基于文献分析的中药毒性分级方法及思考
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河南中医药大学,郑州 450056

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R-33

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Preliminary exploration of toxicity classification method for traditional Chinese medicines based on data mining
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Henan University of Chinese Medicine, Zhengzhou 450056, China

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    摘要:

    中药毒性问题成为制约中医药国际化的主要障碍。合理的毒性中药分级策略是解决该问题的主要途径之一。现有的中药毒性分级仍沿用传统分级法,该分级法虽对中医临床用药具有合理的指导作用,但缺乏定量数据,不够精准,出现同种药物不同书籍对毒性分级记载不同的现象。毒性分级现代研究主要有以口服生药LD50 值划分、多指标综合分类法、基于“物质-功效-毒性”有毒中药评价模式分级方法、沿用现代毒理研究模式等方法,虽然实现了中药毒性分级的定量标准,但脱离中医药理论指导,且与临床实际相差较大,未能体现中医药临床复方用药的实质。在梳理前人中药毒性研究的基础上,提出基于数据挖掘结合毒理研究的赋值评分分级法。该方法基于数据挖掘(毒性中药的古文献毒性记载、临床报道和体内外实验研究)综合现代毒理研究成果,对各项进行赋值加权评分,提出基于文献发掘的毒性中药分级方法,评分越高,毒性越大,并以附子为例,开展其毒性等级确定。本分级方法注重临床复方用药的优势,对临床具有一定的指导作用,可反映毒性大小,但该分级方法内容仍需进一步细化。随着该毒性中药分级法的逐步完善、细化,以期为临床毒性中药的合理应用及中医药国际化提供一定的参考。

    Abstract:

    Toxicity has become a major obstacle to the international use of traditional Chinese medicines, and a rational grading strategy for their toxicity is therefore needed. Although the existing traditional toxicity classification can help to guide the clinical use of traditional Chinese medicines, it lacks quantitative data and is not sufficiently accurate, with different sources reporting different toxicity classifications for the same drug. Modern research on toxicity classification mainly includes classification method based on LD50 of oral raw drugs, multi indicator comprehensive classification method, evaluation model of toxic traditional Chinese medicine based on “substance efficacy toxicity”, and the use of modern toxicology research models. Although these toxicity grading method achieve quantitative standards for traditional Chinese medicine toxicity grading, they deviate from the theoretical guidance of traditional Chinese medicine and differ significantly from clinical practice, failing to reflect the essence of clinical compound medication of traditional Chinese medicine. To sort previous studies on the toxicity of traditional Chinese medicines, this paper proposes a scoring and grading method based on data mining combined with toxicological studies. The proposed method is based on data mining of historical toxicity records for traditional Chinese medicines, clinical reports, and experimental in vitro and in vivo studies, as well as comprehensive modern toxicological research result, followed by the assignment of weighted scores to each item, to derive a toxicity classification method for traditional Chinese medicines. For example, aconite would be graded as highly toxic according to this procedure. This grading method has the advantages of focusing on clinical compound drug use, as well as providing guidance for clinical practice. It can quantitatively indicate the degree of toxicity, thus reflecting the modern characteristics of traditional Chinese medicine. This grading method needs further refinement, but after gradual improvement and refinement, this toxicity classification method for traditional Chinese medicines is expected to promote their rational clinical application and wider international use.

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宋亚刚,田 硕,乔靖怡,武香香,朱星昊,留甜甜,苗明三.基于文献分析的中药毒性分级方法及思考[J].中国比较医学杂志,2023,33(7):149~154.

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  • 收稿日期:2022-06-18
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  • 在线发布日期: 2023-08-18
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