Wu Ziyang, Qian Jiawen, Feng Chenhang, Chen Zhouqi, Gao Xiangfu, Liu Yang, Gao Yuancheng
Department of Nephrology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.
The Third Affiliated Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Front Pharmacol. 2024 Jul 3;15:1427333. doi: 10.3389/fphar.2024.1427333. eCollection 2024.
Aconiti Lateralis Radix Praeparata, commonly known as Fuzi in. traditional Chinese medicine (TCM), is widely utilized in clinical practice despite its inherent toxicity. Since ancient times, TCM practitioners have explored various processing techniques to broaden its clinical applications and enhance its safety profile. This review aims to summarize the effects of processing on the chemical composition, toxicity, and pharmacological properties of Fuzi, as well as investigate potential underlying mechanisms.
Data on phytochemistry, toxicology, pharmacology, and processing methods of Fuzi were gathered from the literature of electronic databases, including Web of Science, PubMed, and CNKI.
Fuzi contains over 100 kinds of chemical compounds, including alkaloids, flavonoids, and polysaccharides, among which alkaloids are the main active compounds. Diester-diterpenoid alkaloids are the main contributors to Fuzi's toxicity and have side effects on some organs, such as the heart, liver, kidneys, nervous system, and reproductive system. The chemical composition of aconite, particularly its alkaloid content, was changed by hydrolysis or substitution reaction during processing to enhance its efficacy and reduce its toxicity. Salted aconite could enhance the therapeutic efficacy of Fuzi in treating kidney diseases and influence its pharmacokinetics.
Processing plays an important role in increasing the efficiency and decreasing toxicity of aconite. Further studies are needed to elucidate the changes of aconite before and after processing and the underlying mechanisms of these changes, thereby providing evidence for the clinical safety of drug use.
附子在传统中医中俗称“附片”，尽管其具有内在毒性，但在临床实践中仍被广泛应用。自古以来，中医从业者探索了各种炮制方法，以拓宽其临床应用范围并提高其安全性。本综述旨在总结炮制对附子化学成分、毒性和药理特性的影响，并研究潜在的作用机制。
从电子数据库（包括Web of Science、PubMed和CNKI）的文献中收集附子的植物化学、毒理学、药理学和炮制方法的数据。
附子含有100多种化合物，包括生物碱、黄酮类化合物和多糖，其中生物碱是主要的活性成分。双酯型二萜生物碱是附子毒性的主要来源，对心脏、肝脏、肾脏、神经系统和生殖系统等一些器官有副作用。附子在炮制过程中通过水解或取代反应改变了其化学成分，特别是生物碱含量，以提高其疗效并降低其毒性。盐附子可提高附子治疗肾脏疾病的疗效并影响其药代动力学。
炮制在提高附子药效和降低毒性方面发挥着重要作用。需要进一步研究阐明附子炮制前后的变化及其潜在机制，从而为临床用药安全提供依据。
