中药药源性心脏毒性研究现状及应对策略  

Research progress and coping strategies of Chinese materia medica induced cardiotoxicity

作　　者：陈丽雯 凌望 柴钰 李华[1] 吴美平[2] CHEN Liwen;LING Wang;CHAI Yu;LI Hua;WU Meiping(Department of Cardiology,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Science and Technology Division,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属市中医医院心病科,上海200071 [2]上海中医药大学科技处,上海201203

出　　处：《上海中医药大学学报》2024年第3期84-92,共9页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81973826)。

摘　　要：随着中医药的发展,中药安全性评价及不良事件发生率的关注度日益提高。中药药源性心脏毒性是指中药对心脏功能或心肌细胞产生的急性或慢性损伤,危害性高且具有致命性,因此早期评估中药心脏毒性、明确毒性成分及其作用机制,寻找减毒增效的手段通过对于减少中药心脏损伤、提高中药安全性、促进中医药发展具有重大意义。全文旨在总结目前该领域的研究难点及诊断-治疗-预防策略,同时聚焦药物因素,列举了已明确或潜在具有心脏毒性的主要中药成分及其毒性产生的机制,提出应加强对于效毒双向的中药药理、毒理研究,逐步明确“量-效-毒”规律,最大限度地发挥中药的疗效,以期共同建立中药心脏毒性安全性评估及防治体系,推进中医药现代化发展。With the continuous emphasis on traditional Chinese medicine(TCM),the safety evaluation and incidence of adverse events in Chinese materia medica has been increasingly concerned.Chinese materia medica induced cardiotoxicity refers to acute or chronic damage to cardiac function or cardiomyocytes,which is highly hazardous and lethal.Therefore,it is of great significance for early assessment of cardiotoxicity induced by Chinese materia medica,identification of toxic components and their mechanisms of action,and search for means to reduce toxicity and increase efficacy to reduce cardiac injury and improve safety of Chinese materia medica,and promote TCM development.The paper aims to summarize current research difficulties and diagnosis-treatment-prevention strategies in this field,meanwhile focusing on drug factors,list main Chinese herbal medicinal ingredients with confirmed or potential cardiotoxicity and their toxicity mechanisms,propose to strengthen the pharmacological and toxicological research on Chinese materia medica with both efficacy and toxicity,and gradually figure out the law of"dose-effect-toxicity"to maximize the efficacy of Chinese materia medica,so as to jointly establish the safety assessment and prevention system of cardiotoxicity of Chinese materia medica and promote the modernization development of Chinese medicine.

关 键 词：中药 心脏毒性 毒性机制 中药安全性 

分 类 号：R285.1[医药卫生—中药学]