中国药物警戒 ›› 2024, Vol. 21 ›› Issue (7): 759-764.
DOI: 10.19803/j.1672-8629.20240294

• 药源性心脏毒性研究专栏 • 上一篇    下一篇

阿霉素心脏毒性的中药防治用药分析及证素实证研究

刘亚迪1, 张晓朦1,2, 蔡海丽1, 陈思颖1, 王雨1,2, 张冰1,2,*   

  1. 1北京中医药大学中药学院,北京 102488;
    2北京中医药大学中药药物警戒与合理用药研究中心,北京 102488
  • 收稿日期:2024-05-08 出版日期:2024-07-15 发布日期:2024-07-31
  • 通讯作者: * 张冰,女,博士,教授·博导,主治医师,中药药物警戒与合理用药。E-mail：zhangb@bucm.edu.cn
  • 作者简介:刘亚迪,女,在读硕士,中药药物警戒与合理用药。
  • 基金资助:
    国家自然科学基金资助项目（82274117）; 国家中医药管理局高水平重点学科建设项目（zyyzdxk-2023257）; 中央高校基本科研业务费专项资金资助项目（2024-JYB-JBZD-054）

Traditional Chinese medicine for prevention and treatment of adriamycin cardiotoxicity and an empirical study of evidence elements

LIU Yadi1, ZHANG Xiaomeng1,2, CAI Haili1, CHEN Siying1, WANG Yu1,2, ZHANG Bing1,2,*   

  1. 1School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 102488, China;
    2Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing 102488, China
  • Received:2024-05-08 Online:2024-07-15 Published:2024-07-31

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摘要： 目的 基于阿霉素心脏毒性中药防治用药分析,在动物实验上进行阿霉素心脏毒性证素验证,为临床中药防治、警戒阿霉素心脏毒性提供参考。方法 检索中国知网、万方数据、维普网中自建库起至2024年3月1日中药防治阿霉素心脏毒性相关文献,分析其用药规律,并以阿霉素每3 d腹腔注射3.5 mg·kg-1建立阿霉素心脏毒性大鼠模型,观察其证素表现。结果 在阿霉素心脏毒性中药防治用药分析中共纳入104味中药,高频药物有黄芪、甘草、麦冬、人参、附子、丹参等。药物功效以补虚为主,活血化瘀为辅,佐以利湿化浊、清热药等。证素实证研究中,阿霉素心脏毒性大鼠较正常组大鼠出现了毛色污秽、掉毛、便溏、瘀血、精神萎靡、倦怠、舌色暗淡表现,血清中抗利尿激素、醛固酮、抗凝血酶Ⅲ含量显著下降,D-二聚体含量显著上升,体现了“虚”“瘀”“湿”的病机特点。结论 防范阿霉素心脏毒性发生可从补虚扶正、活血化瘀、利湿化浊入手,为阿霉素心脏毒性的防治提供了方向。

关键词: 阿霉素, 心脏毒性, 用药分析, 证素, 药物警戒

Abstract: Objective To validify the evidence of adriamycin cardiotoxicity via animal experiments based on the analysis of TCM medications used for the prevention and treatment of adriamycin cardiotoxicity in order to provide data for related treatment. Methods Literature related to the prevention and treatment of anthracycline cardiotoxicity with TCM and published between the inception to March 1st, 2024 was searched for from some databases to analyze the pattern of medications and to establish a rat model of anthracycline cardiotoxicity via injection with doxorubicin at 3.5 mg•kg-1. Results A total of 104 Chinese herbal medicines, such as Astragalus, Glycyrrhiza glabra, Maitong, Ginseng, Radix et Rhizoma Ginseng, Radix et Rhizoma Ginseng, and Salviae Miltiorrhizae, were included. The efficacy of these drugs was determined as tonifying deficiency, activating blood circulation, removing blood stasis, clearing heat, eliminating phlegm, and expelling dampness. Anthracycline cardiotoxic rats showed dirty fur, hair loss, loose stools, stasis of blood, depression, lethargy, decrease in anal temperatures, and dark tongue color. The serum contents of antidiuretic hormone, aldosterone, and antithrombin Ⅲ were significantly decreased while the content of D-dimer was significantly increased. Conclusion The development of drugs for prevention and treatment of anthracycline cardiotoxicity should involve tonifying the deficiency, stimulating blood circulation, eliminating stasis, expelling dampness and resolving turbidity.

Key words: adriamycin, cardiotoxicity, medication pattern, evidence, pharmacovigilance

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