含马兜铃酸中药的研究进展

Research progress of traditional Chinese medicine containing aristolochicacid

马兜铃酸(Aristolochic acids,AAs)及其衍生物为硝基菲类化合物,广泛存在于马兜铃科马兜铃属Aristolochia及细辛属Asarum等植物中。近年来各国多个地区都陆续报道马兜铃科植物药导致肾病的案例,称为"马兜铃酸肾病",引发大量关注,本文就此展开对含AAs中药的研究。目的:为了消除一些人对含AAs中药产生的误区和偏见,并对含AAs的中药有一个正确、理性的认知,辨证地认识其毒性,促进传统中药的开发利用,让中国传统中医药事业得到更广泛的认同。方法及内容:通过对国内外关于含AAs中药的研究成果进行检索,结合已有资料和相关文献,分析含AAs中药在药用方面存在的问题,综述了含AAs中药的毒性研究、临床应用、药理作用、减毒研究的研究进展。结果:含AAs的中药具有肾毒性,其产生肾毒性的机制多而复杂,导致其肾毒性的原因也有主观和客观情况;含马兜铃酸中药虽然存在毒性,但其临床疗效不可忽视;通过科学的方法如炮制、配伍等传统手段以及现代科学技术可以对其毒性进行控制,从而发挥其临床疗效。

Objective:Aristolochic acids(AAs)and their derivatives are nitrophenanthrene compounds,which are widely present in plants such as Aristolochia and Asarum in the family Aristolochia.In recent years,cases of nephropathy caused by aristolochiaceae medicines have been successively reported in many regions in various countries,which are called"aristolochic acid nephropathy",which has attracted a lot of attention.In this paper,the research on traditional Chinese medicine containing AAs is carried out to eliminate the misunderstanding and prejudice on traditional Chinese medicine containing AAs,to have a correct and rational understanding of traditional Chinese medicine containing AAs,to dialectically recognize their toxicity,to promote the development and utilization of traditional Chinese medicine and to promote the wider recognition of traditional Chinese medicine business in China.Method:By searching the research of traditional Chinese medicines containing AAs at home and abroad,combining existing data and related literatures,the medicinal problems of Chinese medicines containing AAs was analyzed.The research progress of toxicity research,clinical application,pharmacological action and toxicity reduction of traditional Chinese medicines containing AAs were summarized.Result:Traditional Chinese medicine containing AAs has nephrotoxicity,and its mechanisms of nephrotoxicity are numerous and complicated.The causes of its nephrotoxicity are subjective and objective.Although traditional Chinese medicine containing AAs is toxic,its clinical efficacy cannot be ignored.Through scientific methods such as traditional processing and compatibility,as well as modern science and technology,its toxicity can be controlled so as to give full play to its clinical efficacy.