雷公藤的毒副作用及在肾病中的合理应用

Toxic and side effects of Tripterygium wilfordii and its reasonable application in nephropathy

雷公藤为我国传统中药,因其具有较强的抗炎、免疫抑制以及足细胞保护作用,已被广泛应用于多种原发和继发性肾脏疾病,尤其在临床治疗棘手的难治性肾病综合征领域,如:膜性肾病、局灶节段肾小球硬化症、糖尿病肾病、过敏性紫癜性肾炎和狼疮肾炎等,展现出独特优势而令人瞩目。但目前仍有不少临床医生对该药的认识存在较大偏差,或畏惧毒性避而不用、或追求疗效疏于监测,影响了该药的正确使用。因此,认识雷公藤的药理及毒副作用,掌握正确的防范措施及合理应用方法,将有助于减少药物的不良反应,充分发挥其临床疗效。

Tripterygium wilfordii Hook. F.（ Tw HF） is of traditional Chinese medicine in China.Because of its strong anti-inflammatory,immunosuppressive,and podocyte-protective effects,it has been widely used in various primary and secondary kidney diseases,especially in the clinical treatment of difficult refractory nephrotic syndrome, such as membranous nephropathy, focal segmental glomerulosclerosis,diabetic nephropathy,anaphylactoid purpura nephritis,and lupus nephritis,etc,showing remarkably unique advantages. However,there are still many clinical doctors with a large deviation in the understanding of the drug： avoiding use of it in fear of its toxicity,or pursuing efficacy without careful monitoring,which affect the correct use of the drug. Therefore,understanding Tw HF’s pharmacological and toxic effects,and grasping the correct preventive measures and reasonable application methods,will help reduce adverse drug reactions and give full play to its clinical efficacy.