Liu Hui, Wang Si-Yu, Zhu Jin-Hao, Kong Ming, Zhou Shan-Shan, Li Song-Lin, Zhu He
Department of Pharmaceutical Analysis, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China.
Department of Pharmaceutical Analysis, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China; Department of Metabolomics, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, China.
J Ethnopharmacol. 2022 Jul 15;293:115250. doi: 10.1016/j.jep.2022.115250. Epub 2022 Mar 31.
Sulfur-fumigation undoubtedly alters the chemical and metabolic profiles, but controversially affects the efficacy and safety of medicinal herbs.
To comprehensively evaluate the effects of sulfur-fumigation on the efficacy and safety of medicinal herbs using a meta-analysis approach and further investigate the potential contributory factors.
Literatures were retrieved on PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Chinese VIP Information and Wanfang, and the outcomes involved activities and toxicities were extracted using standard data extraction forms. The effects of sulfur-fumigation on the efficacy and safety of medicinal herbs were evaluated by meta-analysis approaches.
A total of sixteen studies were included in this study. Sulfur-fumigation reduced the efficacies of medicinal herbs with immune activity [thymus index (SMD = -1.81; P < 0.00001); spleen index (SMD = -1.11; P < 0.0001)], anti-oxidative activity [MDA (SMD = 2.60; P = 0.04); SOD (SMD = -2.21; P < 0.00001)], analgesic activity [heat tolerate time (SMD = -2.51; P = 0.001); writhing time (SMD = 0.36; P = 0.006)], anti-platelet aggregation activity (SMD = -1.84; P = 0.001), and anti-inflammatory activity [ear swelling degree (SMD = 0.47; P = 0.006)]. The reductions might be ascribed to sulfur-fumigation significantly reduced the contents of active ingredients in medicinal herbs, leading to dramatic decrease in the absorption of these ingredients and their metabolites in vivo. Furthermore, sulfur-fumigation induced the toxicities of medicinal herbs, mainly on hepatotoxicity, which might due to fumigation-induced residues of sulfur dioxide and heavy metal, and generations of sulfur-containing derivatives and toxic metabolites. Besides, administrated with sulfur-fumigated medicinal herbs with high sulfur ratio and/or higher dosage showed more significant toxicity.
Sulfur-fumigation reduced the efficacy and safety of medicinal herbs, indicating sulfur-fumigation might not a feasible approach to process medicinal herbs. However, with obvious limitations, much more rigorous designed-trials are still needed to confirm the conclusion.
硫熏无疑会改变中药材的化学和代谢轮廓，但对中药材的功效和安全性的影响存在争议。
采用荟萃分析方法全面评估硫熏对中药材功效和安全性的影响，并进一步探究潜在的影响因素。
通过检索PubMed、Web of Science、Embase、中国知网、维普资讯和万方数据库获取文献，并使用标准数据提取表提取涉及活性和毒性的结果。采用荟萃分析方法评估硫熏对中药材功效和安全性的影响。
本研究共纳入16项研究。硫熏降低了具有免疫活性的中药材的功效[胸腺指数（标准化均数差SMD = -1.81；P < 0.00001）；脾脏指数（SMD = -1.11；P < 0.0001）]、抗氧化活性[丙二醛（MDA，SMD = 2.60；P = 0.04）；超氧化物歧化酶（SOD，SMD = -2.21；P < 0.00001）]、镇痛活性[热耐受时间（SMD = -2.51；P = 0.001）；扭体时间（SMD = 0.36；P = 0.006）]、抗血小板聚集活性（SMD = -1.84；P = 0.001）和抗炎活性[耳肿胀度（SMD = 0.47；P = 0.006）]。这些降低可能归因于硫熏显著降低了中药材中活性成分的含量，导致这些成分及其代谢产物在体内的吸收大幅减少。此外，硫熏会引发中药材的毒性，主要是肝毒性，这可能是由于熏制过程中产生的二氧化硫和重金属残留，以及含硫衍生物和有毒代谢产物的生成。此外，服用硫含量高和/或剂量较大的硫熏中药材显示出更明显的毒性。
硫熏降低了中药材的功效和安全性，表明硫熏可能不是一种可行的中药材加工方法。然而，由于存在明显局限性，仍需要设计更严谨的试验来证实这一结论。
