蒽醌类泻剂肠道安全性研究进展

doi:10.19803/j.1672-8629.20240882

摘要/Abstract

摘要： 目的探讨蒽醌类泻剂的肠道毒性及作用机制,为蒽醌类泻剂合理用药提供参考。方法通过查阅文献、数据库等,分析蒽醌类化合物肠道毒性机制及具体药物。结果长期服用含蒽醌类化合物的泻剂可损伤肠神经系统、胃肠起搏细胞（Cajal间质细胞）而导致泻药性结肠;除此还能造成肠道上皮细胞损伤凋亡而导致结肠黑变病;相关性研究表明结肠黑变病与肠息肉、腺瘤的检出率显著相关,与结直肠癌的发生尚存争议。结论通便类药物研发需平衡疗效与肠毒性间的关系。对于蒽醌类泻剂,需要系统评估长期服用对Cajal间质细胞的影响,并规定每日限量和服用天数。

关键词: 蒽醌, 泻剂, 肠道, 结肠黑变病, 肠神经系统, Cajal间质细胞, 泻药性结肠, 毒性

Abstract: Objective To investigate the intestinal toxicity and mechanisms of action of anthraquinone laxatives, so as to provide a reference for the rational use of anthraquinone laxatives. Methods A comprehensive review and analysis were conducted through literature and database searches on the mechanisms of intestinal toxicity of an-thraquinone compounds and the presence of these compounds in clinical drugs. Results Long-term use of anthraquinone-containing laxatives can damage the enteric nervous system and gastrointestinal pacemaker cells (interstitial cells of Cajal), leading to cathartic colon. Additionally, these compounds can cause damage and apoptosis of intestinal epithelial cells, resulting in melanosis coli. Correlative studies indicate a significant association between melanosis coli and the detection rates of colonic polyps and adenomas, though its link to colorectal cancer remains controversial. Conclusion Future development of laxative drugs and foods should prioritize balancing efficacy with intestinal toxicity. Systematic evaluation of the long-term effects of anthraquinone laxatives on interstitial cells of Cajal is necessary, along with the establishment of daily limits and usage duration guidelines. Restoring intestinal function is essential for addressing functional constipation. Hence, there is an urgent need to focus research on developing drugs or foods that can be used long-term and aid in the recovery of intestinal function.

Key words: Anthraquinones, Laxatives, Intestinal, Melanosis Coli, Enteric Nervous System, Interstitial Cells of Cajal, Cathartic Colon, Toxicity

中图分类号:

R975
R994.11

郑凯帆, 冷泓旭, 徐凯旋, 蔡文璐, 张颖, 赵朋飞, 谭圣杰, 辛贵忠. 蒽醌类泻剂肠道安全性研究进展[J]. 中国药物警戒, 2025, 22(6): 708-713.

ZHENG Kaifan, LENG Hongxu, XU Kaixuan, CAI Wenlu, ZHANG Ying, ZHAO Pengfei, TAN Shengjie, XIN Guizhong. Research Progress on Intestinal Safety of Anthraquinone Laxatives[J]. Chinese Journal of Pharmacovigilance, 2025, 22(6): 708-713.

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