中药十八反药物代谢动力学机制研究进展  

Research progress on the pharmacokinetic mechanism of eighteen incompatible medicaments

作　　者：尚恺琪 王柠柠 刘韶[1,2,3] SHANG Kaiqili;WANG Ningning;LIU Shao(Department of Pharmacy,Xiangya Hospital,Central South University,Changsha 410008,China;National Clinical Research Center for Geriatric Disorders,Changsha 410008,China;The Hunan Institute of Pharmacy Practice and Clinical Research,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院药学部,长沙410008 [2]国家老年疾病临床研究中心,长沙410008 [3]湖南省临床药学研究中心,长沙410008

出　　处：《中华中医药杂志》2025年第2期797-802,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：湖南省自然科学基金项目(No.2023JJ60521)。

摘　　要：中药十八反从古至今一直被视为配伍禁忌,但临床实践中屡有成功应用的案例。现代医学认为药物“相反”的机制主要源于不良的药物相互作用,包括药物代谢动力学和药物效应动力学两个方面,目前对药物代谢动力学研究更为深入。文章主要从药物代谢动力学的角度对中药“十八反”中各组反药对配伍的机制及其在临床应用中的合理性进行分析。通过对各药物的性味、归经、经典及现代临床应用案例的系统梳理,并结合最新的药物代谢动力学研究成果,对各反药对配伍使用的内在机制进行科学解析,旨在为中药的临床应用提供更加精准、科学的用药指导,奠定临床安全与合理用药的坚实基础,从而有效减少或规避不良药物相互作用的风险,进一步提升治疗效果。The eighteen incompatible medicaments have been considered incompatibility since ancient times,but there are still many clinical records of the use of anti-drug pairs with good efficacy.Modern medical research believes that the'incompatibility between two drugs'is due to the adverse interaction between drugs,which can be divided into pharmacokinetics and pharmacodynamics interactions according to their mechanisms,with the former currently being more extensively researched.This review primarily analyzes the mechanisms underlying the formulation of incompatible herbal pairs within the eighteen incompatible medicaments of traditional Chinese medicine(TCM)and the rationality of their clinical applications from the perspective of pharmacokinetics.By systematically reviewing the properties,meridian affliations,classical and modern clinical application cases of each herb,and integrating the latest pharmacokinetic research findings,this review scientifically dissects the intrinsic mechanisms governing the use of incompatible herbal pairs.The aim is to provide more precise and scientific medication guidance for the clinical application of TCM,thereby establishing a solid foundation for clinical safety and rational drug use.This,in turn,will effectively reduce or avoid the risks of adverse drug interactions and further enhance therapeutic efficacy.

关 键 词：十八反 药物代谢动力学 配伍禁忌 药物相互作用 临床应用 

分 类 号：R285[医药卫生—中药学]