重构现代本草——雷公藤

Reconstruction of Chinese materia medica——Tripterygium wilfordii

通过古籍文献调研、中药现代研究进展及其研究成果梳理,结合中医临床及中药学等学科领域内专家学者的认识及应用经验,经讨论认为雷公藤:功效主要为祛风除湿、活血通络、消肿痛、杀虫解毒;病靶为类风湿性关节炎;症靶为疮疹顽癣;标靶为尿蛋白、甲状抗体阳性和胰岛自身抗体阳性;现代药理发现,雷公藤及其有效成分具有调节免疫、抗炎、抗肿瘤、抑制肝纤维化和调控脂质代谢;雷公藤大毒,凡有心、肝、肾器质性病变,白细胞减少者、有生育需求者慎服;孕妇禁服;临床使用剂量为1~50 g,常用剂量为10~15 g,建议从小剂量开始,使用时间不超过1个月。临床使用时需定期监测肝肾功能,根据疾病及患者情况寻求最佳用量,并通过配伍以增效减毒。

Based on the investigation of ancient books and literature, the progress and achievements of modern research on traditional Chinese medicine, and the understanding and application experience of experts and scholars in the field of clinical Chinese medicine and Chinese materia medica, it is believed that Tripterygium wilfordii has the following characteristics: Its effects are mainly expelling wind and removing dampness, promoting blood circulation and dredging collaterals, relieving swellings and pains, killing insects and detoxifying. Its disease target is rheumatoid arthritis, and its symptom targets are sores and stubborn tinea, while its biochemical indicator targets are urine protein, positive thyroid antibody and positive islet autoantibody.According to modern pharmacology, Tripterygium wilfordii and its active ingredients have the functions of regulating immunity,anti-inflammation, anti-tumor, inhibiting liver fibrosis and regulating the lipid metabolism. Highly toxic, it should be taken with caution for those with organic diseases of heart, liver and kidney, leukopenia and fertility needs, while pregnant women are banned to take it. Its clinical dosage range is 1-50 g, and its usual dosage range is 10-15 g, starting from a small dose and administering it for no more than one month. During its clinical use, it is necessary to regularly monitor the liver and kidney functions, to work out its optimal dosage according to a specific disease and patients’ conditions, and to enhance its efficacy and reduce its toxicity through its combination with other herbs.