含吡咯里西啶类生物碱的中药安全性考虑

Safety considerations of traditional Chinese medicine containing pyrrolizidine alkaloids

吡咯里西啶生物碱(PAs)是除马兜铃酸以外,最重要的中药毒性成分之一,有较强的肝毒性,大量暴露后可引起肝窦综合征(HSOS),中毒后早期临床表现无特异性,多数患者未能及时就诊,预后不佳。目前有一定数量的中药含该类成分,这些中药无论是对毒性成分的含量限定方面,还是说明书安全性警示方面都接近空白,存在较大的临床用药安全性隐患,本文将结合肝毒性吡咯里西啶生物碱(HPAs)所致肝损伤特点和含HPAs的中药存在的安全性问题,提出相关建议,亟待含该类成分的中药安全性问题引起各方重视。

Pyrloricidine alkaloid(PAs) is one of the most important toxic components of traditional Chinese medicine except aristolochic acid. It has strong hepatotoxicity and can cause hepatic sinus syndrome(HSOS) after a large amount of exposure. The early clinical manifestations after poisoning are not specific, and most patients fail to seek medical treatment in time, with poor prognosis. There are a certain number of traditional Chinese medicine containing the composition, these traditional Chinese medicine is neither to limit the content of toxic components, nor for manual safety warning, there is a big clinical medication safety hidden danger. Based on the characteristics of hepatotoxicity pyrrolizidine alkaloids(HPAs) induced liver injury and the safety problems of HPAs containing traditional Chinese medicine, relevant suggestions are proposed in this paper, hoping that the safety problems of traditional Chinese medicine containing HPAs will attract attention from all sides.