常用曲类中药研究进展

Research Progress on Commonly-Used Fermented Chinese Medicinals

曲类中药临床应用广泛,具有健脾消食、促进胃肠道蠕动的功效。临床常用的曲类中药有六神曲、半夏曲、建神曲、沉香曲、红曲等。六神曲健脾和胃、消食调中,具有促进胃肠道蠕动、调节肠道菌群、保护肠道以及止泻的作用;建神曲在健脾、消食和中的基础上,又有解表化湿之效;半夏曲擅降逆止呕、化痰止咳,具有抗菌、抗氧化、抗肿瘤等作用;沉香曲更倾向于理气、行气化滞、疏肝和胃等,有保护肝脏、缓解炎症反应、抑制结核分枝杆菌的作用;红曲在活血化瘀、化浊降脂等方面效果更佳,具有降血脂、降血糖、降血压、抗感染、预防和治疗骨质疏松等作用,并具有良好的抗肿瘤活性。目前,对于曲类中药的研究存在以下不足:(1)各类曲剂的具体有效成分不明确;(2)曲类中药的作用机制及代谢机理研究尚少;(3)曲类中药的安全性评价、安全剂量范围及不良反应报道较少;(4)发酵过程中是否产生新的毒性成分、制备工艺的优化及质量评价缺乏统一标准。目前,我国仍采用传统固态发酵制曲法,过程较为繁琐,容易受到其他杂菌的干预,且各地曲剂配方不统一,药效存在差别。今后,应加大对曲类中药的安全剂量范围、体内代谢过程、剂量疗效是否成正比等相关问题的研究,在临床中灵活运用曲类中药。

Fermented Chinese medicinals are widely used in clinical practice,and have the effects of invigorating spleen and helping digestion,and promoting gastrointestinal peristalsis.The commonly-used ones mainly include Miraculous Fermented Medicine of Six Ingredients,Fermented Pinellia,Spirit-Strengthening Fermented Medicine of Various Ingredients,Fermented Chinese Eaglewood Wood Fermented Medicine,Fermented Red Rice,etc.Miraculous Fermented Medicine of Six Ingredients can strengthen the spleen and harmonize the stomach,help digestion,promote gastrointestinal peristalsis,regulate intestinal flora,protect intestinal tract and stop diarrhea.Spirit-Strengthening Fermented Medicine of Various Ingredients can relieve exterior and resolve dampness on the basis of invigorating the spleen and digesting food.Fermented Pinellia is good at lowering counter-flow of qi,stopping vomiting,resolving phlegm and relieving cough,and has anti-bacterial,anti-oxidant and anti-tumor effects.Fermented Chinese Eaglewood Wood Fermented Medicine is more inclined to regulate qi,promote qi stagnation,soothe liver and stomach,which can protect liver,alleviate inflammatory reactions and inhibit mycobacterium tuberculosis.Fermented Red Rice has a better effect in promoting blood circulation,removing blood stasis,resolving turbidity and reducing blood fat.It has the functions of lowering blood fat,blood sugar,blood pressure,anti-infection,prevention and treatment of osteoporosis,and good anti-tumor activity.At present,there are some deficiencies in the research of fermented Chinese medicinals:(1)The specific effective components of various kinds of fermented medicine starter are not clear;(2)There are few studies on the mechanism and metabolism of fermented Chinese medicinals;(3)There are few related reports on safety evaluation,safe dosage range and adverse reactions;(4)Whether new toxic components,optimization of preparation process and quality evaluation are produced in fermentation process are lack of unified standards.At present,traditional solid-state fermentation is still used in making fermented medicine in China,which has complicated process and is easy to be interfered by other miscellaneous bacteria.In addition,the formulas of fermented medicine in different places are not uniform,and the efficacy is different.In the future,it is necessary to increase the research on the safety dosage range,metabolism process in vivo and whether the dosage is proportional to the curative effect,so as to flexibly use fermented Chinese medicinals in clinical practice.