扶正制毒配伍降低雷公藤肾毒性研究进展
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摘要
雷公藤对治疗类风湿性关节炎等自身免疫功能亢进性疾病具有肯定疗效。近年来其抗炎,抗肿瘤,免疫调节,抗生育以及抗人类免疫缺陷(HIV)病毒和治疗阿耳茨海默氏病等作用,已成为目前国内外研究的热点。但雷公藤临床使用过程中易出现多脏器毒性损伤,尤其是肾脏毒性发生频繁且中毒后果严重,致使雷公藤的使用和推广受到了限制。本文借鉴前人使用雷公藤用药规律的经验,深入归类分析,探索和总结中医处方的规律,并依据"异类相制"理论指导下的"扶正制毒"中药配伍方法,提出了雷公藤肾毒性配伍减毒的组方原则,针对雷公藤导致的毒副症状,利用中医中药辨证筛选出合适的药物与之配伍减毒,依法遣药组方,发挥其相辅相成、相反相制的综合作用,以期为提高雷公藤临床应用的安全性提供参考。
Triptergium wilfordii( TW) is a characteristic traditional Chinese medicine( TCM) in China,with certain effect for autoimmune hyperthyroidism diseases like rheumatoid arthritis( RA). In recent years,it has been one of the hot natural medicines both at home and abroad for functions of anti-inflammatory,anti-tumor,immunomodulatory,anti-fertility,anti-HIV virus and treatment of Alzheimer's disease. However,multiple-organ injury is common in the clinical application of TW,especially the frequent renal toxicity and serious consequences of poisoning. Therefore,application and promotion of TW are restricted. In this paper, we would explore the prescription rules of TW based on the previous researchers' text mining experience,explore and summarize the rules of TCM prescriptions through in-depth analysis and classification. Meanwhile, we would put forward the combination principles of detoxicity prescriptions on renal toxicity of TW compatibility based on "toxicity restriction by strengthening the body resistance"methods under the guidance of the theory of "diversity restriction". For the clinical toxicity and adverse effect of TW,right medicines were selected for compatibility with TW for detoxicity,in order to make them play a comprehensive role in the complementary and opposite phase system with TW,and provide references for improving the security of the clinical application of TW.
Triptergium wilfordii( TW) is a characteristic traditional Chinese medicine( TCM) in China,with certain effect for autoimmune hyperthyroidism diseases like rheumatoid arthritis( RA). In recent years,it has been one of the hot natural medicines both at home and abroad for functions of anti-inflammatory,anti-tumor,immunomodulatory,anti-fertility,anti-HIV virus and treatment of Alzheimer's disease. However,multiple-organ injury is common in the clinical application of TW,especially the frequent renal toxicity and serious consequences of poisoning. Therefore,application and promotion of TW are restricted. In this paper, we would explore the prescription rules of TW based on the previous researchers' text mining experience,explore and summarize the rules of TCM prescriptions through in-depth analysis and classification. Meanwhile, we would put forward the combination principles of detoxicity prescriptions on renal toxicity of TW compatibility based on "toxicity restriction by strengthening the body resistance"methods under the guidance of the theory of "diversity restriction". For the clinical toxicity and adverse effect of TW,right medicines were selected for compatibility with TW for detoxicity,in order to make them play a comprehensive role in the complementary and opposite phase system with TW,and provide references for improving the security of the clinical application of TW.
引文
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[18]石卫东.论扶正祛邪法则的临床意义[J].光明中医,2011,26(3):421-423.
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[20]张静,江莹,王芳,等.基于“异类相制”理论探讨雷公藤肝毒性配伍减毒的作用[J].中草药,2014,45(18):2711-2715.
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[25]盛梅笑,孙伟,刑昌赢,等.益肾清利颗粒联合低剂量雷公藤多苷片治疗慢性原发性肾小球疾病肾虚湿热证疗效观察[J].中国中西医结合杂志,2013,33(12):1636-1641.
[26]王红君.益肾清利活血方联合雷公藤多苷片治疗慢性肾小球肾炎的临床研究[J].中国医学导报,2012,9(27):88-90.
[27]杨启超,杨立豹,赵彦锁,等.中药益肾清利活血方配合雷公藤多苷片治疗慢性肾小球肾炎的疗效[J].辽宁中医杂志,2013,40(12):2483-2484.
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[31]陈杰彬,吕佩佳,赖伟兰,等.肾康丸联合雷公藤多苷治疗糖尿病肾病Ⅳ期的临床观察[J].中国中西医结合肾病杂志,2013,14(7):611-613.
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