[关键词]
[摘要]
中药药源性肝毒性和中药组分、个体差异及配伍等方面关系密切。从化学成分、作用机制、临床与动物实验的比较3个方面对中药引起的肝毒性进行分析、归纳和总结。结果发现生物碱、萜类、蒽醌类化合物是引起中药肝毒性的主要化学成分,肝毒性作用机制包括药物代谢酶基因表达异常、肝细胞凋亡失调、脂质过氧化损伤、线粒体损伤、炎症反应等。中药化学成分复杂,在关注其临床疗效的同时也应重视其所引起的肝毒性,才能进一步确保临床合理用药。
[Key word]
[Abstract]
Drug-induced liver toxicity of Chinese herbs is closely related to chemical components in drugs, individual difference and compatibility. Hepatotoxicity caused by Chinese materia medica was analyzed, generalized and summarized from three perspectives including chemical composition, mechanism of action and comparison of clinical application with animal experiments in this paper. Alkaloids, terpenoids and anthraquinones are the main chemical components that cause liver toxicity of traditional Chinese herbs. The mechanisms of hepatotoxicity include abnormal drug metabolism enzyme gene expression, apoptosis disorder of hepatocytes, lipid peroxidation damage, mitochondrial damage and inflammatory response. The chemical ingredients of traditional Chinese medicine are complex. With clinical efficacy of Chinese drugs paid attention to, the problem of hepatotoxicity should also be taken seriously in order to further ensure rational medication clinically.
[中图分类号]
[基金项目]
国家“重大新药创制”科技重大专项(2017ZX09304002);上海市2020年度“科技创新行动计划”生物医药科技支撑专项(20S21902100);上海申康医院发展中心《市级医院医企协同临床试验管理项目》(20CR4003B)