细辛毒性辨析及安全风险评控策略的研究与思考  

Research and reflection on toxicity analysis and safety risk assessment and control strategies of Asari Radix et Rhizoma

作　　者：张慧杰 黄娜娜[1,2] 孙蓉 ZHANG Huijie;HUANG Nana;SUN Rong(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;The Second Hospital of Shandong University,Jinan 250033,China;Advanced Medical Research Institute,Shandong University,Jinan 250012,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]山东大学第二医院,山东济南250033 [3]山东大学高等医学研究院,山东济南250012

出　　处：《中草药》2024年第24期8589-8601,共13页Chinese Traditional and Herbal Drugs

基　　金：国家重点研发计划课题二(2022YFC3502102);山东大学高等医学研究院前沿学科发展基金(GYY2023QY01)。

摘　　要：在临床功用主治背景下对细辛Asari Radix et Rhizoma“毒”的古籍记载、不良反应表达、毒性影响、靶器官毒性及其损伤机制进行信息挖掘。利用中国知网、万方、维普和Pubmed数据库对细辛近20年的文献和临床报道进行整理、分析与归纳,发现细辛在不同功效背景下的用法用量各不相同,且不局限于“不过钱”,临床不良反应主要表现在神经系统、心血管系统、皮肤、免疫系统、消化系统等;毒理学研究表明细辛有不同程度的神经、肺、肝、肾、心脏、生殖毒性,毒性机制涉及炎症通路、氧化应激、免疫损伤等。因此,以中医理论为指导,依托功效与主治开展细辛毒性辨析、评价及安全风险控制,进一步厘清“人、药、病”对细辛用药安全风险的影响,是切实保证临床用药安全的有效策略。We conducted information mining on the ancient literature records,expression of toxic side effects,toxic effects,target organ toxicity,and damage mechanisms of Xixin(Asari Radix et Rhizoma)’s“toxicity”based on the clinical functional indications.Then,we sorted out,analyzed and summarized the recent 20 years of literature and clinical reports related to Asari Radix et Rhizoma by using CNKI,Wanfang,Weipu and Pubmed databases.It was found that the usage and dosage of Asari Radix et Rhizoma vary under different efficacy backgrounds,and is not limited to the dose can not exceed one qian.Clinical adverse reactions are mainly manifested in the nervous system,cardiovascular system,skin,immune system,digestive system,and toxicological studies have shown that it has varying degrees of toxicity of nerves,lungs,liver,kidneys,heart,and reproduction,with toxicity mechanism involving inflammatory pathway,oxidative stress,immune damage,and more.Therefore,we should rely on efficacy and indications to conduct toxicity analysis,evaluation,and safety risk control of Asari Radix et Rhizoma guided by traditional Chinese medicine theory,further clarify the impact of“human,drug,disease”on the safety risks of its medication,which is an effective strategy to ensure clinical medication safety.

关 键 词：细辛 不良反应 靶器官毒性 安全风险 炎症通路 氧化应激 免疫损伤 

分 类 号：R285[医药卫生—中药学]