
徐玥雯
李梦瑶
杨明
徐焕华
ZENG Huimin;JIANG Zhenhong;SHI Yunxia;YANG Jianhao;HUANG Kaifeng;LI Miaolin;XU Yuewen;LI Mengyao;YANG Ming;XU Huanhua(Key Laboratory of Modern Preparation of TCM,Ministry of Education,Jiangxi University of Chinese Medicine,Nanchang 330004;National Key Laboratory for the Modernization of Classical and Famous Prescriptions of Chinese Medicine,Jiangxi University of Chinese Medicine,Nanchang 330004;Jiangxi Key Laboratory of Molecular Medicine,the Second Affiliated Hospital of Nanchang University,Nanchang 330006;Research Center for Dfferentiation and Development of Traditional Chinese Medicine Basic Theory,Jiangxi University of Chinese Medicine,Nanchang 330004)
出处
《中药药理与临床》
北大核心
2025年第3期108-115,共8页
Pharmacology and Clinics of Chinese Materia Medica
基金
江西省自然科学基金项目(编号:20224BAB216105、20232BAB206167、20242BAB25577)
国家自然科学基金(编号:82304857、82460814)
中药研制与中药安全性创新团队(编号:ZYYCXTD-D-202207)。
关键词
含砷制剂
中药复方
减毒配伍
砷甲基转移酶(As3MT)
甲基供体平衡稳态
Arsenic-containing preparation
TCM compound
Toxicity reduction and compatibility
Arsenic methyltransferase(As3MT)
methyl donor
