传统中药雄黄应用概况及其安全性

雄黄作为传统中药已有2000余年历史，并为1963年至2005年的各版《中国药典》收载。雄黄主要用于治疗蛇虫咬伤、虫积腹痛、惊痫及疟疾。近年研究表明，雄黄有抗菌、镇痛消炎和提高机体免疫力的作用；雄黄制剂能有效治疗白血病。雄黄的剂量为0．05-0．1g／d。实际上，据不完全统计，约有66种雄黄制剂的常用量超过《中国药典》规定。雄黄的主要成分为二硫化二砷（As2S2）。尽管二硫化二砷的毒性较小，但雄黄大量长期应用可引起急、慢性中毒，这可能与其所含可溶性三氧化二砷（As2O3）有关。雄黄所致严重不良反应有出血、肝肾衰竭、呼吸中枢麻痹，甚至死亡。作者认为，雄黄临床应用的利弊应在对雄黄及其制剂的有效性和安全性作深入调查研究的基础上再进行科学评价。

A survey of application of traditional Chinese medicine realgar and its safety

Realgar （Xionghuang） has a history of two thousand years and more as a traditional Chinese medicine, and it was included in each edition of Chinese Pharmacopoeia from 1963 to 2005, Realgar is mainly used for treatment of snack and insect bite, parasitogenic abdominal pain, convulsions, and malaria. Recent studies suggest that realgar has antibacterial, analgesic and anti- inflammatory effects as well as the effect of enhancing immunity; realgar preparations are effective for treating leukemia. The daily dosage of realgar is 0, 05 - 0, 1 g. Actually, according to incomplete statistics, the commonly used dosage of about 66 realgar preparations exceeds the dosage limit in Chinese Pharmacopeia, The main composition of realgar is arsenic disulfide （As2S2）. Despite lower toxicity of arsenic disulfide, acute or chronic poisoning can occur after high dosage or long-term use of realgar. And it might be related to soluble arsenic trioxide （As2O3 ） in realgar, Realgar-induced serious adverse reactions include hemorrhage, hepatorenal failure, paralysis of respiration centre, and death, The authors suggest that the scientific reassessment of its benefit and risk in clinical practice should be performed on the basis of a thorough investigation and study in the efficacy and safety of realgar and its preparations.