致肝损伤中药的减毒措施及肝损伤的中药防治作用  

Toxicity Reduction Measures of Herbal Medicines Causing Liver Injury and Role of Herbal Medicines in Preventing and Treating Liver Injury

作　　者：赵明明[1] 苗明三[1] ZHAO Mingming;MIAO Mingsan(Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学,郑州450046

出　　处：《中国实验方剂学杂志》2023年第15期273-282,共10页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家中医药管理局标准化项目(GZY-FJS-2020-219);河南省中医药科学研究专项(20-21ZYZD02);河南省重大公益专项(201300310100)。

摘　　要：中药在疾病预防和治疗的过程中发挥重大作用,但部分中药在临床的长期应用过程中,给人体带来的不良反应也逐渐显现出来,肝损伤属于其中之一。肝损伤也是中药新药研发过程中作为临床安全用药的重要检查项目,已成为众多上市药物退出市场的重要原因。随着对中药临床用药安全性的关注增加,关于中药肝损伤研究日益增多,大多数研究集中于中药或者中药成分的肝脏损伤研究。为了提高中药的安全性,该文总结了部分致肝损伤中药的物质基础和机制及降低中药肝损伤的措施,包括减少给药剂量和疗程,改变给药途径,改变药物剂型,药物配伍和炮制等方法;此外该文还总结了防治各种诱导物诱发肝损伤的单体中药、中药复方和中药成分及防治肝损伤的生物效应和作用机制。结合现代致肝损伤中药的减毒研究,提出明确致肝损伤中药的安全剂量和“毒-效”界限,明确减毒措施的减毒机制及确定致肝损伤中药的毒性物质基础,为致肝损伤中药的临床应用提供安全性保障;结合中药防治肝损伤的研究,提出加强中药防治肝损伤的临床研究的同时,利用现代科学技术“从局部到整体”来阐释中药复方防治肝损伤的科学内涵,进而为临床防治肝损伤提供科学依据。Chinese herbal medicines play a great role in disease prevention and treatment,while some may cause adverse effects on the human body after of long-term application.Liver injury,one of such adverse effects,is an important check item in the development of new Chinese medicines for clinical application and has become a major reason for the withdrawal of many listed drugs from the market.With the rising concern about the safety of Chinese herbal medicines,studies about liver injury caused by herbal medicines are increasing.Most of the studies focus on liver injury caused by Chinese herbal medicines or their ingredients.To improve the safety of Chinese herbal medicines,this paper summarizes the material basis and mechanisms of several Chinese herbal medicines that cause liver injury and the measures to reduce liver injury.These measures include reducing the dose and course of administration,changing the route of administration,and altering the dosage form,compatibility,and processing.In addition,this paper introduces the biological effects and mechanisms of single Chinese herbal medicines,Chinese medicine prescriptions,and active components in the prevention and treatment of liver injury.Furthermore,this paper proposes the safe dose and efficacy-toxicity boundary of Chinese herbal medicines that may cause liver injury by referring to the modern research on toxicity reduction,clarifies the mechanisms of toxicity reduction measures,and determines the material basis of liver injury induced by Chinese herbal medicines,which will ensure the safe application of herbal medicines in clinical practice.Finally,this paper suggests that efforts should be made to strengthen the clinical research on the prevention and treatment of liver injury and elucidate the scientific connotation of the prevention and treatment of liver injury by Chinese herbal medicines by using modern science and technology,aiming to provide a scientific basis for the clinical prevention and treatment of liver injury.

关 键 词：中药 防治 肝损伤 减毒措施 

分 类 号：R284[医药卫生—中药学] R285[医药卫生—中医学] R289R287R22R2-031R33R24