商陆利尿作用与肾毒性研究进展  

Research on Diuretic Activity and Nephrotoxicity of Radix Phytolaccae

作　　者：孙文学 盛云华[3] 黄坚[3] 金若敏[4] 唐黎明[3] SUN Wenxue;SHENG Yunhua;HUANG Jian;JIN Ruomin;TANG Liming(School of Pharmacy,Fudan University,Shanghai 201203,China;China State Institute of Pharmaceutical Industry,Shanghai 201203,China;Shanghai Institute of Food and Drug Control,Shanghai 201203,China;Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]复旦大学药学院,上海201203 [2]中国医药工业研究总院,上海201203 [3]上海市食品药品检验所,上海201203 [4]上海中医药大学,上海201203

出　　处：《世界中医药》2020年第23期3586-3592,共7页World Chinese Medicine

基　　金：国家重点研发计划项目(SQ2017YFC170204)——基于器官芯片技术的中药安全性有效性评价体系。

摘　　要：商陆为商陆科植物商陆或垂序商陆的干燥根,功效主要为逐水消肿、通利二便。商陆临床常用于治疗水肿、肾炎、腹水等疾病,发挥利尿作用;利尿作用机制与肾脏水通道蛋白表达下调及体液代谢相关激素水平改变进而降低肾小管和集合管的重吸收功能相关。动物试验研究发现,长时间大剂量给予商陆水煎液,会诱发实验动物肾损伤;体外试验表明商陆主要活性成分商陆皂苷甲对人肾小管上皮细胞具有显著的细胞毒性作用;其肾毒性机制与氧化应激、炎性反应、细胞凋亡等相关。商陆临床可通过发挥利尿作用治疗肾小球肾炎、水肿等疾病,但长时间大剂量使用又会造成肾损伤,因此进一步深入探索商陆利尿作用与肾毒性之间的关系,结合早期生物标志物预警肾毒性,加强商陆质量控制标准,对提高商陆临床应用安全性与有效性有重要意义。Radix Phytolaccae is the dry root of Phytolacca acinosa Roxb.or Phytolacca Amerrcana L..its main effects are reducing swellingedema and anuria and constipation and nephritis and diuresis.Radix Phytolaccae in clinics is commonly used to in the treatment of edema,glomerulonephritis,ascites and other diseases and as a diuretic;its diuretic mechanism is related to down-regulation of renal aquaporin expression in renal water channels and changes in hormone levels associated with humoral metabolism.However,animal studies found that long-term high-dose administration of Radix Phytolaccae decoction could induce kidney damage in experimental animals.In vitro tests showed the main active ingredient of Radix Phytolaccae,esculentoside A,has significant cytotoxic effects on human renal tubular epithelial cells.Its nephrotoxic mechanism is related to oxidative stress,apoptosis,and inflammatory response.Radix Phytolaccae is clinically used for the treatment of diseases such as glomerulonephritis,edema etc.But long-term high-dose use can cause kidney damage.Therefore,further exploration of the relationship between the diuretic effect and nephrotoxicity need to be conducted,combined with early biomarkers or early warning nephrotoxicity.Quality control standards should be strenghened,which is important for improving the safety and rationality of the clinical application of Radix Phytolaccae.

关 键 词：商陆 利尿作用 利尿作用机制 肾毒性 肾毒性机制 早期生物标志物 质量控制 质量标准 

分 类 号：R285[医药卫生—中药学]