从古今文献效/毒记载演变探讨中药淫羊藿安全合理用药  

Exploring the safe and rational use of Epimedii Folium based on the evolution of efficacy/toxicity records in ancient and modern literature

作　　者：高源 王伽伯 肖小河 柏兆方 GAO Yuan;WANG Jia-bo;XIAO Xiao-he;BAI Zhao-fang(School of Traditional Chinese Medicine,Capital Medical University,Beijing 100069,China;China Military Institute of Chinese Medicine,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China;Senior Department of Hepatology,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China)

机构地区：[1]首都医科大学中医药学院,北京100069 [2]中国人民解放军总医院第五医学中心,全军中医药研究所,北京100039 [3]中国人民解放军总医院第五医学中心,肝病医学部,北京100039

出　　处：《药学学报》2023年第2期246-257,共12页Acta Pharmaceutica Sinica

基　　金：国家自然科学基金资助项目(8163000655,81874368,82004057);国家中医药传承创新团队项目(ZYYCXTD-C-202005);北京市科技新星(Z181100006218001).

摘　　要：淫羊藿是临床常用的传统“无毒”补益类中药,但近年来淫羊藿相关制剂致肝损伤报道频发,更有单味淫羊藿诱发肝损伤的临床病例报道,为淫羊藿临床安全合理应用带来极大挑战。本文基于古今文献,从品种、炮制方法、临床不良反应、药理作用、毒性机制等角度对淫羊藿安全应用进行较为系统的汇总分析,并结合本课题组工作基础,提出构建淫羊藿临床安全合理应用的“人-药-用”综合防控体系,以期全面实现淫羊藿毒性的可防可控,保证淫羊藿的临床安全性。Epimedii Folium is a traditional non-toxic Chinese herbal medicine.However,liver injury caused by Chinese herb preparations,including Epimedii Folium,is frequently reported over the years.Based on ancient and modern literature,this paper systematically summarized and analyzed the safe application of Epimedii Folium from the perspectives of varieties,processing methods,clinical adverse reactions,pharmacological effects and toxic mechanism.Combined with our team work,we build the comprehensive prevention and control system"humandrug-application",for the safe and rational application of Epimedii Folium.This study is expected to provide support for scientific evaluation and precise prevention and control of the safety risk of Epimedii Folium.

关 键 词：淫羊藿 毒性 安全性 病证毒理学 合理用药 

分 类 号：R969.3[医药卫生—药理学]