雷公藤减毒研究进展

Attenuation Effect of Tripterygii Radix et Rhizoma

雷公藤为治疗类风湿性关节炎常用中药,具有清热解毒,祛风除湿,消肿止痛,杀虫止痒的功用,现代药理研究表明其具有抗炎、镇痛、抗肿瘤及免疫调节等作用,临床主要用于治疗免疫性疾病、肾脏性疾病、皮肤性疾病等,对类风湿性关节炎的疗效尤为显著。但严重的毒副作用,尤其是肝肾毒性,限制了其临床应用,成为迫切需要解决的难题,故雷公藤的减毒研究成为近年来的研究热点。本课题组主要研究雷公藤的经皮给药对其减毒增效的作用,但目前雷公藤的应用困境仍然没有得到改善,故对2006年至2016年近10年来雷公藤减毒研究的相关文献进行检索,包括传统的炮制减毒、配伍减毒和现代的制剂减毒、结构修饰减毒、生物技术减毒以及其相互的联合应用等,分析雷公藤的减毒现状和困境,对比现存减毒方式间的差异,为雷公藤减毒增效研究提供思路,促进其合理开发和临床安全应用,也为其他有毒中药的合理应用提供参考。

Tripterygii Radix et Rhizoma is a kind of commonly used traditional Chinese medicine （TCM） in treating rheumatoid arthritis, with multiple pharmacological effects, including heat-clearing and detoxifying, eliminating wind and dampness, detumescence and analgesia, parasite destroy and itching relieving. According the development of modern pharmacological research, it shows anti-inflammatory, analgesic, anti-tumor and immune regulatory effects, and has been clinically applied to treat immune diseases, renal disease and dermatosis disease, particularly for rheumatoid arthritis. However, due to its multi-organ toxicity, especially hepatotoxicity and nephrotoxicity, it has been restricted from being widely used in clinic, which has become a hot research topic in recent years. Our research group focused on the attenuation and synergy effect of Tripterygii Radix et Rhizoma through transdermal drug delivery, in order to promote application of Tripterygii Radix et Rhizoma. This paper collects and analyzes relevant literatures from 2006 to 2016, including traditional processing for attenuation, combined administration for attenuation, modern preparations for attenuation, structural modification for attenuation, biological technology for attenuation and their combined applications. By analysis of the current conditions and difficulties in developing the attenuation and synergy of Tripterygii Radix et Rhizoma and comparing the differences with the existing attenuation modes, this study provides ideas for further studies on attenuation and synergy of Tripterygii Radix et Rhizoma, promote the rational development and safe clinical application, and offers a reference for the rational application of other toxic TCMs.