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含汞矿物药的毒性研究进展(1)
http://www.100md.com 2017年4月1日 《中国中药杂志》2017年第7期
     [摘要] 矿物药是中药中富有特色的组成部分,含汞矿物药朱砂、红粉、轻粉由于其镇心安神,杀菌灭毒,化腐生肌等作用在临床上得到了廣泛的应用。但因为汞的毒性,其临床用药的合理性和安全性受到了质疑。该文简要概述了含汞矿物药的功效,并针对其肝肾毒性,神经毒性,胚胎及遗传毒性作用及毒性机制进行了总结。含汞矿物药朱砂和轻粉在服用方式不当或高剂量服用时会导致急性肝肾毒性,朱砂、红粉和轻粉在长期外用时可能导致慢性肝肾毒性,神经毒性及胚胎遗传毒性。在对含汞矿物药的毒性进行研究时,除了研究汞在机体和组织的蓄积,还应研究不同方式进入机体的含汞毒性成分的种类和形态,并且需要考虑用药的剂量及时间长短问题,从而为含汞矿物药在临床的合理用药以及安全性提供参考。

    [关键词] 矿物药; 朱砂; 红粉; 轻粉; 毒性

    Toxicity of mineral Chinese medicines containing mercury element

    WANG Xiaoye1, LIN Ruichao1,2, DONG Shifen1, GUAN Jun1, SUN Lu1, HUANG Jianmei1,2*

    (1. School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100102, China;

    2. Beijing Key Laboratory of Traditional Chinese Medicine Quality Evaluation, Beijing University of Chinese Medicine, Beijing 100102, China)

    [Abstract] Mineral Chinese medicine is the distinctive part of the Chinese traditional medicine. The mineral Chinese medicines containing mercury elements such as cinnabaris, calomelas and hydrargyri oxydum rubrum are widely applied in the clinical conditions because of their efficacy of sedative, sterilization, removing necrotic tissue and promoting granulation. However, the rationality and security of clinical application are questioned because of the toxic effect caused by mercury compounds. This paper would summarize the efficacy of the mineral Chinese medicines containing mercury element, as well as their hepatotoxicity, nephrotoxicity, embryotoxicity, and neurotoxicity effect and mechanisms. Improper usage or high dose of the mineral Chinese medicines containing mercury element would cause acute hepatotoxicity. Cinnabaris, calomelas and hydrargyri oxydum rubrum may lead to chronic hepatotoxicity, nephrotoxicity, embryotoxicity and neurotoxicity when they were applied externally to the skin for longterm use. In addition to the accumulation of mercury elements in the tissues and organs, the species and forms of mercury compounds absorbed into the body in different ways, should be also studied in order to understand the toxicity of the mineral Chinese medicines containing mercury element. Meanwhile the dose and period of treatment shall be also considered in order to provide the references for rational and safe clinical application of the mineral Chinese medicines containing mercury element.

    [Key words] mineral Chinese medicine; cinnabaris; hydrargyri oxydum rubrum; calomelas; toxicity

    含汞矿物药的应用在我国具有悠久的历史和丰富的临床实践经验,随着现代研究手段的更新,人们对矿物药的药理和毒理有了更加深入的研究[1]。本文简要概述了含汞矿物药朱砂、红粉和轻粉的功效,总结了这3味含汞矿物药主要的毒性成分、毒性作用以及毒理机制,为含汞矿物药及其制剂的临床合理、安全使用提供理论依据。 (王晓烨 林瑞超 董世芬 关君 孙璐 黄建梅)
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