中药配伍减毒新策略新方法:成分靶标效应互作  

New strategy and method in traditional Chinese medicine compatibility for detoxification based on component-target-effect interaction

作　　者：柏兆方 石伟 高源 王伽伯 肖小河 BAI Zhao-fang;SHI Wei;GAO Yuan;WANG Jia-bo;XIAO Xiao-he(Military Institute of Chinese Materia,Fifth Medical Center of Chinese PLA General Hospital,Beijing 100039,China;Department of Hepatology,Fifth Medical Center of Chinese PLA General Hospital,Beijing 100039,China;State Key Laboratory for Quality Ensurance and Sustainable Use of Dao-di Herbs,Beijing 100700,China;School of Traditional Chinese Medicine,Capital Medical University,Beijing 100069,China)

机构地区：[1]中国人民解放军总医院第五医学中心全军中医药研究所,北京100039 [2]中国人民解放军总医院第五医学中心肝病医学部研究所,北京100039 [3]道地药材品质保障与资源持续利用全国重点实验室,北京100700 [4]首都医科大学中医药学院,北京100069

出　　处：《中国中药杂志》2025年第4期853-859,共7页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金联合基金重点项目(U23A20519);国家自然科学基金项目(82230118);中央本级重大增减支项目(2060302)。

摘　　要：中医历来十分重视中药安全性问题,并总结形成了丰富而宝贵的中药安全用药理论和经验,为保证临床安全精准用药发挥了不可替代的作用。但近年来中药毒性理论认知发生深刻变革,中药不仅存在传统固有型毒性,还存在与机体因素等相关的特异质型和间接型毒性,这导致以防控固有型毒性为主的传统中药安全用药理论和经验,难以用于指导新发现的特异质型和间接型毒性中药的风险防控对策制定。为此,根据中药毒性类型及成因机制特点,笔者团队提出了基于成分靶标效应互作的中药配伍减毒策略和方法,即通过成分互作、靶标互作和(或)效应互作阻断药物损害发生和促进损伤修复实现配伍减毒,并由此建立符合现代中药毒性认知的中药配伍减毒对策,实现临床安全精准用药。成分靶标效应互作已示范应用于何首乌、补骨脂和淫羊藿等中药配伍减毒对策制定,并阐释了甘草“调和诸药解百毒”的新机制,为相关中药临床安全精准用药提供了科学依据。该文就成分靶标效应互作的科学内涵、应用形式以及应用实例进行概述,以期为保障中药临床精准用药提供理论和方法学基础,创新中药配伍减毒理论和方法。The safety of traditional Chinese medicine(TCM)has always been taken very seriously,and rich and valuable theories and experiences have been developed to ensure the safe and precise use of TCM in clinical practices.In recent years,the cognitive theory of toxicity of TCM,has undergone a profound change.TCM is characterized by the existence of intrinsic toxicity,idiosyncratic toxicity,and indirect toxicity related to organic factors.Therefore,the traditional theories and experiences of TCM,which focus on the prevention and control of intrinsic toxicity,fail to be used for the development of risk prevention and control countermeasures for newly discovered TCM with idiosyncratic toxicity and indirect toxicity.Accordingly,based on the toxicity classification and mechanism characteristics of TCM,this paper proposed a new strategy and method in TCM compatibility for detoxification based on componenttarget-effect interaction.The strategy based on component-target-effect interaction is to carry out TCM compatibility for detoxification by blocking the occurrence of drug-mediated damage and promoting damage repair through component interactions,target interactions,and/or effect interactions.Based on this theory,the paper established a strategy for TCM compatibility that aligned with the cognitive theory of toxicity of TCM,so as to achieve safe and precise use of TCM in clinical practices.The strategy based on component-targeteffect interaction has been exemplarily applied to the development of countermeasures to reduce the toxicity of TCM,including Polygonum Multiflorum,Epimedii Folium,and Psoraleae Fructus,and a new mechanism of Glycyrrhizae Radix et Rhizoma to"harmonize various medicines and detoxify myriad poisons"was illustrated,providing a scientific basis for the safe and precise use of TCM in clinical practice.This paper explained the scientific connotation,application forms,and application examples of componenttarget-effect interaction,aiming to provide a theoretical and methodological basis for guaranteeing the pre

关 键 词：中药毒性 配伍减毒 成分靶标效应互作 安全精准用药 

分 类 号：R28[医药卫生—中药学]