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重构本草——水蛭

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通过古籍文献调研、中医药现代研究成果的梳理,结合中医临床及中药学等学科领域内知名专家学者的认识及应用经验,归纳出水蛭:功效主要为破血通经,逐瘀消癥.症靶为闭经或月经量少或月经血块多,心腹疼痛,肢体感觉异常,跌扑损伤之肿胀、疼痛、出血.标靶为腹内结块、肿瘤,恢复期脑卒中,肾纤维化,肝纤维化改变.现代药理研究发现,水蛭及其有效成分具有抗凝、抗血栓、抗肿瘤、抗炎、抗纤维化、降血脂、保护血管内皮细胞、抗神经损伤等作用.水蛭煎剂可引发胃肠道反应及过敏反应,孕妇及月经过多者禁用.高温破坏水蛭素,临床使用应注意冲服法或用量.临床使用水蛭煎服剂量多为 1~9 g,打粉吞服剂量为 0.3~10 g,内服时当根据不同疾病,或同一疾病的不同阶段进行辨证使用,并积极探索水蛭用量与症靶、标靶的量效关系构建.
Reconstruction of Chinese materia medica-leech
Through the investigation of ancient books and the sorting of the modern research achievements of traditional Chinese medicine,combined with the understanding and application experience of well-known experts and scholars in desciplinary fields such as traditional Chinese medicine clinical medicine and science of Chinese materia medica,it is concluded that leeches mainly have the effects of breaking blood and unblocking meridians,and eliminating blood stasis and eliminating symptoms.The symptom targets are amenorrhea,low menstrual volume,or excessive menstrual blood clots,abdominal pain,abnormal sensation of limbs,and swelling,pain,bleeding caused by falls.The biochemical indicator targets are abdominal masses,tumors,convalescent stroke,renal fibrosis,and liver fibrosis changes.Modern pharmacological studies have found that leech and its active ingredients have the effects of anti-coagulant,antithrombosis,anti-tumor,anti-inflammatory,anti-fibrosis,reducing blood lipid,protecting vascular endothelial cells,and anti nerve injury.Leech decoction can cause gastrointestinal and allergic reactions,and is contraindicated for pregnant women and those with excessive menstruation.Leech is destroyed by high temperature.In clinical use,attention should be paid to the use of being administered after dissolved or dosage.In clinical use,the decoction dosage of leech is usually 1-9g,and the ingestion dosage of powdered leech is 0.3-10g.When taken orally,it should be used dialectically according to different diseases or different stages of the same disease,and the construction of dose-effect relationship between the dosage of leech and the symptom target and biomeidical indicator target should be explored actively.

leechsymptom targetbiochemical indicator targetreconstruction of materia medicaclinical verification

沈梦菲、黄晓巍、张伟、赵林华

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北京中医药大学,北京 100029

长春中医药大学药学院,长春 130117

西安市中医医院脑病医院,西安 710021

中国中医科学院广安门医院代谢病研究所,北京 100053

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水蛭 症靶 标靶 重构本草 临床回归

中国科学院学部咨询评议项目国家自然科学基金面上项目中国工程科技发展战略海南研究院咨询研究项目中国中医科学院科技创新工程北京中医药大学壶天客座教授科研启动经费资助

2021-ZW10-A-0178197383722-HN-ZD-03CI2021A016052023-XJ-KYQD-006

2024

长春中医药大学学报
长春中医药大学

长春中医药大学学报

CSTPCD
影响因子:0.916
ISSN:1007-4813
年,卷(期):2024.40(2)
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