近几年中药附子的文献研究

附子作为有毒中药常用于多种疾病的治疗,由于广泛的临床应用和潜在的毒性受到青睐,其中,附子化学成分和药理作用等研究取得了许多实验成果。本文通过检索中国知网、万方、维普等数据库,分析梳理大量文献,对附子结构及药理进行探讨分析,旨在扩大附子使用范围和提高使用频率,为附子实验研究和应用研究提供参考和借鉴。     

至阳八阵穴隔附子饼灸治疗糖尿病胃轻瘫临床研究

目的观察至阳八阵穴隔附子饼灸治疗脾胃气虚型糖尿病胃轻瘫的疗效及对胃泌素(GAS)、胃动素(MTL)和血管活性肠肽(VIP)水平的影响。方法86例脾胃气虚型糖尿病胃轻瘫患者随机分为对照组和治疗组,每组43例。治疗组给予至阳八阵穴隔附子饼灸;对照组口服枸橼酸莫沙必利片。治疗12周后观察胃轻瘫主要症状指数量表症状积分改善情况、胃排空率及血清GAS、MTL、VIP水平。结果治疗组治疗后在胃轻瘫主要症状指数量表症状积分及胃排空率方面明显高于对照组,差异均有统计学意义(P<0.05)。治疗组治疗后血清GAS、MTL水平明显高于对照组,血清VIP水平明显低于对照组,差异均有统计学意义(P<0.05)。治疗组总有效率为90.7%,明显高于对照组的72.1%(P<0.05)。结论采用至阳八阵穴隔附子饼灸能快速促进糖尿病胃轻瘫患者胃功能的恢复,改善症状和体征,其作用机制可能与升高患者血清GAS和MTL水平,降低VIP水平有关。     

Aconitum in Traditional Chinese Medicine-A valuable drug or an unpredictable risk?

Aconitum species have been used in China as an essential drug in Traditional Chinese Medicine (TCM) for 2000 years. Reviewing the clinical application of Aconitum, their pharmacological effects, toxicity and detoxifying measures, herb–herb interactions, clinical taboos, famous herbal formulas, traditional and current herbal processing methods based upon a wide range of literature investigations serve as a case study to explore the multidisciplinary implications of botanicals used in TCM. The toxicological risk of improper usage of Aconitum remains very high, especially in countries like China, India and Japan. The toxicity of Aconitum mainly derives from the diester diterpene alkaloids (DDAs) including aconitine (AC), mesaconitine (MA) and hypaconitine (HA). They can be decomposed into less or non-toxic derivatives through Chinese traditional processing methods (Paozhi), which play an essential role in detoxification. Using Paozhi, the three main forms of processed aconite – Yanfuzi, Heishunpian and Baifupian – can be obtained (CPCommission, 2005). Moreover, some new processing techniques have been developed in China such as pressure-steaming. The current development of fingerprint assays, in particular HPLC, has set a good basis to conduct an appropriate quality control for TCM crude herbs and their ready-made products. Therefore, a stipulation for a maximum level of DDA content of Aconitum is highly desirable in order to guarantee the clinical safety and its low toxicity in decoctions. Newly developed HPLC methods have made the accurate and simultaneous determination and quantification of DDA content interesting.     

Clinical application of Aconitum carmichaelii Debx. (Fu Zi in Chinese) by traditional Chinese medicine physicians--A cross-sectional questionnaire survey in Beijing

ObjectiveTo investigate clinical application of aconite root (Aconitum carmichaelii Debx.; hereinafter “aconite”) by traditional Chinese medicine (TCM) physicians in TCM hospitals in Beijing and explore the specific use of aconite and the effect of different doses on decoction time.MethodsThis was a cross-sectional study using two-stage sampling. Questionnaires were administered among TCM physicians from TCM hospitals in Beijing between September 2020 and August 2021. The questionnaire mainly included general demographics, clinical backgrounds of TCM physicians, and clinical application of aconite. The data analyses were performed using SPSS 20.0.ResultsA total of 387 questionnaires were collected, of which 385 were valid. Of the 385 participating TCM physicians, 331 (85.97%) used aconite in clinical practice. The top three medical diagnoses treated with aconite were heart failure, diarrhea without cause, and chronic gastritis. The TCM pattern treated most frequently with a high dose of aconite was spleen-kidney yang deficiency, and the TCM pattern treated most frequently with a low dose was spleen yang deficiency, while spleen-kidney yang deficiency was treated most frequently with a common dose of aconite. The top three common formulas were Sini decoction, Mahuang Xixin Fuzi decoction, and Zhenwu decoction. Hei Shun Pian was the most common herbal pieces of aconite. The highest frequency of the maximum dose of aconite was 15 g, that of the minimum dose was 3 g, and that of the common dose was 10 g. There was a certain correlation between decoction time and the dose of aconite. Most TCM physicians advised their patients to take medicine twice a day.ConclusionIn this study, we refined and quantified the use of aconite and enriched the exploration of the clinical application of aconite besides its provisions in the Pharmacopoeia of the People's Republic of China.     

附子汤对类风湿性关节炎大鼠抗炎及关节影响研究

目的 探讨附子汤对类风湿性关节炎大鼠抗炎及关节的影响。方法 本研究将32只SD大鼠随机分成4组:对照组、CIA组、地塞米松组、附子汤组。其中3组通过尾根部皮下注射混合乳剂诱导形成类风湿性关节炎(CIA)模型。附子汤组给予7 m L/kg附子汤,地塞米松组给予0.025 mg/kg地塞米松。对照组和CIA组大鼠给予等剂量生理盐水。监测指标:大鼠体重、右后足厚度和关节炎指数、器官指数(心、肝、脾、肺、肾和胸腺)、TNF-α、IL-1β和IL-6的血清浓度,同时检查滑膜组织病理。结果 与对照组相比,地塞米松组的大鼠肝、肾指数显著上升(P0.01)及脾、胸腺指数显著下降(P0.01)。CIA组和附子汤组的肺、心指数与对照组无显著差异;CIA组、地塞米松组和附子汤组大鼠右后足厚度和关节炎指数与对照组有显著性增加(P0.01),治疗后足爪厚度显著下降(P0.01);CIA组大鼠血清TNF-α,IL-1β和IL-6水平显著高于正常大鼠(P0.05)。经附子汤及地塞米松治疗,CIA大鼠血清中TNF-α, IL-1β和IL-6的水平均显著下降(P0.01);HE染色结果显示对照组滑膜、软骨和骨组织无病变。附子汤和地塞米松治疗后滑膜中病理得到明显改善。结论 附子汤可以抑制炎症因子的释放来缓解类风湿性关节炎,从而保护关节,为类风湿性关节炎提供了一种有效的治疗药物。     

附子总生物碱的提取纯化工艺

目的筛选附子水溶性总生物碱的提取工艺和纯化方法。方法以总生物碱的提取率为指标,采用多种提取工艺比较,正交设计优选总生物碱的醇提工艺、大孔吸附树脂纯化工艺。结果附子醇提的最佳工艺为4倍量体积分数为85%的乙醇溶液回流提取4次,每次2 h,再通过D 101大孔吸附树脂纯化,水、体积分数为10%、80%的乙醇溶液梯度洗脱,收集体积分数为10%的乙醇洗脱部分浓缩干燥,测定总生物碱含量质量分数为54%,总转移率为71%。结论该符合工业化生产要求。     

《五十二病方》乌头中毒解救方药简析

乌头为镇痛良药,然其毒性甚大,故如何解毒,成为古今医者研究的重要课题,《五十二病方》在乌头解毒方面,内容丰富,记载详细,用药众多,方法独特,既为后世留下了宝贵的解毒经验,也为后世解救乌头中毒开启了先河。     

国产乌头类生药榜嘎类和牛扁类的形态组织学研究

本文报道榜嘎类包括两种乌头:船盔乌头Aconitum naviculare Stapf和甘青乌头A.tanguticum Stapf及牛扁类包括五种乌头:牛扁乌头A.barbatum var.puberulum Ledeb.、高乌头A.sinomontanum Nakai、空茎乌头A.apetalum B.Fedtsch.、赣皖乌头A.finetianum Hand.-Mazz.、花葶乌头A.scaposum Franch.根部的形态与组织构造研究,结果表明这两类共七种乌头可根据生药外形及显微特征进行鉴别。     

乌头与半夏配伍外用镇痛疗效及皮肤急，陡毒性研究

目的：观察鸟头与半夏间半量、等量、倍量配伍剂量外用对镇痛效应和皮肤局部吸收急性毒性的影响。方法：（1）采用小鼠醋酸扭体法试验观察鸟头与半夏配伍剂量的外用镇痛效应；（2）采用家免皮肤局部吸收急性毒性试验观察乌头与半夏不同配伍剂量外用对皮肤的急性毒性。结果：（1）镇痛效应：乌头：半夏（1：0．5）在浓度为66．7％时，对醋酸扭体有明显抑制（P〈0．05）；乌头：半夏（1：1）在浓度为66．7％和33．4％时，均能显著抑制醋酸扭体（P〈0．01、P〈0．05）；乌头：半夏（1：2）在浓度为66．7％时亦能明显抑制醋酸扭体（P〈0．01）。（2）皮肤的急性毒性：乌头：半夏犬剂量（浓度为78％）动物死亡率：1：1为3／4、1：2为3／4、1：0．5为3／4；乌头：半夏中剂量（浓度为39％）动物死亡率：1：1为0／4、1：2为2／4、1：0．5为1／4；乌头：半夏小剂量（浓度为19．5％）动物死亡率：1：1为0／4、1：2为1／4、1：0．5为0／4。结论：镇痛试验结果表明，乌头：半夏比例以1：1为好，乌头：半夏在等量时拟有增强镇痛疗效作用；皮肤急性毒性试验结果表明，乌头：半夏1：2毒性较大；乌头：半夏1：1毒性较小，乌头：半夏在等量时拟有相互抑制毒性作用，随着剂量的变化毒性拟有增加的趋势，特别是半夏剂量超过乌头时毒性增加最为明显。     

乌头类中药的胚胎毒性及致畸性

目的：研究乌头类中药盐附子、生川乌、生草乌的胚胎毒性及致畸性。方法：选用SD大鼠，实验分为5组：盐附子1．14g生药/kg，3．43g生药/kg；10．30g生药/kg，生川乌13．0g生药/kg；生草乌8．3g生药/kg，另设阴性对照（蒸馏水）组和阳性对照（维生素A）组，试验组和阴性对照组大鼠于妊娠第7至16天，阳性对照组大鼠于妊娠第9至12天灌胃给药。结果：盐附子10．30g生药/kg剂量组和生川乌13．0g生药/kg剂量组、生草乌8．3g生药/kg剂量组对大鼠都出现了轻微母体毒性（孕鼠体重增加缓慢和摄食量减少）；与阴性对照组比较，生草乌8.3g生药/kg剂量组出现胎鼠身长减小，胸骨骨化数减少（P〈0．05）；其余无异常。结论：在本实验条件下，乌头类中药盐附子、生川乌、生草乌对大鼠均无致畸作用；生草乌8．3g生药/kg有一定的胚胎毒性。