大黄肝肾毒性及其减毒方法现代研究进展

大黄作为临床上经常使用的药物,具有清热泻下、燥湿解毒、保肝利胆、抗炎、抗细菌内毒素和降糖等作用,其临床应用十分广泛,可用于防治便秘、黄疸、消化性溃疡和细菌性痢疾等多种疾病。然而近几年随着对大黄的研究不断深入,临床上滥用和误用大黄等情况频繁出现,其不良反应的报道日渐增多,因此其毒副作用也越来越受到国内外的关注。本文通过整理近年来关于大黄肝毒性、肾毒性的文章,主要从大黄的肝、肾毒性作用和毒理机制以及合理应用减毒这3个方面进行总结和讨论,对有关大黄肝毒性、肾毒性的药理、毒理研究进行简要综述,分别从肝肾生化指标、细胞凋亡、线粒体功能、基因和蛋白表达及信号通路等多个方面对大黄的肝、肾毒性进行了论述和阐释,并从炮制减毒和配伍减毒两方面对大黄的减毒方法进行概括总结,从而较为客观全面地理解大黄的肝肾毒性,阐明大黄造成肝肾损伤的毒理机制,为大黄炮制减毒和配伍减毒的机制提供一定的参考,使大黄在"毒性问题"方面更具说服力,从而对大黄的临床安全合理使用和深入研究提供进一步的理论依据。

Hepatotoxicity and Nephrotoxicity of Rhei Radix et Rhizoma and Its Attenuation Methods

Rhei Radix et Rhizoma is a common medicine in clinic, which is widely used for a variety of diseases,such as constipation, jaundice, peptic ulcer, bacillary dysentery. In recent years, there have been many cases of clinical abuse and increasing number of adverse reactions about Rhei Radix et Rhizoma. Many reports concerned with its toxicity have drawn more and more attention at home and abroad. This review makes a brief summary on the toxicity research of Rhei Radix et Rhizoma in recent years in the aspects of hepatotoxicity, nephrotoxicity and its corresponding toxicity-controlling methods. Liver and kidney toxicity of Rhei Radix et Rhizoma was explained in various aspects, including liver and kidney biochemical indicators, apoptosis, mitochondrial function, gene and protein expression and signaling pathway. Besides, the attenuation methods of Rhei Radix et Rhizoma were summarized in aspects of processing and compatibility of traditional Chinese medicine. In conclusion, this study explains hepatotoxicity and nephrotoxicity of Rhei Radix et Rhizoma objectively, and explore relevant toxicological mechanisms, in order to provide proper reference for its further research and the safety of clinical use.