中药肾毒性国内外研究现状

Current research situation of nephrotoxicity of Chinese herbal medicine

通过对国内外报道的所有可能导致肾毒性的中药进行系统全面的总结,为将来中药肾毒性的针对性研究提供依据。国外研究检索资源包括：Pub Med和Cochrane图书馆,国内研究检索资源为国家食品药品监督管理总局药品不良反应监测中心数据库。检索的起止日期为建库到2017年1月1日,不对纳入的研究类型进行限定。共纳入28篇英文文献,报告的具有肾毒性风险的单味中药或方剂共97种,其中6种具有肾毒性风险的中药文献量较多,分别为：马兜铃酸类中药（5篇）、雷公藤（4篇）、丁公藤（2篇）、大黄（2篇）、麻黄（2篇）、苍术（2篇）,其余的91种中药均仅有1篇文献报道其具有肾毒性风险。CDFA药品不良反应信息通报报告的肾毒性风险的中药有16种,包括感冒清片（胶囊）、珍菊降压片、雷公藤制剂、维C银翘片、穿琥宁注射剂、双黄连注射剂、清开灵注射剂、莲必治注射液、含青木香的中药汤剂、冠心苏合丸、舒肝理气丸、二十五味松石丸、含广防己的中药汤剂、含朱砂莲的中药颗粒剂、感冒通（片剂）、龙胆泻肝丸。目前,除了马兜铃酸类中药,报告最多的具有肾毒性风险的中药是雷公藤制剂。

To provide the basis for the future research on the nephrotoxicity of Chinese herbal medicine through systematic and comprehensive summary of all the Chinese herbal medicines which may lead to nephrotoxicity. Foreign resources included Pub Med and Cochrane library,and domestic research resources was China Food and Drug Administration（ CDFA） Adverse Drug Reaction Monitoring Center database. The databases were searched from establishment to January 1,2017. There was no limitation on research type. 28 English studies were found,including 97 Chinese herbs or prescriptions with the risk of nephrotoxicity. The following six Chinese herbal medicines with the risk of nephrotoxicity had a large number of studies： aristolochic acid（ 5 studies）,Tripterygium wilfordii（ 4 studies）,Erycibe obtusifolia（ 2 studies）,Rheum palmatum（ 2 studies）,Ephedra sinica（ 2 studies）,and Atractylodes lances（ 2 studies）. The remaining 91 Chinese medicines were reported with risk of nephrotoxicity in only 1 study respectively. CDFA reported 16 Chinese herbal medicines with the risk of nephrotoxicity,including Ganmaoqing Pian（ capsule）,Zhenju Jiangya Pian,T. wilfordii preparation,Vc-Yinqiao Pian,Chuanhuning injection,Shuanghuanglian injection,Qingkailing injection,Lianbizhi injection,herbal decoction containing Aristolochiae Radix,Guanxin Suhe Wan,Shugan Liqi Wan,Ershiwuwei Songshi Wan,herbal decoction containing Aristolochia Fangchi,herbal granules containing root of Kaempfer Dutchmanspipe,Ganmaotong（ tablets）,and Longdan Xiegan Wan. Currently,in addition to aristolochic acids,the most reported Chinese herbal medicine with the risk of nephrotoxicity is T. wilfordii preparation.