乌头类中药的风险-效益评估

Risk-benefit assessment of aconitum napellus

效益与风险是药品的固有属性,风险-效益评价结果是衡量临床合理用药水平的重要指标,但目前中药尚无相关评价模型与实例研究。立旨于此,文章剖析了古今毒-效、风险-效益内涵,并以毒性中药乌头为示例,综合数据挖掘、多准则决策分析等方法建立中药风险-效益关系评价模式。结果显示,乌头类中药在多种病症的治疗中风险-效益关系具有一定优势,如类风湿性关节炎、强直性脊柱炎等。但由于中药应用复杂,评估结果受品种、辨证、炮制、用量、配伍、患者体质等多方面因素影响,同时也受现有研究基础的局限。文章从多途径、多层面、多角度呈现了乌头类中药临床应用的风险与效益,为临床深入评估中药用药风险与实例探索提供了参考,推动了合理用药进程。

The benefits and risks are both inherent properties of drugs, and risk-benefit evaluation result is an important index to measure the level of rational drug use. However, there is no relevant evaluation model and case studies for traditional Chinese medicine. Aiming at that, the connotation of toxicity-effect and risk-benefit were analyzed in this article. Taking the toxic Chinese medicine aconite as an example, the evaluating model was built by comprehensively applying the methods of data-mining, multi-criteria decision analysis and others. The results showed that there were certain advantages in risk-benefit relationship while aconitum napellus in the treatment of many diseases, such as rheumatoid arthritis, ankylosing spondylitis, and so on. However, the applications of traditional Chinese medicine were complicated, and their evaluation results were influenced by various factors such as breed, syndrome differentiation, processing, dosage, combination, patient habitus, and they were also subject to the limitations of existing research. In this paper, the risk and benefit of clinical application of aconitum napellus were presented from multimethod, multi-level and multi-angle, which could provide a reference for clinical in-depth evaluation of the risk and case studies of traditional Chinese medicine and promote the rational drug use process.