常用傳統中藥之毒理概觀   全文下載

An Overview of the Toxicology of Commonly Used Traditional Chinese Medicine

傳統中藥在許多國家的醫療保健系統中扮演很重要的角色。近幾年中藥及天然物在新藥研發的潛能又重新被重視，一般認為中藥研發缺乏有系統的藥理、毒理及臨床研究。最近研究顯示中藥能治療某些西藥無效的疾病，但是因為藥效及安全性評估資料之不足，使得中藥的發展仍然受限制。此短篇概論將綜合整理常用中藥的急性、器官、基因、分析及臨床毒理資料，希望能成為一份中藥毒理介紹及參考資料。急毒性試驗顯示中藥的半致死劑量分佈由無毒到超毒等級。中藥毒性標的器官包含肝、腎、腸胃道、神經系統及心臟等。部份中藥在安姆氏試驗中顯示有致突變性，在細胞基因毒性試驗中有能力增加不按計畫之DNA合成，微小核生成及染色體異變。化學分析結果顯示有些中藥被農藥、重金屬污染或被添加西藥。中藥不當的使用及特異體質反應可能造成中藥的不良副作用。因此，完備、有系統的毒性試驗及詳細的毒理機制研究，將非常有助於中藥藥效、安全性之評估及新藥研發。

Traditional Chinese medicine (TCM) plays an important role in health care systems in many parts of the world. Recently, interest in TCM has revived due to the rediscovery of the potential of TCM and natural products in new drug development. There is a general perception that TCM lacks systematic pharmacological, toxicological, and clinical studies. The deficiency in efficacy and safety has been a major hindrance to the progress of TCM, despite the success of herbal medicine in treatment of diseases for which the orthodox drugs in western medicine are ineffective. This brief review aims to serve as an introduction and a reference guide to TCM toxicology. The review summarizes the toxicity of some commonly used TCMs in terms of acute, systematic, genetic, analytic, and clinical toxicology. Acute toxicity study has shown that herbal medicines and their chemical constituents exhibit LD50 values ranging from the practically nontoxic to supertoxic categories. Target organs of TCM toxicity include liver, kidney, gastrointestinal tract, nervous, and cardiovascular systems. TCM shows mutagenicity in the Ames test and increases the incidence of unscheduled DNA synthesis, micronucleus formation, and chromosomal aberration in cytogenetic assays. Some TCM products are contaminated with pesticides and heavy metals and adulterated with drugs of western medicine. Improper dispensing and use of TCM and individual idiosyncracy may result in adverse effects and fatality. Future TCM research, new drug development, and safety evaluation require adequate toxicity testing and mechanistic toxicology studies. 傳統中藥在許多國家的醫療保健系統中扮演很重要的角色。近幾年中藥及天然物在新藥研發的潛能又重新被重視，一般認為中藥研發缺乏有系統的藥理、毒理及臨床研究。最近研究顯示中藥能治療某些西藥無效的疾病，但是因為藥效及安全性評估資料之不足，使得中藥的發展仍然受限制。此短篇概論將綜合整理常用中藥的急性、器官、基因、分析及臨床毒理資料，希望能成為一份中藥毒理介紹及參考資料。急毒性試驗顯示中藥的半致死劑量分佈由無毒到超毒等級。中藥毒性標的器官包含肝、腎、腸胃道、神經系統及心臟等。部份中藥在安姆氏試驗中顯示有致突變性，在細胞基因毒性試驗中有能力增加不按計畫之DNA合成，微小核生成及染色體異變。化學分析結果顯示有些中藥被農藥、重金屬污染或被添加西藥。中藥不當的使用及特異體質反應可能造成中藥的不良副作用。因此，完備、有系統的毒性試驗及詳細的毒理機制研究，將非常有助於中藥藥效、安全性之評估及新藥研發。