附子心脏毒性及配伍减毒增效机制研究进展

附子来源于毛茛科植物乌头Aconitum carmichaeli Debx.，最主要的毒性反应表现为心脏毒性和神经毒性，其中心脏是主要的靶器官之一。目前普遍认为附子所致心脏毒性是由双酯型二萜生物碱直接或间接作用于心脏的结果，其毒性机制与Ca²⁺超载、脂质过氧化反应、细胞凋亡以及迷走神经兴奋性增高有关。研究发现附子与其他传统中草药配伍能通过影响体内代谢过程、抗Ca²⁺超载、抗氧化应激、抗凋亡等机制发挥减毒增效作用。就近年来国内外对附子心脏毒性及配伍减毒增效相关机制的研究进展进行综述，以期为附子的深入研究和临床安全用药提供参考。

Research progress on aconite-induced cardiotoxicity and mechanism of attenuation and synergy of compatibility

Aconite is from Aconitum carmichaeli, the main toxic reactions of aconite are cardiotoxicity and neurotoxicity, among which the heart is one of the most important target organs. At present, it is generally believed that the aconite-induced cardiotoxicity is caused by the direct or indirect action of diester diterpenoid alkaloids on the heart, and the toxic mechanism may be related to Ca²⁺ overload,lipid peroxidation, cell apoptosis and increased vagus nerve excitability. It is found that the compatibility of aconite with other traditional Chinese herbal medicines can play a role in attenuation and synergy by influencing the metabolic in vivo, decrease of intracellular Ca²⁺ overload, antioxidative stress, anti-apoptotic. In this paper, the research progress on cardiotoxicity of aconite and related mechanisms of attenuation and synergy of compatibility at home and abroad were reviewed in recent years, providing reference for further study and clinical safe medication of aconite.