Wei Xu-Ya, Qiu Zi-Dong, Chen Jin-Long, Sun Rui-Qi, Huang Lu-Qi, Lai Chang-Jiang-Sheng
State Key Laboratory Breeding Base of Dao-di Herbs,National Resource Center for Chinese Materia Medica,China Academy of Chinese Medical Sciences Beijing 100700,China.
School of Pharmacy and Chemistry,Dali University Dali 671000,China.
Zhongguo Zhong Yao Za Zhi. 2019 Sep;44(17):3695-3704. doi: 10.19540/j.cnki.cjcmm.20190629.301.
Aconitums,represented by Aconite Radix,Aconiti Lateralis Radix Praeparata and Aconiti Kusnezoffh Folium,is a kind of traditional Chinese medicine with a long medicinal history in China. They possess the significant toxicity and therapeutic effects simultaneously. Their potent effects of rescuing from dying,curing rheumatism,anti-inflammation,and analgesia make Aconitums highly regarded by physicians and pharmacists of various dynasties. However,countless poisoning cases caused by an irrational use of Aconitums were reported. In case of improper application and exceeding the therapeutic window,the acute cardiotoxicity and neurotoxicity would be caused,seriously threatening health and even life of the users. Therefore,the clinical application of Aconitums is limited to some extent. To avoid its toxicity and ensure the safety of medicinal use,Aconitums is usually used in a form of its processed products instead of the crude herbs,or combined with some other traditional Chinese medicines in a normal prescription. A proper processing and compatibility method can detoxicate its severe toxicity,reduce the adverse reactions,and also significantly broaden the indications and application range of Aconitums. This provides a guarantee for the secondary exploitation and utilization of Aconitums. In this paper,the traditional processing methods of Aconitums,along with the modern advancement were reviewed,and the mechanisms of detoxification by processing and compatibility were also illuminated. The physical detoxification mode and chemical detoxification mode were found as two main detoxification ways for Aconitums. In particular,the detoxification by hydrolysis,ion-pair,and saponification were three main means. The mechanisms illustrated in this paper can be a reference to the development of modern processing method and a guidance for appropriate use of Aconitums in clinical application.
以附子、制附子和草乌叶为代表的乌头类中药是我国药用历史悠久的一类传统中药。它们同时具有显著的毒性和治疗作用。其回阳救逆、祛风除湿、抗炎、镇痛等强大功效备受历代医家和药师的重视。然而,报道了无数因不合理使用乌头类药物而导致的中毒案例。若应用不当且超出治疗窗,会引发急性心脏毒性和神经毒性,严重威胁使用者的健康甚至生命。因此,乌头类药物的临床应用在一定程度上受到限制。为避免其毒性并确保用药安全,乌头类药物通常以炮制后的形式而非生药使用,或在常规方剂中与其他一些中药配伍。恰当的炮制和配伍方法可解除其剧毒,减少不良反应,还能显著拓宽乌头类药物的适应证和应用范围。这为乌头类药物的二次开发利用提供了保障。本文综述了乌头类药物的传统炮制方法以及现代研究进展,阐明了炮制和配伍减毒的机制。发现物理解毒方式和化学解毒方式是乌头类药物的两种主要解毒途径。特别是水解、离子对和皂化是三种主要的解毒手段。本文阐述的机制可为现代炮制方法的发展提供参考,并为乌头类药物在临床应用中的合理使用提供指导。