“壮水之主”法减轻雷公藤多苷所致女性生殖损伤的思路探讨  

Exploration of"Strengthening Kidney Yin"Method to Alleviate Female Reproductive Damage Caused by Glycosides of Tripterygium wilfordii Polyglycoside

作　　者：屈亚雪 丁樱[1,2] 韩姗姗[1,2] 代彦林 裴秋霞 QU Yaxue;DING Ying;HAN Shanshan;DAI Yanlin;PEI Qiuxia(Department of Pediatrics,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;College of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学第一附属医院,儿科医院,郑州450000 [2]河南中医药大学儿科医学院,郑州450046

出　　处：《中国实验方剂学杂志》2024年第10期210-216,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82205187);中国博士后科学基金项目(2021M690940);河南省医学科技攻关计划联合共建项目(LHGJ20230684)。

摘　　要：雷公藤多苷是目前最常用的雷公藤制剂之一,具有抗炎、调节免疫等作用,其对临床上某些自身免疫性疾病及肾脏病的独特疗效几乎是其他类似药物所无法替代的,但其可能引起的生殖损伤是阻碍其在临床应用的瓶颈所在。女性患者在临床使用中常出现月经周期紊乱、经量减少甚至闭经、不孕等症状,其主要的毒性机制在于损伤卵巢的生殖及内分泌功能和抑制卵泡的生长发育等,故在临床用药时,了解雷公藤多苷对女性生殖的损伤作用、掌握其解毒方法十分必要。然而针对以上问题,目前并没有明确的解决方法。中医理论认为“肾主生殖”,且肾阴肾精与女性经卵的关系密切,故考虑雷公藤多苷所致生殖系统损伤隶属于肾虚阴伤精亏范畴,进而提出“壮水之主”法,指出临床使用中可通过补肾滋阴填精而有效减轻雷公藤多苷对女性的生殖毒性损伤,并总结目前中药、经方、验方、针刺等方面的已有相关研究来佐证“壮水之主”法的必要性,以期为雷公藤临床的安全合理用药提供理论指导依据。Tripterygium wilfordii polyglycosides are one of the most commonly used Tripterygium wilfordii preparations,which have anti-inflammatory and immune-regulating effects.Their unique therapeutic effect on some autoimmune diseases and kidney diseases is almost irreplaceable by other similar drugs,but the possible reproductive damage is the bottleneck that hinders their clinical application.In clinical use,female patients often suffer from menstrual cycle disorders,decreased menstrual flow,even amenorrhea,infertility,and other symptoms,and the main toxic mechanism lies in damaging the reproductive and endocrine functions of the ovary and inhibiting the growth and development of follicles.Therefore,it is particularly necessary to understand the toxic and side effects of Tripterygium wilfordii polyglycosides on female reproduction and master the detoxification methods during clinical use.However,there is no clear solution to these problems.According to the theory of traditional Chinese medicine,"kidney governs reproduction",and the relationship between kidney Yin,kidney essence,and female ovum is close.Therefore,by considering that the damage to the reproductive system caused by Tripterygium wilfordii polyglycosides belongs to the category of kidney deficiency,Yin damage,and essence deficiency,the"strengthening kidney Yin"method is proposed.It points out that the reproductive toxicity damage of Tripterygium wilfordii polyglycosides on the female can be effectively alleviated by tonifying kidney and Yin essence in clinical use.The relevant research on traditional Chinese medicine,classical prescription,test prescription,and acupuncture is summarized to verify the necessity of the"strengthening kidney Yin"method,so as to provide a theoretical basis for the safe and rational clinical use of Tripterygium wilfordii.

关 键 词：壮水之主 肾阴精 雷公藤多苷 生殖损伤 

分 类 号：R2-0[医药卫生—中医学] R33[文化科学—情报学] G353.11R339.2