中国药物警戒 ›› 2026, Vol. 23 ›› Issue (1): 7-11.
DOI: 10.19803/j.1672-8629.20250816

• 雷公藤效-毒研究专栏 • 上一篇    下一篇

基于中医五行与现代机制整合分析的雷公藤器官毒性特征与防治研究

张晓朦1,2, 曲聪聪3, 季宇鑫1, 林志健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;
    3青岛市中医医院临床药理实验基地,青岛大学附属青岛市海慈医院,山东 青岛 266033
  • 收稿日期:2025-11-15 出版日期:2026-01-15 发布日期:2026-01-15
  • 通讯作者: *张冰,女,博士,教授·博导,中药药物警戒与合理用药。E-mail: zhangb@bucm.edu.cn
  • 作者简介:张晓朦,女,博士,讲师,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（82204643）; 国家中医药管理局高水平重点学科建设项目-临床中药学（zyyzdxk-2023257）

Characteristics and Prevention of Organ Toxicity Induced by Tripterygium wilfordii Based on Integration of Five-Element Theory TCM and Modern Mechanisms

ZHANG Xiaomeng1,2, QU Congcong3, JI Yuxin1, LIN Zhijian1,2, ZHANG Bing1,2,*   

  1. 1School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 102488, China;
    2Center for Pharmacovigilance and Rational Use of Medicine, Beijing University of Chinese Medicine, Beijing 102488, China;
    3Clinical Pharmacology Base, Qingdao Hospital of Traditional Chinese Medicine, Qingdao Haici Hospital Affiliated to Qingdao University, Qingdao Shandong 266033, China
  • Received:2025-11-15 Online:2026-01-15 Published:2026-01-15

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摘要： 目的 针对雷公藤疗效显著但临床用药风险突出的问题,通过传统与现代理论整合分析,提出其器官毒性传变假说,为构建精准防控策略提供参考。方法 系统综述雷公藤所致肝、肾、心、胃肠等各个器官损伤的临床表现与分子机制,结合中医五行学说与现代毒理学,构建阐释器官毒性机制的框架。结果 基于五行生克乘侮关系和毒理学综合分析,发现雷公藤器官毒性存在时序性关联,表现为“始于肝木,继而克脾、乘心、及肾,终可累肺伤髓”的动态传变路径。从整合视角揭示其毒性并非孤立靶点效应,而是具有一定跨器官通信传递特征。结论 基于“截断传变”思想,提出涵盖早期预警、中药配伍减毒及现代靶向干预的综合防治策略。该框架不仅为雷公藤临床安全用药提供新思路,也为中药器官毒性研究提供参考。

关键词: 雷公藤, 器官毒性, 五行传变, 跨器官通信, 中药药物警戒

Abstract: Objective To propose a hypothesis on the transmission and transformation of organ toxicity by Tripterygium wilfordii based on traditional Chinese medicine (TCM) theories and modern pathophysiological mechanisms in order to contribute to related prevention and control strategies. Methods The clinical manifestations and molecular mechanisms underlying the damage induced by Tripterygium wilfordii to the liver, kidney, heart, gastrointestinal tract and other organs were reviewed. By integrating the Five-element Theory of TCM with modern toxicology, a framework was established to elucidate the mechanisms of such organ toxicity. Results Based on analysis involving Five-element interactions and biological signaling pathways, a time-dependent progression pattern of organ injury was identified, characterized by a dynamic sequence of “originating in the liver (wood), followed by damage to the spleen (earth), heart (fire), and kidney (water), ultimately affecting the lung (metal) and bone marrow”. Such integration suggested that the toxicity of Tripterygium wilfordii did not merely result from isolated organ targeting, but was a networked and sequentially propagated pathological process across organs. Conclusion According to the principle of “blocking disease transmission”, a comprehensive prevention strategy has been proposed that involves early biomarker-based warning systems, rational herb-herb compatibility in TCM formulations for toxicity mitigation, and modern targeted interventions. This integrated framework can not only facilitate safe clinical use of Tripterygium wilfordii, but also provide a reproducible paradigm for investigating organ toxicity in other herbal medicines.

Key words: Tripterygium wilfordii, Organ Toxicity, Five-Element Transmission and Transformation, Inter-Organ Communication, Pharmacovigilance of Traditional Chinese Medicine

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