马兜铃酸类化合物（aristolochic acid analogues，AAAs）是一类硝基菲类化合物，广泛存在于马兜铃科植物中。长期以来，学界的研究多集中于其较强的肾毒性、致癌性等不良反应，而对其潜在的药理活性（如抗炎、镇痛、抗肿瘤等）的关注相对较少。面对该类成分毒性-药效并存的双重特性，如何平衡其毒性与其药用价值是关键。通过炮制、配伍、结构修饰等多种手段降低不良反应，能为此类成分及中药安全使用提供保障。通过系统综述AAAs群体药理作用、减毒方法等方面的研究进展，以期为含AAAs药物的临床应用提供参考。

Aristolochic acid analogues (AAAs) are a class of nitrophenanthrene derivatives predominantly occurring in Aristolochiaceae plants. Over the past decades, academic research has mostly focused on its strong adverse reactions such as nephrotoxicity and carcinogenicity. In contrast, their potential pharmacological activities—including anti-inflammatory, analgesic, and antitumor effects—have remained relatively underexplored, resulting in an imbalanced understanding of this compound class. In the face of the dual characteristics of toxicity and efficacy of this type of component, how to balance its toxicity and medicinal value is the key. Methods such as processing, compatibility, and structural modification may reduce adverse reactions, which could provide guarantees for the safe use of such components and traditional Chinese medicine. This review integrates current global advances in AAAs research, with a particular focus on their pharmacological activities and detoxification strategies, to provide references for the clinical application of drugs containing AAAs.

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国家重点研发计划项目（2022YFC3500902）；中医药传承与创新“百千万”人才项目（第一批全国西医学习中医优秀人才研修项目）（国中医药人教发[2019]13号）