ABSTRACT
ObjectiveTo count and analyze the toxic traditional Chinese medicines and their characteristics in Chinese Materia Medica， so as to provide reference for the development and application of toxic drugs. MethodThe traditional Chinese medicines included in Chinese Materia Medica were screened one by one， and the inclusion criteria were "drug properties"， "usage and dosage" and "major poison， highly poisonous， poisonous， slightly poisonous， slightly poisonous" appearing in ancient books. Standard toxic traditional Chinese medicines were entered into an excel sheet for statistical analysis. ResultA total of 1 408 toxic Chinese medicines were included. The properties and flavors were mainly cold， bitter， pungent and sweet； the main meridians were liver， lung， spleen and stomach； the root， whole grass and leaves were the most used medicinal parts， and there were many toxic drugs. The pre-treatment methods are mainly sun-dried， fresh， fried， calcined， and sunburned； the efficacy categories are mainly heat-clearing drugs， rheumatism drugs， blood-activating and stasis-removing drugs； oral administration methods are mainly decoctions， pills， and powders ， mainly for external application， dipping， and coating； the dosage for oral administration is mostly 9-15 g， 3-9 g， 3-6 g， and an appropriate amount is mainly for external use. ConclusionThere are many toxic Chinese medicines clearly recorded in Chinese Materia Medica， but only 83 kinds of clearly toxic Chinese medicines are included in Chinese Pharmacopoeia， which need to be further strengthened by experimental observation and clinical data verification. The clinical application of toxic traditional Chinese medicine is mainly based on heat toxin blood syndrome and rheumatic arthralgia， which is closely related to its nature， taste and meridian return. Able to move， has the effect of activating Qi and activating blood， "sweet" can replenish energy and slow down， and has the effect of tonic， alleviation and pain relief， and mostly used for the treatment of heat syndrome， blood syndrome and arthralgia syndrome. However， there are certain limitations in the classification and processing conditions of toxic traditional Chinese medicines， which need to be further improved and scientifically verified.
ABSTRACT
ObjectiveTo count and analyze the toxic traditional Chinese medicines and their characteristics in Chinese Materia Medica， so as to provide reference for the development and application of toxic drugs. MethodThe traditional Chinese medicines included in Chinese Materia Medica were screened one by one， and the inclusion criteria were "drug properties"， "usage and dosage" and "major poison， highly poisonous， poisonous， slightly poisonous， slightly poisonous" appearing in ancient books. Standard toxic traditional Chinese medicines were entered into an excel sheet for statistical analysis. ResultA total of 1 408 toxic Chinese medicines were included. The properties and flavors were mainly cold， bitter， pungent and sweet； the main meridians were liver， lung， spleen and stomach； the root， whole grass and leaves were the most used medicinal parts， and there were many toxic drugs. The pre-treatment methods are mainly sun-dried， fresh， fried， calcined， and sunburned； the efficacy categories are mainly heat-clearing drugs， rheumatism drugs， blood-activating and stasis-removing drugs； oral administration methods are mainly decoctions， pills， and powders ， mainly for external application， dipping， and coating； the dosage for oral administration is mostly 9-15 g， 3-9 g， 3-6 g， and an appropriate amount is mainly for external use. ConclusionThere are many toxic Chinese medicines clearly recorded in Chinese Materia Medica， but only 83 kinds of clearly toxic Chinese medicines are included in Chinese Pharmacopoeia， which need to be further strengthened by experimental observation and clinical data verification. The clinical application of toxic traditional Chinese medicine is mainly based on heat toxin blood syndrome and rheumatic arthralgia， which is closely related to its nature， taste and meridian return. Able to move， has the effect of activating Qi and activating blood， "sweet" can replenish energy and slow down， and has the effect of tonic， alleviation and pain relief， and mostly used for the treatment of heat syndrome， blood syndrome and arthralgia syndrome. However， there are certain limitations in the classification and processing conditions of toxic traditional Chinese medicines， which need to be further improved and scientifically verified.
ABSTRACT
Toxicity-attenuating compatibility is an effective measure to ensure the safety of Chinese medicine. Involving the origin, processing method, compatibility mode, and dosage, it faces multiple challenges, such as the uncertainty of toxic substances, toxicity latency, indefinite safe dose, complex toxicity-efficacy relationship, and individual difference. As a result, research on clinical safety of Chinese medicine is limited by the consistency at "molecular-cellular-organ-overall" levels, unclear interaction of multiple medicinals and multiple substances, the "toxicity-efficacy-compatibility-syndrome" correlation, and the "dosage-time-toxicity-efficacy" conversion law. Therefore, following the principle of "starting from the clinical practice, verifying via the theoretical basis, and finally applying in clinical practice", we verified the toxicity at "molecular-cellular-organ-overall" levels, revealed the interaction of multiple medicinals and substances, collected evidence at multiple levels, clarified the "dosage-time-toxicity-efficacy" relationship, and tested the consistency between basic and clinical biomarkers. On this basis, we studied the toxicity-alleviating and efficacy-enhancing(preserving) compatibility characteristics, the fate of one medicinal and multiple medicinals in vivo, the molecular mechanism of toxicity, the "dosage-time-toxicity-efficacy" conversion law, and the clinical characteristics of toxic traditional Chinese medicine based on disease and syndrome. The three mechanisms of toxicity-attenuating compatibility reflect the seven-reaction theory in Chinese medicine compatibility. Finally, the strategies for safe use of Chinese medicine were proposed.
Subject(s)
Drugs, Chinese Herbal/toxicity , Medicine, Chinese Traditional , Research DesignABSTRACT
In recent years,the safety of " toxic" traditional Chinese medicine has received great attention. Similarly,the safety of " toxic" Chinese medicines for external use should not be ignored. In this paper,the adverse reactions of toxic Chinese medicine for external use were systematically studied; the causes for adverse reactions were analyzed; and the key problems on the external use of toxic Chinese medicine in modern clinical practice were put forward. For example,usage dosage(time,area),specific efficacy of external use,early warning index of toxicity,toxic dose,adverse effects,toxic symptoms and corresponding treatment measures all had no reference basis,lacking a systematic toxicity evaluation medication criteria for clinical external use of toxic Chinese medicine. Attention shall be paid to the toxicity of toxic Chinese medicine for external use,and the theory of toxicity evaluation should be established for the external use of " toxic" traditional Chinese medicine under specific conditions. The early warning mechanism for toxic and adverse effects were clarified,and relevant early warning sensitive indicators applicable to clinical use were established in this study to control its risk factors. The study on the mechanism of pharmacodynamics and toxicology of " toxic" traditional Chinese medicine for external use was strengthened to clarify the usage and specific effects of external use. On the basis of this,the study of synergism and reduction of toxicity was carried out to maximize the efficacy of external use of traditional Chinese medicine under specific conditions. A toxicity standard of " toxic" Chinese medicines for external use was put forward,which was of great significance to guide clinical safety,rationality,effectiveness as well as the research and development of new dosage forms for external use of traditional Chinese medicine.
Subject(s)
Humans , Drug-Related Side Effects and Adverse Reactions , Drugs, Chinese Herbal , Toxicity , Medicine, Chinese Traditional , ResearchABSTRACT
Traditional Chinese medicine has a long history in clinical application, and been proved to be safe and effective. In recent years, the toxicity and side-effects caused by the western medicine have been attracted much attention. As a result, increasing people have shifted their attention to traditional Chinese medicine. Nonetheless, due to the natural origin of traditional Chinese medicine and the lack of basic knowledge about them, many people mistakenly consider the absolute safety of traditional Chinese medicine, except for well-known toxic ones, such as arsenic. However, according to the clinical practices and recent studies, great importance shall be attached to the toxicity of non-toxic traditional Chinese medicine, in particular the hepatotoxicity. Relevant studies indicated that the toxicity of non-toxic traditional Chinese medicine is closely correlated with individual gene polymorphism and constitution. By discussing the causes and mechanisms of the hepatotoxicity induced by non-toxic traditional Chinese medicine in clinical practices, we wrote this article with the aim to provide new ideas for individualized clinical therapy of traditional Chinese medicine and give guidance for rational and safe use of traditional Chinese medicine.
ABSTRACT
OBJECTIVE:Suggest to improve the quality standard of toxic traditional Chinese medicines.METHODS:The"content determination"and"limit test"of 72 toxic traditional Chinese medicines recorded in Chinese pharmacopoeia(2005 edition) were briefly introduced.RESULTS:Only 11%of the total 72 toxic traditional Chinese medicines had the items of both"content determination"and"limit test".CONCLUSION:The quality standard of toxic traditional Chinese medicines should be improved to achieve quality control in accordance with the standard of"low toxicity but high effectiveness"so as to ensure safe and effective drug use in the clinic.