雷公藤血液毒性机制及防治的研究进展  

Research Progress on Blood Toxicity of Leigongteng(Tripterygium wilfordii Hook.f.)and Its Prevention

作　　者：郑肖庆 丁樱[1,2] 徐闪闪[2] 郭婷[2] ZHENG Xiaoqing;DING Ying;XU Shanshan;GUO Ting(Medical College of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学儿科医学院,河南郑州450000 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中华中医药学刊》2024年第4期175-179,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81873343)。

摘　　要：雷公藤用药历史悠久,具有祛风除湿、活血化瘀、清热解毒等功效,常用于多种免疫系统疾病的治疗,疗效显著。作为一种传统有毒中药,其血液毒性也不容小觑,限制了其在很多领域的应用,也愈发受到广泛关注。通过综述雷公藤相关研究,梳理分析血液毒性表现特点发现,患者临床表现轻重不同,重者可能会产生骨髓抑制,但发生率低,且大多可逆。由于其所含化学成分复杂,不同成分致血液毒性产生的机制各异。对雷公藤所含有的主要毒性成分进行归类梳理,并从抑制细胞周期、影响转录调节、致突变及诱导细胞凋亡等方面总结其血液毒性作用机制,对雷公藤减毒的中西医防治措施进行整理与发掘,总结单味中药、中药复方及西药减毒机制,为其在临床的使用提供参考与依据。Leigongteng(Tripterygium wilfordii Hook.f.,TWHF)has a long history of medication.It has the effects of dispelling wind and dampness,promoting blood circulation and removing blood stasis,clearing heat and detoxification.It is often used in the treatment of various immune system diseases,and the curative effect is remarkable.As a traditional toxic Chinese medicine,its blood toxicity cannot be underestimated,which limits its application in many fields and has attracted more and more attention.By reviewing the related research of TWHF,combing and analyzing the characteristics of hematological toxicity,it is found that the clinical manifestations of patients are different.In severe cases,bone marrow suppression may occur,but the incidence is low and most of them are reversible.Due to its complex chemical composition,the mechanisms of blood toxicity caused by different components are different.In this paper,the main toxic components contained in TWHF were classified and sorted out,and the mechanism of its blood toxicity was summarized from the aspects of inhibiting cell cycle,affecting transcriptional regulation,mutagenesis and inducing apoptosis.The prevention and treatment measures of traditional Chinese medicine and western medicine for TWHF attenuation were sorted out and explored,and the attenuation mechanism of single Chinese medicine,Chinese medicine compound and western medicine was summarized to provide reference and basis for its clinical use.

关 键 词：雷公藤 血液毒性 作用机制 配伍减毒 

分 类 号：R282.710.5[医药卫生—中药学]