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[“有毒”中药多证据整合评价与预测方法的建立]

[Establishment of multiple evidence-integrated evaluation and prediction method for "toxic" Chinese medicines].

作者信息

Cui He-Rong, Zhang Xiao-Yu, You Liang-Zhen, Zheng Rui, Chen Zhao, Jiang Yin, Zhang Jing-Jing, Shang Hong-Cai

机构信息

Dongzhimen Hospital, Beijing University of Chinese Medicine Beijing 100700, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2022 Apr;47(8):2266-2272. doi: 10.19540/j.cnki.cjcmm.20211129.601.

Abstract

Traditional Chinese medicine(TCM) carries the experience and theoretical knowledge of the ancients, and the use of "toxic" Chinese medicines is a major feature and advantage of TCM. "Toxic" Chinese medicines have unique clinical value and certain medication risk under the guidance of TCM theories such as compatibility for detoxification and treatment based on syndrome differentiation. In recent years, the safety events of Chinese medicines have occurred frequently, which has made the safety of Chinese medicine a public concern in China and abroad. However, limited by conventional cognitive laws and technical methods, basic research on toxicity of Chinese medicines fails to be combined with the clinical application. As a result, it is difficult to identify the clinical characteristics of, predict toxic and side effects of, or form a universal precise medication regimen for "toxic" Chinese medicines, which restricts the clinical application of them. In view of the problem that the toxicity of "toxic" Chinese medicines is difficult to be predicted and restricts the clinical application, the evidence-based research concept will provide new ideas for safe applcation of them in clinical practice. The integrated development of multiple disciplines and techniques in the field of big data and artificial intelligence will also promote the renewal and development of the research models for "toxic" Chinese medicines. Our team tried to propose the academic concept of evidence-based Chinese medicine toxicology and establish the data-intelligence research mode for "toxic" Chinese medicines and the intelligent risk prediction method for medicinal combination in the early stage, which provided methodological supports for solving the above problem. Thus, on the basis of summarizing the research status and problems of the clinical medication regimen of "toxic" Chinese medicines, our team took the evidence-based toxicology of TCM as the core concept, and tried to construct the multiple-evidence integrated evaluation and prediction method for "toxic" Chinese medicine, so as to guide the establishment of the non-toxic medication regimen of "toxic" Chinese medicines. Specifically, through the analysis of multivariate data obtained from the basic research, the evidence-based toxicology database of Chinese medicines and the individualized "toxicity-effect" intelligent prediction platform were built based on the disease-syndrome virtual patients, so as to identify the clinical characteristics and risks of "toxic" Chinese medicines and develop individualized medication regime. This study is expected to provide a methodological reference for the establishment of medication regimen and risk prevention strategy for "toxic" Chinese medicines. The method established in this study will bridge clinical research and basic research, enhance the transformation of the scientific connotation of attenuated compatibility, promote the development of evidence-based Chinese medicine toxicology, and ensure the clinical safety of "toxic" Chinese medicines.

摘要

中医药承载着古人的经验和理论知识,使用“有毒”中药是中医药的一大特色和优势。在中医的解毒配伍、辨证论治等理论指导下,“有毒”中药具有独特的临床价值,但也存在一定的用药风险。近年来,中药安全事件频发,中药安全性成为国内外公众关注的问题。然而,受传统认知规律和技术方法的限制,中药毒性的基础研究未能与临床应用相结合。因此,难以明确“有毒”中药的临床特点、预测其毒副作用,也难以形成通用的精准用药方案,这限制了其临床应用。针对“有毒”中药毒性难以预测且限制临床应用的问题,循证研究理念为其临床安全应用提供了新思路。大数据和人工智能领域多学科、多技术的融合发展,也将推动“有毒”中药研究模式的更新与发展。我们团队前期尝试提出循证中药毒理学的学术概念,建立“有毒”中药的数据智能研究模式和药物配伍智能风险预测方法,为解决上述问题提供了方法学支撑。因此,在总结“有毒”中药临床用药方案研究现状与问题的基础上,我们团队以中医循证毒理学为核心理念,尝试构建“有毒”中药多证据综合评价与预测方法,以指导“有毒”中药无毒用药方案的建立。具体而言,通过分析基础研究获取的多源数据,基于病-证虚拟患者构建中药循证毒理学数据库和个体化“毒性-效应”智能预测平台,以明确“有毒”中药的临床特点和风险,制定个体化用药方案。本研究有望为“有毒”中药用药方案的制定和风险防控策略提供方法学参考。本研究建立的方法将架起临床研究与基础研究之间的桥梁,增强减毒配伍科学内涵的转化,推动循证中药毒理学的发展,保障“有毒”中药的临床安全。

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