Kaiser H
Z Rheumatol. 2008 May;67(3):252-62. doi: 10.1007/s00393-008-0257-x.
The empirical administration of medication of plant, animal and even mineral origin goes back thousands of years. It was only in the 19th century that such therapy gained a scientific basis by means of the possibility to extract the active substances and analyze them chemically, and ultimately create them synthetically and modify them chemically.Meadow saffron was used from the 2nd century BC for the treatment of joint disease and gout; the active ingredient colchicine was discovered in 1819. For 4000 years willow bark has also been considered a remedy against fever, pain and gout. The active ingredient salicin was isolated in 1829, followed by salicyl acid in 1838, while the better tolerated acetylsalicylic acid was synthesized in 1897. Although the antipyretic agent cinchona was never a rheumatic remedy, it was initially considered an important antiinflammatory medication. In 1844, during the search for an alternative to quinin, antipyrin was developed, from which many antiphlogistic, antipyretic and analgetic active substances were later derived. Following the Second World War, the strongest antiinflammatory drug, cortisone, was discovered, derivates of which are still indispensable today for the treatment of inflammatory rheumatic diseases. At about the same time, there was a new wave of research which lead to the development of a large number of so-called non-steroidal antiinflammatory drugs. Following the discovery of proinflammatory cytokines in the 1970s, it became possible in the 1990s to produce antibodies against these substances, which gave rheumatic therapy new perspectives in the form of "biologicals". The sap from poppy seed capsules was already considered to have analgesic properties in the time of Hippocrates. The active ingredient morphine was isolated at the beginning of the 19th century. Today, only synthetically produced"opioids" are used, if at all, for the treatment of rheumatic disease.
使用植物、动物乃至矿物来源药物的经验疗法可以追溯到数千年前。直到19世纪,这种疗法才有了科学依据,因为那时人们有可能提取活性物质并进行化学分析,最终实现其合成与化学改性。公元前2世纪起,秋水仙就被用于治疗关节疾病和痛风;1819年发现了其活性成分秋水仙碱。四千年来,柳树皮也一直被视为治疗发热、疼痛和痛风的药物。1829年分离出活性成分水杨苷,1838年分离出水杨酸,1897年合成了耐受性更好的乙酰水杨酸。尽管退热剂金鸡纳从未被用作治疗风湿的药物,但它最初被认为是一种重要的抗炎药。1844年,在寻找奎宁替代品的过程中,开发出了安替比林,后来从它衍生出了许多抗炎、退热和止痛的活性物质。第二次世界大战后,发现了最强效的抗炎药物可的松,其衍生物至今仍是治疗炎性风湿疾病不可或缺的药物。大约在同一时期,掀起了新一轮研究热潮,催生了大量所谓的非甾体抗炎药。20世纪70年代发现促炎细胞因子后,20世纪90年代能够生产针对这些物质的抗体,这为风湿治疗带来了“生物制剂”形式的新前景。早在希波克拉底时代,罂粟蒴果的汁液就被认为具有止痛特性。19世纪初分离出活性成分吗啡。如今,治疗风湿疾病即便使用“阿片类药物”,也只用合成生产的。