毒性药材天仙子的文献研究及风险探讨

Literature Review and Risk Assessment of Hyoscymi Semen

目的总结毒性药材天仙子的研究现状,探讨其临床应用的安全风险。方法查阅古今本草典籍及期刊文献,对天仙子药用历史、药理毒理研究、临床应用等方面进行归纳总结。结果中药天仙子具有悠久的药用历史,古代本草经典均有所记载。现代研究证实天仙子中所含的东莨菪碱、阿托品等生物碱是其发挥药理和毒理作用的主要成分。有诸多因误服导致中毒的文献病例报告。中毒主要表现为口干、皮肤潮红、烦躁不安,较重者则会出现心动过速、瞳孔放大、运动失调,甚至昏迷等症状。天仙子在文献中的临床应用主要为外敷治疗皮肤肿块、疼痛、感染、溃烂等。结论天仙子为药典收载的大毒药材。文献显示天仙子的安全风险主要有:易混药材较多,易误用、误服而导致中毒;民间验方将天仙子用于受损皮肤,且存在用量不准确、用法不规范、用药时间较长等问题;尚未有公认的天仙子炮制减毒的方法 ,以上因素均应引起重视。

Objective To summarize the researches of HyoscymiSemen, and explore its risks in clinical practices. Methods The literatures of Hyoscyamus niger L. seeds were collected and summarized in the aspects of herbalogy, chemical constituents, pharmacology, toxicity, processing, and so on. Results HyoscymiSemen has a long history of medicinal usage, which has been recorded in many ancient medical books. Modern studies have shown that hyoscine and atropine are the main composition mediating the pharmacological and toxic effects of Hyoscymi Semen. A lot of poisoning cases caused by accidental ingestion of high doses of HyoscymiSemen. seeds have been reported, which were expressed as dry mouth, skin reddening, restlessness, tachycardia, dilated pupils, urinary retention, constipation, and even coma. It has been reported in the literatures that Hyoscyml Semen were primarily used in the external treatment of the lumps, pain, infection, fester of skin etc. Conclusion Hyoscym Semen is documented as a hypertoxic drug in Chinese pharmacopoeia. There were many risks of HyoscymiSemen in literatures such as poisoning induced by misidentification or misuse of easily confused medicinal materials, irrational usage and dosage as well as long-time application of HyoseymiSemen in the treatment of injured skin as recorded in folk prescriptions, and furthermore, there were no acknowledged processing and poison reducing methods of HyoscymiSemen so far. The risks mentioned above should be seriously considered in the clinical application ofHyoscymiSemen.