煅石膏的研究进展及含钙止血材料应用概况  

Research Progress of Gypsum Ustum and Application of Calcium-containing Hemostatic Materials

作　　者：张玉松 罗达 程芳芳[1] 姚卫峰[1] 陈佩东[1] 包贝华[1] 张丽[1] ZHANG Yu-song;LUO Da;CHENG Fang-fang;YAO Wei-feng;CHEN Pei-dong;BAO Bei-hua;ZHANG Li(Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization,National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学江苏省中药资源产业化过程协同创新中心,中药资源产业化与方剂创新药物国家地方联合工程研究中心,南京210023

出　　处：《中国实验方剂学杂志》2021年第1期223-228,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：江苏省“六大人才高峰”高层次人才项目(2016-YY026);江苏高校“青蓝工程”中青年学术带头人项目(2016)。

摘　　要：矿物药是传统中医药的重要组成部分,具有悠久的应用历史。其中矿物止血药对多种出血病证的临床应用广泛、用药经验丰富且疗效显著。石膏作为临床常用的矿物药,生石膏的功效为清热泻火、除烦止渴,而煅石膏为生石膏经高温煅烧的炮制品,主要由无水硫酸钙(CaSO4)组成,具有收湿、生肌、敛疮、止血的功效,常外用于治疗溃疡不敛、湿疹瘙痒、水火烫伤、外伤出血等。止血机制研究表明,Ca^(2+)作为凝血因子Ⅳ参与凝血过程的内外凝血级联多个关键环节,并且参与调节血小板活化、聚集,促进生成不溶性纤维蛋白,最终形成血凝块防止出血。Ca^(2+)是重要的止血物质基础,但是石膏、煅石膏均含有Ca^(2+),煅石膏具有显著的止血作用,而石膏没有止血作用,石膏经过炮制后性味、功效发生了明显改变,体现了炮制特色,但目前尚未完全阐明煅石膏的炮制机制。因此,该文对石膏煅制前后比较研究情况进行总结与分析,围绕煅制工艺、晶型比较、元素含量、药效比较等进行综述,并总结Ca^(2+)参与止血的各个环节。此外,对其他含钙矿物药及新型含钙止血材料如海藻酸钙、介孔硅酸钙和纳米凝胶止血材料的止血性能进行探讨,以期为阐明煅石膏的炮制机制提供借鉴,为临床辨证使用煅石膏提供依据,并为后续新型含钙止血材料的开发提供借鉴。Mineral medicine is an indispensable part of traditional Chinese medicine and has a long history of application. Among them,mineral-based hemostatics have been widely applied for the treatment of various hemorrhagic diseases with extensive clinical experience and established efficacy. Gypsum Fibrosum(GF),a commonly used mineral medicine in clinical,can clear away heat,and relieve anxiety and thirst.Gypsum Ustum(GU)is the processed product of GF after calcining at high temperature. It is mainly composed of anhydrous calcium sulfate(CaSO4)with the functions of moisturizing,promoting muscle growth,astringent sores and hemostasis. GU is often used externally to treat ulcer,itching,eczema,water and fire scalds,trauma bleeding,etc. Studies on the mechanism of hemostasis have shown that Ca^(2+)(coagulation factor Ⅳ)is involved in many key processes of the internal and external coagulation cascades and can prevent bleeding by regulating platelet activation and aggregation,and promoting the production of insoluble fibrin and the ultimate formation of a blood clot. GF and GU both contain Ca^(2+)which provide an important material basis of hemostatic effect for both compounds, but GU has a significant hemostatic effect, while GF has no hemostatic effect. After processing,the taste and efficacy of the GF have been obviously changed which reflects the characteristics of processing,but the processing mechanism of GU has not been fully clarified. Therefore,based on studies of GF before and after calcining, this paper focused on these aspects including calcining process, crystal form comparison, element content, efficacy comparison, and summarized various aspects of Ca^(2+)involved in hemostasis. In addition, the hemostatic properties of other calcium-containing mineral medicines and new calcium-containing hemostatic materials such as calcium alginate,mesoporous calcium silicate and nanogel hemostatic materials were also discussed. The paper aimed to provide a reference for elucidating processing mechanism and clinical dialect

关 键 词：煅石膏 钙离子(Ca^(2+)) 矿物药 物质基础 炮制机制 凝血途径 止血 

分 类 号：R22[医药卫生—中医基础理论] R943.1[医药卫生—中医学]