基于中药系统毒理学数据库探讨中药致心脏毒性的作用特点及规律

目的 基于中药系统毒理学数据库分析探讨中药致心脏毒性的作用特点及规律，为中药增效减毒和临床应用提供一定依据。方法 检索中药系统毒理学数据库收录的252味中药，汇总数据库中收录的文献，研究探讨中药致心脏毒性的作用特点，采用频数算法分析致心脏毒性中药的功效、四气五味、归经、毒性等级及毒性成分，总结分布规律。结果 筛选并纳入致心脏毒性药物共74味，同时具有其他脏器毒性的中药共65味，其中兼有肝毒性的中药最多，肾毒性、神经系统毒性次之。祛风湿药占比最高（除其他类），活血化瘀药、外用药次之；药味以苦为主，辛、甘次之；药性以温为主，寒、平次之；归经主入肝、肺、脾经；毒性以中毒为主。致心脏毒性的活性成分主要为生物碱类，其次为甾体类、萜类。结论 中药致心脏毒性临床病理表现主要为心肌细胞损伤；临床毒性表现主要为心律失常、心力衰竭、心肌梗死等；机制研究多以细胞能量代谢、离子通道为主；减毒方法包括炮制、配伍、针刺等；致心脏毒性中药多性温，味苦，归肝、肺、脾经，毒性等级多为中毒；心脏毒性物质基础以生物碱类成分为主。

Exploration of characteristics and regularity of cardiotoxicity induced by traditional Chinese medicine based on TCMSTD

Objective To analyze the characteristics and regularity of cardiotoxicity induced by traditional Chinese medicine based on Traditional Chinese Medicine System Toxicology Database (TCMSTD), and to provide a certain basis for the enhancing the efficacy and reducing toxicity of traditional Chinese medicine and its clinical application. Methods A total of 252 traditional Chinese medicines included in the TCMSTD were searched to gather the literature included in the database and study the characteristics of cardiotoxicity induced by traditional Chinese medicine, and the frequency algorithm was used to discuss the efficacy, four natures and five flavors, meridian tropism, toxic grades and toxic components of cardiotoxic traditional Chinese medicine, and summarize the distribution pattern. Results A total of 74 cardiotoxic drugs were screened and included, of which 65 were also toxic to other organs. Among them, traditional Chinese medicine with hepatotoxicity is the most, followed by nephrotoxicity and neurotoxicity. Dispel wind dampness drugs accounted for the highest proportion (except other categories), followed by blood circulation and blood stasis drugs and external drugs. The flavor of drugs was mainly bitter, followed by pungent and sweet; The property of drugs was mainly warm, and others were cold and flat; The liver, lung and spleen meridians were in majority; The toxicity is mainly middle. The cardiotoxic drugs components were mainly alkaloids, followed by steroids and terpenoids. Conclusion The clinical pathological manifestations of cardiotoxicity caused by traditional Chinese medicine are mainly cardiomyocyte damage; The clinical toxicity is mainly arrhythmia, heart failure and myocardial infarction; The mechanism studies mainly include cell energy metabolism and ion channel; The methods of reducing toxicity include preparation, compatibility, acupuncture, etc; Traditional Chinese medicine that causes cardiac toxicity is often warm, bitter in taste, and belongs to the liver, lung, and spleen meridians; and the toxicity is mainly middle; The cardiotoxic substance base is mainly composed of alkaloid components.