摘要
随着精准化与个体化成为未来医学发展的必然趋势,性别差异对药物疗效及毒性的影响也在全球范围内重新受到重视。部分中药药效及毒性潜在的性别差异现象是客观存在的。在中医理论模型中性别差异被解构为阴阳盛衰、气血偏颇的具体表现,这种认知方式使性别因素自然融入辨证体系而非作为独立变量处理,但其中已隐含对性别差异的独特认知,并在中药方剂临床应用上得以体现。现代医学对性别差异的生物学基础已有科学系统的认识,同时亦部分揭示了常见疾病病理机制的性别差异,为解析中药的性别特异性效应提供了理论框架。该文基于传统理论及现代文献,整理了方剂、单味中药及其组分的药效、毒性和药代动力学的性别差异。然而,目前以中药性别差异为主题的研究仍较匮乏,后续可结合新技术新方法逐步解决现有方法之局限,推进性别差异从临床研究到基础研究的前溯。中药性别差异的揭示有助于阐释传统用药经验的科学内涵,指导药食同源等中药健康产品的精准开发及应用,明确其受众人群和产品定位,也为优化临床用药策略提供科学依据,谨为同类研究提供参考。
As precision and individualization become an inevitable trend in the future development of medicine,the sex differences in drug efficacy and toxicity have once again received global attention.The potential sex differences in the efficacy and toxicity of Chinese materia medica are objectively existent.In the theoretical model of traditional Chinese medicine(TCM),sex differences are deconstructed as specific manifestations of the exuberance and decline of Yin and Yang and the imbalance of Qi and blood.This cognitive approach naturally integrates sex factors into the syndrome differentiation system rather than treating them as independent variables.However,it already implies a unique understanding of sex differences and is reflected in the clinical application of TCM prescriptions.Modern medicine has a scientific and systematic understanding of the biological basis of sex differences,and it has partially revealed the sex differences in the pathological mechanisms of common diseases,providing a theoretical framework for analyzing the sex-specific effects of TCM.By reviewing traditional theories and modern literature,this article elaborates on the sex differences in the efficacy,toxicity,and pharmacokinetics of prescriptions,Chinese medicinal materials,and their components.However,the studies on sex differences in Chinese materia medica are still scarce.In the future,new technologies and methods can be combined to gradually solve the limitations of existing methods and promote the traceability of sex differences from clinical research to basic research.Revealing the sex differences in Chinese materia medica helps to explain the scientific connotation of traditional medication experience,guide the precise development and application of TCM health products with both edible and medicinal values,clarify their target audience and product positioning,and provide a scientific basis for optimizing clinical medication strategies.This review aims to provide a reference for similar studies.
作者
赵梓邯
周骏辉
韦智江
罗志强
白瑞斌
李卫东
杨健
ZHAO Zihan;ZHOU Junhui;WEI Zhijiang;LUO Zhiqiang;BAI Ruibin;LI Weidong;YANG Jian(State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs,National Resource Center for Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China;Beijing Stomatological Hospital,Capital Medical University,Beijing 100069,China;School of Chinese Materia Medica,Beijing University of Chinese Medicine,Beijing 102488,China)
出处
《中国实验方剂学杂志》
北大核心
2025年第23期276-284,共9页
Chinese Journal of Experimental Traditional Medical Formulae
基金
中国中医科学院基本科研业务费优秀青年科技人才培养专项(ZZ17-YQ-044)
中国中医科学院中药资源中心自主选题研究项目(ZZXT202301)
中国中医科学院科技创新工程项目(CI2023E002)
国家中医药管理局高水平中医药重点学科建设项目(ZYYZDXK-2023244)。
关键词
中药
性别差异
精准医学
药效
毒性
Chinese materia medica
sex differences
precision medicine
efficacy
toxicity
