从古今炮制方法演变探讨何首乌毒性的潜在影响因素

Investigation of potential toxic factors for fleece-flower root: from perspective of processing methods evolution

近年来,何首乌致肝损伤报道快速增长,引起了国内外的高度关注。但综观本草文献,记载何首乌毒性者寥寥。为何古代记载何首乌的毒性很少,而现在有关何首乌毒性的报道却很多?古代强调何首乌"制非九次,勿寝其毒",作为典型的生熟异治中药,何首乌临床效用的安全发挥很大程度上受制于其炮制工艺的规范性与可靠性。何首乌古代炮制强调九蒸九曝,而现代工艺已简化为仅蒸制一次,这其中的差异环节是否为何首乌肝损伤事件增多的潜在诱因?对此进行深入分析,将为其毒性研究提供新的角度与线索。为此,该文在整理历代医籍中收载的何首乌炮制方法的基础上,对比现代炮制规范及相关研究,探讨何首乌炮制减毒的影响因素与关键问题,以期为针对性建立何首乌炮制减毒工艺规范提供参考思路。

In recent years,the rapid growth of reports on fleece-flower root-caused liver damages has drawn wide attention of both at home and abroad,however,there were rare literature on toxicology of fleece-flower root in ancient Chinese medicine. But why there are so many reports on toxicology of fleece-flower root now compared with the ancient literature？ As a typical tonic medicine,the clinical utility of fleece-flower root was largely limited by its standardization and reliability of processing methods in ancient Chinese medicine.The ancient processing methods of fleece-flower root emphasized nine times of steaming and nine times of drying,while the modern processes have been simplified into one time of steaming. Whether the differences between ancient and modern processing methods are the potential cause of the increased events of fleece-flower root-caused liver damages. We will make deep analysis and provide new clues and perspectives for the research on its toxicity. This article,therefore,would discuss the affecting factors and key problems in toxicity attenuation of fleece-flower root on the basis of sorting out the processing methods of fleece-flower root in ancient medical books and modern standards,in order to provide the reference for establishing specification for toxicity attenuation of fleece-flower root.