摘要
"十八反"中的"海藻-甘草"组合历来备受争议,近年来众多学者对海藻-甘草组合的毒性进行了相关实验研究,文章从急性毒性、肝毒性、肾毒性、心毒性、肠道毒性、血液系统毒性和电解质变化等方面对海藻-甘草组合的毒性实验结果进行综述,并检索其他"十八反"组合毒性研究,发现"十八反"毒性研究存在多是在正常大鼠上进行、毒性研究与临床脱节、毒性研究缺乏中医药理论指导、毒性研究不全面、毒性研究内容表浅、未从"有故无殒"角度探究"十八反"毒性研究、"量-时-毒"研究不足、"十八反"的毒性研究缺乏系统性、毒性物质基础研究不足问题,提出在病理状态下进行反药组合毒性研究,在复方中进行毒性研究,在中医病或证的模型下进行毒性研究,加强毒性机制研究,拓展"十八反"反药组合毒性表征研究范围,从"有故无殒"角度同时在生理和病理状态探究"十八反"毒性研究,加深肾毒性、心毒性等毒性研究,增强"十八反"毒性研究的系统性等建议.为"十八反"的深入研究和临床合理应用提供了参考.
Abstract
The seaweed-licorice combination in the'eighteen incompatible medicaments'has always been controversial.In recent years,many scholars have carried out relevant experimental studies on the toxicity of seaweed-licorice combination.This paper reviews the toxicity test results of seaweed-licorice combination from the aspects of acute toxicity,hepatotoxicity,nephrotoxicity,cardiotoxicity,intestinal toxicity,blood system toxicity and electrolyte changes.And searching for other'eighteen incompatible medicaments'combination toxicity studies,it was found that most of the'eighteen incompatible medicaments'toxicity studies were conducted on normal rats,with toxicity studies disconnected from clinical practice,toxicity studies lacking of traditional Chinese medicine theory guidance,incomplete toxicity studies,superficial toxicity studies lacking in-depth studies,failure to explore'eighteen incompatible medicaments'toxicity studies from the perspective of'no cause,no loss',insufficient depth of toxicity studies in'dose-time-toxicity',and a lack of systematic toxicity studies on eighteen incompatible medicaments,and lacking of basic research of toxicity material.Through reflection,suggestions are proposed for conducting toxicity research on anti drug combinations in pathological states,compound formulas,conducting toxicity research under the model of traditional Chinese medicine diseases or syndromes,strengthening toxicity mechanism research,expanding the scope of toxicity characterization research on'eighteen incompatible medicaments'combinations,exploring'eighteen incompatible medicaments'toxicity research from both physiological and pathological states from a'no cause,no loss'perspective,strengthen research on the'dose-time-toxicity'of'eighteen incompatible medicaments',and enhancing the study of nephrotoxicity,cardiotoxicity and other toxicity,and to enhance the systematization of the study of'eighteen incompatible medicaments'toxicity.This study provides a reference for further research and rational clinical application of'eighteen incompatible medicaments'.
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