服用人参导致“上火”的研究综述
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摘要
目的:系统整理服用人参引起"上火"的文献报道,对服用人参导致"上火"的传统阐释和现代机制研究进行总结及分析。方法:通过手动检索国内外关于人参及"上火"的相关文献,分别从传统中医药学及生物化学、药物化学等,对其进行分析与总结。结果:服用人参过量或不当可能会导致"上火",中医理论认为补气过,生气速于血,"气有余便是火"。现代研究认为,服用人参过量或不当会引起机体内白介素、多巴胺、肾上腺皮质激素等水平升高,导致人体出现睡眠障碍、口腔溃疡、鼻出血等症状。服用人参导致"上火"的化学成分认为有人参皂苷Ro、人参皂苷Rg1、田七素三种单体成分及人参二醇、人参三醇、次生人参皂苷等一类成分。服用人参致"上火"的相关机理研究结论有矛盾。结论:人参中的主要有效成分对机体的作用机制与"上火"时机体内的生化指标变化情况存在相似性。服用人参致"上火"的化学物质基础及作用机理缺乏科学可信的实验数据支持,有待进一步深入研究。
To systematically collect the relative literatures about‘internal heat'caused by taking ginseng, to summarize and analyze the scientific definition of‘internal heat'according to Traditional Chinese Medicine(TCM) theory and modern mechanism research. Through literature review, this article also analyzed and discussed the theory of‘fire'based on the view of TCM, biochemistry and medicinal chemistry. It has been reported that the excessive and improper use of ginseng might lead‘internal heat'. According to TCM theory, excessive nourishment of Qi will lead the generation speed of Qi faster than Blood, which will then cause‘fire'. Modern researches indicated that the overdose or improper use of ginseng increased the levels of interleukin, dopamine, adrenal-cortical hormone as well as other biomarkers, which would then cause insomnia, oral ulcer, nose bleeding and other symptoms. Researchers indicated that ginsenoside Ro,ginsenoside Rg1, dencichine as well as panoxadiol, panoxatriol and other secondary ginseng saponin would cause‘fire'.However, the conclusion about mechanism study on‘fire'was conflicting. The changes on biochemical index caused by the main active components from ginseng are very similar to which caused by‘fire'. The chemical substances and their mechanisms on‘fire'after the treatment of ginseng still need to be further studied.
To systematically collect the relative literatures about‘internal heat'caused by taking ginseng, to summarize and analyze the scientific definition of‘internal heat'according to Traditional Chinese Medicine(TCM) theory and modern mechanism research. Through literature review, this article also analyzed and discussed the theory of‘fire'based on the view of TCM, biochemistry and medicinal chemistry. It has been reported that the excessive and improper use of ginseng might lead‘internal heat'. According to TCM theory, excessive nourishment of Qi will lead the generation speed of Qi faster than Blood, which will then cause‘fire'. Modern researches indicated that the overdose or improper use of ginseng increased the levels of interleukin, dopamine, adrenal-cortical hormone as well as other biomarkers, which would then cause insomnia, oral ulcer, nose bleeding and other symptoms. Researchers indicated that ginsenoside Ro,ginsenoside Rg1, dencichine as well as panoxadiol, panoxatriol and other secondary ginseng saponin would cause‘fire'.However, the conclusion about mechanism study on‘fire'was conflicting. The changes on biochemical index caused by the main active components from ginseng are very similar to which caused by‘fire'. The chemical substances and their mechanisms on‘fire'after the treatment of ginseng still need to be further studied.
引文
1国家药典委员会.中华人民共和国药典.一部.北京:中国医药科技出版社,2015:8.
2 于水永,马屏南.服用人参常见的五种误解.中国药物经济学,2013,9(48):266-267.
3 马捷,宋月晗,梁嵘,等.“上火”科学内涵的文献研究.中医学报,2016,31(3):373-375.
4 苏鑫,孙大中.“上火”与应激反应相关性探析.中华中医药杂志,2015,30(1):32-34.
5 谢志军,王伟杰.上火病因病机初探.浙江中医药大学学报,2013,37(3):226-228.
6 钟天飞,徐莉,李海昌.中医角度浅析糖皮质激素与上火的关系.山西中医学院学报,2016,17(2):12-14.
7 朱星瑜,赵婷,王耀东,等.上火从郁论治思路浅析.新中医,2016,48(7):264-266.
8 钱苏海,钱俊华.中医“上火”的内涵、表述及其应用初探.浙江中医药大学学报,2015,39(6):430-435.
9 上海中医学院.阴虚火旺与肾上腺皮质、髓质激素关系的初步探讨.上海中医药杂志,1979,13(5):8-11.
10 何蓉蓉,果原博.论“上火”与应激反应.世界科学技术——中医药现代化,2008,10(5):38-41.
11 孙娜,徐钢,徐珊,等.人参炮制对其化学成分和药理作用的影响.中国药房,2016,27(6):857-859.
12 Wang Y,Ma L,Sun Y,et al.Metabonomics study on the hot syndrome of traditional Chinese medicine by rapid resolution liquid chromatography combinedwith quadrupole time-of-flight tandem mass spectrometry.Archives of Pharmacal Research,2014,37(10):899-906.
13 Sigel R K.Ginseng abuse syndrome.Problems with the panacea.Journal of the American Medical Association,1979,241(15):1614-1615.
14 人参不可滥用.新农业,1994,12:26.
15 Paik D J,Lee C H.Review of cases of patient risk associated with ginseng abuse and misuse.Journal of Ginseng Research,2015,39(2):89-93.
16 谢燮,陈少秋,吕颖芳,等.长期服用人参皂苷大鼠尿液代谢组学研究.中国中药杂志,2014,39(23):4675-4679.
17 贾执瑛.人参各主要成分对机体作用的比较研究.上海交通大学,2013.
18 郭优勤,魏桂林,钟秋明,等.浅谈人参的临床应用.中国现代药物应用,2011,5(7):128-129.
19 刘忠第.《伤寒论》的人参应用规律研究.北京中医药大学,2010.
20 Song J Y,Han S K,Bae K G,et al.Radio protective effects of ginseng,an immunomodulator.Radiation Research,2003,159:768-774.
21 Qi L W,Wang C Z,Yuan C S.Ginsenosides from American ginseng:Chemical and pharmacological diversity.Phytochemistry,2011,72(8):689-699.
22 Oh K W,Kim H S,Wagner G C.Inhibitory effects of ginseng total saponin on methamphetamine-induced striatal dopamine increase in mice.Archives of Pharmacal Research,1997,20:516-518.
23 Kim Y,Choi E H,Doo M,et al.Anti-stress effects of ginseng via downregulation of tyrosine hydroxylase(TH)and dopamineβ-hydroxylase(DBH)gene expression in immobilization-stressed rats and PC12 cells.Nutrition Research and Practice,2010,4(4):270-275.
24 胡广.人参花蕾药用价值远超参根.中成药,2005,27(1):21.
25 魏爱书.黑曲霉发酵参的化学成分与药理学研究.吉林农业大学,2012.
26 赵远,孙娜,刘蓬蓬,等.生晒参、红参与平性参对气虚大鼠作用的比较研究.中医药导报,2014,20(4):12-15.
27 曲胜军,沈晓庆,张凡,等.不同人参炮制品中5种人参皂苷的含量研究.亚太传统医药,2013,9(1):34-36.
28 Kimura Y,Okuda H,Arichi S.Effects of various ginseng saponins on 5-hydroxytryptamine release and aggregation in human platelets.Journal of Pharmacy and Pharmacology,1988,40:838-843.
29 Park H J,Lee J H,Song Y B,et al.Effects of dietary supplementation of lipophilic fraction from Panax ginseng on c GMP and c AMP in rat platelets andon blood coagulation.Biological and Pharmaceutical Bulletin,1996,19(11):1434-1439.
30 Lau A J,Toh D F,Chua T K,et al.Antiplatelet and anticoagulanteffects of Panax notoginseng:comparison of raw and steamed Panax notoginseng with Panax ginseng and Panax quinquefolium.Journal of Ethnopharmacology,2009,125:380-386.
31 Xu X,Dou D Q.The ginseng′s fireness is associated with the lowering activity of liver Na+-K+-ATPase.Journal of Ethnopharmacology,2016,190:241-250.
32 董瑞馨,宋毓敏,房丽,等.高血压病并鼻出血17例原因分析.中国误诊学杂志,2012,12(2):417.
33 李海洲,那学武,朱丽明,等.鼻出血部位及出血原因的研究及鼻内镜下治疗体会.临床耳鼻咽喉头颈外科杂志,2014,28(20):1608-1610.
34 翟静波,王晓辉,曹红波,等.大学生“上火”症状特点的关联规则分析.天津中医药,2016,33(8):462-464.
35 吴金飞,梁嵘,王盛花,等.758例体检者“上火”体验的回顾性调查.世界科学技术——中医药现代化,2007,9(5):39-43.
36 何汝帮,杨安平.“上火”证发病机理的研究综述.亚太传统医药,2008,4(12):144-145.
37 王召平,吴金飞,梁嵘,等.体检人群中轻浅热证(上火)者的体检数据分析.世界科学技术——中医药现代化,2010,12(4):536-539.
38 刘长江,王烈臣.莱菔导气汤治疗人参中毒综合征61例.江苏中医,1988,(9):16-17.
39 孙一帆,罗兰堂.中西医结合救治小儿急性人参中毒36例.湖北中医杂志,1999,(5):32-33.
40 府明棣,叶进.人参不良反应之探析.辽宁中医杂志,2015,42(6):1214-1215.
41 苏鑫,孙大中.服用人参“上火”之理论释析.华中医药杂志,2015,30(20):494-495.
42 孙媛媛.栀制人参炮制原理研究.辽宁中医药大学,2010.
2 于水永,马屏南.服用人参常见的五种误解.中国药物经济学,2013,9(48):266-267.
3 马捷,宋月晗,梁嵘,等.“上火”科学内涵的文献研究.中医学报,2016,31(3):373-375.
4 苏鑫,孙大中.“上火”与应激反应相关性探析.中华中医药杂志,2015,30(1):32-34.
5 谢志军,王伟杰.上火病因病机初探.浙江中医药大学学报,2013,37(3):226-228.
6 钟天飞,徐莉,李海昌.中医角度浅析糖皮质激素与上火的关系.山西中医学院学报,2016,17(2):12-14.
7 朱星瑜,赵婷,王耀东,等.上火从郁论治思路浅析.新中医,2016,48(7):264-266.
8 钱苏海,钱俊华.中医“上火”的内涵、表述及其应用初探.浙江中医药大学学报,2015,39(6):430-435.
9 上海中医学院.阴虚火旺与肾上腺皮质、髓质激素关系的初步探讨.上海中医药杂志,1979,13(5):8-11.
10 何蓉蓉,果原博.论“上火”与应激反应.世界科学技术——中医药现代化,2008,10(5):38-41.
11 孙娜,徐钢,徐珊,等.人参炮制对其化学成分和药理作用的影响.中国药房,2016,27(6):857-859.
12 Wang Y,Ma L,Sun Y,et al.Metabonomics study on the hot syndrome of traditional Chinese medicine by rapid resolution liquid chromatography combinedwith quadrupole time-of-flight tandem mass spectrometry.Archives of Pharmacal Research,2014,37(10):899-906.
13 Sigel R K.Ginseng abuse syndrome.Problems with the panacea.Journal of the American Medical Association,1979,241(15):1614-1615.
14 人参不可滥用.新农业,1994,12:26.
15 Paik D J,Lee C H.Review of cases of patient risk associated with ginseng abuse and misuse.Journal of Ginseng Research,2015,39(2):89-93.
16 谢燮,陈少秋,吕颖芳,等.长期服用人参皂苷大鼠尿液代谢组学研究.中国中药杂志,2014,39(23):4675-4679.
17 贾执瑛.人参各主要成分对机体作用的比较研究.上海交通大学,2013.
18 郭优勤,魏桂林,钟秋明,等.浅谈人参的临床应用.中国现代药物应用,2011,5(7):128-129.
19 刘忠第.《伤寒论》的人参应用规律研究.北京中医药大学,2010.
20 Song J Y,Han S K,Bae K G,et al.Radio protective effects of ginseng,an immunomodulator.Radiation Research,2003,159:768-774.
21 Qi L W,Wang C Z,Yuan C S.Ginsenosides from American ginseng:Chemical and pharmacological diversity.Phytochemistry,2011,72(8):689-699.
22 Oh K W,Kim H S,Wagner G C.Inhibitory effects of ginseng total saponin on methamphetamine-induced striatal dopamine increase in mice.Archives of Pharmacal Research,1997,20:516-518.
23 Kim Y,Choi E H,Doo M,et al.Anti-stress effects of ginseng via downregulation of tyrosine hydroxylase(TH)and dopamineβ-hydroxylase(DBH)gene expression in immobilization-stressed rats and PC12 cells.Nutrition Research and Practice,2010,4(4):270-275.
24 胡广.人参花蕾药用价值远超参根.中成药,2005,27(1):21.
25 魏爱书.黑曲霉发酵参的化学成分与药理学研究.吉林农业大学,2012.
26 赵远,孙娜,刘蓬蓬,等.生晒参、红参与平性参对气虚大鼠作用的比较研究.中医药导报,2014,20(4):12-15.
27 曲胜军,沈晓庆,张凡,等.不同人参炮制品中5种人参皂苷的含量研究.亚太传统医药,2013,9(1):34-36.
28 Kimura Y,Okuda H,Arichi S.Effects of various ginseng saponins on 5-hydroxytryptamine release and aggregation in human platelets.Journal of Pharmacy and Pharmacology,1988,40:838-843.
29 Park H J,Lee J H,Song Y B,et al.Effects of dietary supplementation of lipophilic fraction from Panax ginseng on c GMP and c AMP in rat platelets andon blood coagulation.Biological and Pharmaceutical Bulletin,1996,19(11):1434-1439.
30 Lau A J,Toh D F,Chua T K,et al.Antiplatelet and anticoagulanteffects of Panax notoginseng:comparison of raw and steamed Panax notoginseng with Panax ginseng and Panax quinquefolium.Journal of Ethnopharmacology,2009,125:380-386.
31 Xu X,Dou D Q.The ginseng′s fireness is associated with the lowering activity of liver Na+-K+-ATPase.Journal of Ethnopharmacology,2016,190:241-250.
32 董瑞馨,宋毓敏,房丽,等.高血压病并鼻出血17例原因分析.中国误诊学杂志,2012,12(2):417.
33 李海洲,那学武,朱丽明,等.鼻出血部位及出血原因的研究及鼻内镜下治疗体会.临床耳鼻咽喉头颈外科杂志,2014,28(20):1608-1610.
34 翟静波,王晓辉,曹红波,等.大学生“上火”症状特点的关联规则分析.天津中医药,2016,33(8):462-464.
35 吴金飞,梁嵘,王盛花,等.758例体检者“上火”体验的回顾性调查.世界科学技术——中医药现代化,2007,9(5):39-43.
36 何汝帮,杨安平.“上火”证发病机理的研究综述.亚太传统医药,2008,4(12):144-145.
37 王召平,吴金飞,梁嵘,等.体检人群中轻浅热证(上火)者的体检数据分析.世界科学技术——中医药现代化,2010,12(4):536-539.
38 刘长江,王烈臣.莱菔导气汤治疗人参中毒综合征61例.江苏中医,1988,(9):16-17.
39 孙一帆,罗兰堂.中西医结合救治小儿急性人参中毒36例.湖北中医杂志,1999,(5):32-33.
40 府明棣,叶进.人参不良反应之探析.辽宁中医杂志,2015,42(6):1214-1215.
41 苏鑫,孙大中.服用人参“上火”之理论释析.华中医药杂志,2015,30(20):494-495.
42 孙媛媛.栀制人参炮制原理研究.辽宁中医药大学,2010.