Feng Yu-Ling, Miao Jia-wei, Li Jing, Sung An-Sheng, Liu Jie
Zhongguo Zhong Yao Za Zhi. 2014 Sep;39(17):3221-5.
Realgar-containing Niuhuang Jiedu tablet (NHJD) has been applied in clinic for more than 800 years. However, because realgar contains arsenic (As), it has aroused wide concerns and controversies both at home and abroad. Currently, there are two misunderstandings about realgar-containing Chinese patent medicines. First, some people exaggerated realgar's toxicity as that of arsenic. Second, they recommended to remove realgar from traditional Chinese medicine compounds. In this paper, the authors summarized the advance in studies on NHJD, and proposed different opinions: (1) It is inappropriate to take total As as the index in safety evaluation of NHJD. (2) The toxicity of NHJD is dependent on the dose and duration of administration. (3) Realgar is an active ingredient of NHJD, and shall be deeply studied. Classic realgar-containing traditional Chinese medicine prescriptions, such as Niuhuang Jiedu tablet, shall be evaluated with rigorous modern scientific basis, with the aim to guide rational and safe application.
含雄黄的牛黄解毒片（NHJD）已在临床上应用800多年。然而，由于雄黄含有砷（As），它在国内外引起了广泛关注和争议。目前，对于含雄黄的中成药存在两种误解。第一，一些人将雄黄的毒性夸大至与砷相同。第二，他们建议从中药复方中去除雄黄。在本文中，作者总结了牛黄解毒片的研究进展，并提出了不同观点：（1）在牛黄解毒片的安全性评价中，以总砷作为指标是不合适的。（2）牛黄解毒片的毒性取决于给药剂量和持续时间。（3）雄黄是牛黄解毒片的有效成分，应深入研究。经典的含雄黄中药方剂，如牛黄解毒片，应以严谨的现代科学依据进行评价，以指导合理、安全应用。
