肺系病中药不良反应临床对策
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摘要
文章追溯了近年来呼吸系统疾病治疗常用中草药不良反应机制研究,采撷其中可在临床实用的思想和策略。论证于"十八反""十九畏"之真伪,述要于单味药炮制、煎服之科学规范,精求于"异类相制"之法要,探究于"有故无殒"之思想,终归于中正平和之大略。通过拓展研究的深度和广度,提出更多针对肺系病中药不良反应的传统临床对策的证实、修正、再挖掘和创新,以为临床工作之助力与信心。
In this paper, the mechanism of the adverse reactions of traditional Chinese herbs used in the treatment of respiratory diseases in recent years was reviewed. To demonstrate the truth and falsity of ‘the eighteen incompatible medicaments' and ‘the nineteen medicaments of mutual restraint', it is necessary to expatiate on the scientific norms of single drug processing and decoction, to seek for the method of ‘different kinds of things are conditioned on each other', to explore the thought of ‘You Gu Wu Yun', and finally to conclude the general strategy of justice and peace. By paying attention to the depth and breadth of the research, more traditional clinical countermeasures for the adverse reactions of traditional Chinese medicine on lung diseases were proposed to confirm, revise, rediscover and innovate, so as to facilitate the clinical work and confidence of doctors.
In this paper, the mechanism of the adverse reactions of traditional Chinese herbs used in the treatment of respiratory diseases in recent years was reviewed. To demonstrate the truth and falsity of ‘the eighteen incompatible medicaments' and ‘the nineteen medicaments of mutual restraint', it is necessary to expatiate on the scientific norms of single drug processing and decoction, to seek for the method of ‘different kinds of things are conditioned on each other', to explore the thought of ‘You Gu Wu Yun', and finally to conclude the general strategy of justice and peace. By paying attention to the depth and breadth of the research, more traditional clinical countermeasures for the adverse reactions of traditional Chinese medicine on lung diseases were proposed to confirm, revise, rediscover and innovate, so as to facilitate the clinical work and confidence of doctors.
引文
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[2]柳海艳,钟赣生,刘云翔,等.接近临床应用剂量下甘遂半夏汤加减甘遂甘草反药组合对腹水大鼠利水作用的影响.中国中药杂志,2014,39(14):2726-2732
[3]刘云翔,钟生,柳海艳,等.优选配比条件下海澡玉壶汤加减海藻甘草反药组合对大鼠甲状腺肿大的治疗作用.科技导报,2015,33(15):87-91
[4]刘文龙,宋凤瑞,刘志强,等.川乌与半夏、瓜蒌、贝母、白蔹、白芨配伍禁忌的化学研究.化学学报,2010,68(9):890-896
[5]赖晓艺,庄朋伟,卢志强,等.“半蒌贝蔹及攻乌”反药组合对制川乌镇痛作用的影响.天津中医药大学学报,2014,33(1):32-35
[6]孟宪生,康廷国,叶挺祥,等.中药细辛与藜芦配伍化学成分变化的UPLC/Q-TOF-MS研究.中华中医药学刊,2010,28(4):754-759
[7]朱冠秀,王宇光,李飞,等.采用均匀设计研究南沙参、北沙参配伍藜芦相反的毒性作用规律.中国中西医结合杂志,2013,33(5):686-690
[8]丁爱华,华永庆,洪敏,等.海藻与甘草反药组合对大鼠离体回肠收缩及小鼠小肠推进功能的影响.中华中医药杂志,2014,29(1):87-91
[9]Dan Y,Liu H Y,Gao W W,et al.Activities of essential oils from Asarum heterotropoides var.mandshuricum against five phytopathogens.Crop Protection,2010,29(3):295-299
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[11]熊玉兰,荆宇,尚明英,等.细辛非挥发性提取物抗炎镇痛作用研究.中国中药杂志,2009,34(17):2252
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[13]赵腾斐.半夏毒性作用机制及生姜解半夏毒的研究.南京:南京中医药大学,2010
[14]Su J,Cheng J,Sun H X,et al.Tripterygium glycosides impairs the proliferation of granulosa cells and decreases the reproductive outcomes in female rats.Birth Defects Res B Dev Reprod Toxicol,2014,101(3):283
[15]Zhu X,Zhang J,Huo R F,et al.Evaluation of the efficacy and safety of different Tripterygium preparations on collagen-induced arthritis in rats.J Ethnopharmacol,2014:283-290
[16]谢彤,周学平,林丽丽,等.基于“异类相制”的雷公藤复方配伍减毒代谢组学研究.中国中药杂志,2016,41(6):1124-1129
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[19]李振彬,王志强,宫彩霞,等.白芍总苷对雷公藤多苷治疗狼疮性肾炎减毒增效作用的实验研究.中药新药与临床药理,2009,20(6):513-516
[20]李涯松,童培建,马红珍,等.甘草对雷公藤治疗类风湿关节炎的减毒增效作用.中国中西医结合杂志,2006,12(16):1117-1119
[21]方泓,唐斌擎.过敏性鼻炎-哮喘综合征中医治疗心得.上海中医药杂志,2010,44(10):44-45
[22]刘华平.史锁芳教授应用大剂量甘草治疗支气管哮喘经验.中医学报,2010,25(2):230-231
[23]黄辉.史锁芳治疗过敏性鼻炎-哮喘综合征经验.上海中医药杂志,2010,44(12):5-6
[24]王艳辉,赵海平,王伽伯,等.基于“有故无殒”思想的熟大黄对肝脏量-毒/效关系研究.中国中药杂志,2014,39(15):2918-2923
[25]冯群,栾永福,孙蓉,等.基于功效和物质基础的雷公藤毒性研究进展.中国药物警戒,2013,10(2):88-92
[26]曹亮亮,王文晓,张丽,等.基于“有故无殒”思想的醋甘遂毒性研究.中国中药杂志,2015,40(16):3249-3255
[27]Li X X,Du F Y,Liu H X,et al.Investigation of the active components in Tripterygium wilfordii leading to its acute hepatotoxicty and nephrotoxicity.J Ethnopharmacol,2015,162:238-243
[28]Sun L,Li H,Huang X,et al.Triptolide alters barrier function in renal proximal tubular cells in rats.Toxicology Letters,2013,223(1):96-102
[29]厉莉,赵然,李春君,等.雷公藤多苷对糖尿病大鼠肾脏的保护作用.中国糖尿病杂志,2016,24(5):459-464
[30]张琴,欧阳林旗,胡炜航,等.基于“有故无殒”思想的雷公藤肾毒性研究.中国药业,2016,25(20):117-119
[31]宋纯东,侯小静,薛黎明,等.雷公藤多苷片对糖尿病肾病大鼠肾组织WT1的影响.中华中医药杂志,2015,30(12):4472-4474
[32]毕伟博,崔红生.张仲景“和”思想面面观.中华中医药杂志,2015,30(12):4227-4230
[2]柳海艳,钟赣生,刘云翔,等.接近临床应用剂量下甘遂半夏汤加减甘遂甘草反药组合对腹水大鼠利水作用的影响.中国中药杂志,2014,39(14):2726-2732
[3]刘云翔,钟生,柳海艳,等.优选配比条件下海澡玉壶汤加减海藻甘草反药组合对大鼠甲状腺肿大的治疗作用.科技导报,2015,33(15):87-91
[4]刘文龙,宋凤瑞,刘志强,等.川乌与半夏、瓜蒌、贝母、白蔹、白芨配伍禁忌的化学研究.化学学报,2010,68(9):890-896
[5]赖晓艺,庄朋伟,卢志强,等.“半蒌贝蔹及攻乌”反药组合对制川乌镇痛作用的影响.天津中医药大学学报,2014,33(1):32-35
[6]孟宪生,康廷国,叶挺祥,等.中药细辛与藜芦配伍化学成分变化的UPLC/Q-TOF-MS研究.中华中医药学刊,2010,28(4):754-759
[7]朱冠秀,王宇光,李飞,等.采用均匀设计研究南沙参、北沙参配伍藜芦相反的毒性作用规律.中国中西医结合杂志,2013,33(5):686-690
[8]丁爱华,华永庆,洪敏,等.海藻与甘草反药组合对大鼠离体回肠收缩及小鼠小肠推进功能的影响.中华中医药杂志,2014,29(1):87-91
[9]Dan Y,Liu H Y,Gao W W,et al.Activities of essential oils from Asarum heterotropoides var.mandshuricum against five phytopathogens.Crop Protection,2010,29(3):295-299
[10]Cai S Q,Yu J,Wang X,et al.Cytotoxic activity of some Asarum plants.Fitoterapia,2008,79(4):293-297
[11]熊玉兰,荆宇,尚明英,等.细辛非挥发性提取物抗炎镇痛作用研究.中国中药杂志,2009,34(17):2252
[12]钟凌云.半夏刺激性毒性成分、炮制减毒机理及工艺研究.南京:南京中医药大学,2007
[13]赵腾斐.半夏毒性作用机制及生姜解半夏毒的研究.南京:南京中医药大学,2010
[14]Su J,Cheng J,Sun H X,et al.Tripterygium glycosides impairs the proliferation of granulosa cells and decreases the reproductive outcomes in female rats.Birth Defects Res B Dev Reprod Toxicol,2014,101(3):283
[15]Zhu X,Zhang J,Huo R F,et al.Evaluation of the efficacy and safety of different Tripterygium preparations on collagen-induced arthritis in rats.J Ethnopharmacol,2014:283-290
[16]谢彤,周学平,林丽丽,等.基于“异类相制”的雷公藤复方配伍减毒代谢组学研究.中国中药杂志,2016,41(6):1124-1129
[17]李桓,周学平,陆艳.雷公藤“异类相制”配伍减毒作用探讨.中医杂志,2015,56(1):10
[18]刘建群,洪沁,张维,等.凤尾草对雷公藤甲素的减毒作用.中国医院药学杂志,2010,30(6):443-446
[19]李振彬,王志强,宫彩霞,等.白芍总苷对雷公藤多苷治疗狼疮性肾炎减毒增效作用的实验研究.中药新药与临床药理,2009,20(6):513-516
[20]李涯松,童培建,马红珍,等.甘草对雷公藤治疗类风湿关节炎的减毒增效作用.中国中西医结合杂志,2006,12(16):1117-1119
[21]方泓,唐斌擎.过敏性鼻炎-哮喘综合征中医治疗心得.上海中医药杂志,2010,44(10):44-45
[22]刘华平.史锁芳教授应用大剂量甘草治疗支气管哮喘经验.中医学报,2010,25(2):230-231
[23]黄辉.史锁芳治疗过敏性鼻炎-哮喘综合征经验.上海中医药杂志,2010,44(12):5-6
[24]王艳辉,赵海平,王伽伯,等.基于“有故无殒”思想的熟大黄对肝脏量-毒/效关系研究.中国中药杂志,2014,39(15):2918-2923
[25]冯群,栾永福,孙蓉,等.基于功效和物质基础的雷公藤毒性研究进展.中国药物警戒,2013,10(2):88-92
[26]曹亮亮,王文晓,张丽,等.基于“有故无殒”思想的醋甘遂毒性研究.中国中药杂志,2015,40(16):3249-3255
[27]Li X X,Du F Y,Liu H X,et al.Investigation of the active components in Tripterygium wilfordii leading to its acute hepatotoxicty and nephrotoxicity.J Ethnopharmacol,2015,162:238-243
[28]Sun L,Li H,Huang X,et al.Triptolide alters barrier function in renal proximal tubular cells in rats.Toxicology Letters,2013,223(1):96-102
[29]厉莉,赵然,李春君,等.雷公藤多苷对糖尿病大鼠肾脏的保护作用.中国糖尿病杂志,2016,24(5):459-464
[30]张琴,欧阳林旗,胡炜航,等.基于“有故无殒”思想的雷公藤肾毒性研究.中国药业,2016,25(20):117-119
[31]宋纯东,侯小静,薛黎明,等.雷公藤多苷片对糖尿病肾病大鼠肾组织WT1的影响.中华中医药杂志,2015,30(12):4472-4474
[32]毕伟博,崔红生.张仲景“和”思想面面观.中华中医药杂志,2015,30(12):4227-4230