《上海市中药饮片炮制规范》2018年版毒性饮片分析

Analysis on Toxic TCM Decoction Pieces in Processing Standard of TCM Decoction Pieces in Shanghai(2018 Edition)

目的为临床应用《上海市中药饮片炮制规范》2018年版收载的毒性饮片提供参考。方法对《上海市中药饮片炮制规范》2018年版收载中药饮片的“性味与归经”“用法与用量”“注意”项下内容进行归纳,总结毒性中药饮片品种与毒性分级及临床注意事项。结果《上海市中药饮片炮制规范》2018年版共收载中药饮片973种(包括8种正文品种项下的备注品种及49种非常用品种),共收载毒性中药120种(包括8种正文品种项下的备注品种),其中大毒17种、有毒62种、小毒41种。对毒性中药的使用有限制性规定,其中孕妇禁用34种,婴幼儿、儿童禁用2种,孕妇忌服16种,小儿忌服1种,孕妇慎用17种,运动员慎用2种,只可外用、不可内服2种,内服宜慎12种,不宜内服2种,不宜生用1种,入丸散用13种。结论《上海市中药饮片炮制规范》2018年版收载的中药饮片中,含有毒性和注意项的饮片仅占小部分,但应引起重视,使用时应严格遵照《上海市中药饮片炮制规范》2018年版标准执行。

Objective To provide reference for clinical use of toxic TCM decoction pieces contained in Processing Standard of TCM Decoction Pieces in Shanghai(2018 Edition).Methods“Property,tastes and meridian”,“usage and dosage”,and“notice”of toxic TCM decoction pieces contained in Processing Standard of TCM Decoction Pieces in Shanghai(2018 Edition)were concluded.Species and toxicity classification and precautions for clinical usage of toxic TCM decoction pieces were summarized.Results Processing Standard of TCM Decoction Pieces in Shanghai(2018 Edition)contained 973 TCM decoction pieces(including 8 kinds of note varieties under the main text variety and 49 kinds of unusual varieties),120 toxic TCM decotion pieces(including 8 kinds of note varieties under the main text variety),in which,17 had great toxicity,62 had general toxicity and 41 had small toxicity.There were restrictive provisions for the use of toxic TCM decoction pieces,in which,34 were forbidden for pregnant women and 2 were forbidden for children,16 should be contraindicated for pregnant women and 1 should be contraindicated for children,17 should be avoided for pregnant women and 2 should be avoided for athletes,2 cannot be taken orally,12 should be avoided when taken orally,2 were inappropriate for being taken orally,1 was inappropriate for using with crude drugs,13 were used by pills.Conclusion Among the TCM decoction pieces contained in Processing Standard of TCM Decoction Pieces in Shanghai(2018 Edition),the decoction pieces that contain toxicity and cautions only account for a small part,but they should be paid attention to,and Processing Standard of TCM Decoction Pieces in Shanghai(2018 Edition)should be followed strictly when using them.