中国药物应用与监测
中國藥物應用與鑑測
중국약물응용여감측
CHINESE JOURNAL OF DRUG APPLICATION AND MONITORING
2014年
3期
173-176
,共4页
雷公藤%肝毒性%生殖毒性%血液毒性%药品不良反应
雷公籐%肝毒性%生殖毒性%血液毒性%藥品不良反應
뢰공등%간독성%생식독성%혈액독성%약품불량반응
Tripterygium wilfordii%Liver injury%Reproductive toxicity%Hematotoxicity%Adverse drug reaction
目的：了解雷公藤制剂所致肝毒性、生殖毒性、血液系统毒性不良反应发生的特点和规律，为促进其安全使用提供参考。方法：检索中国生物医学文献数据库、中国期刊全文数据库及中文科技期刊数据库，收集雷公藤制剂引起生殖毒性、肝毒性、血液系统毒性的病例，对其不良反应发生的特点进行归纳总结。结果：共检索到32篇文献，涉及病例43例。其中，致生殖毒性文献6篇，病例8例，主要临床表现为：闭经伴性欲减退，性激素水平下降，功能失调性子宫出血，卵巢、子宫萎缩等；致肝毒性文献7篇，病例10例，主要临床表现为：纳差、乏力、恶心、尿黄、黄疸、全身皮肤黏膜黄染、巩膜黄染、皮疹、发热等；致血液系统毒性文献19篇，病例25例，主要临床表现为：全身不适，腹痛，腹泻，伴发热，重度贫血、鼻出血、皮肤瘀斑等，严重者可致急性再生障碍性贫血，纯红再生障碍性贫血及粒细胞缺乏症、骨髓抑制、类白血病反应等。结论：雷公藤制剂具有肝毒性、生殖毒性和血液系统毒性，应严格掌握其适应证和禁忌证，控制合理的给药时间，小剂量、短期用药，关注配伍减毒和禁忌，选用新剂型如缓释片、双层栓剂等可以在一定程度上减少其不良反应的发生。
目的：瞭解雷公籐製劑所緻肝毒性、生殖毒性、血液繫統毒性不良反應髮生的特點和規律，為促進其安全使用提供參攷。方法：檢索中國生物醫學文獻數據庫、中國期刊全文數據庫及中文科技期刊數據庫，收集雷公籐製劑引起生殖毒性、肝毒性、血液繫統毒性的病例，對其不良反應髮生的特點進行歸納總結。結果：共檢索到32篇文獻，涉及病例43例。其中，緻生殖毒性文獻6篇，病例8例，主要臨床錶現為：閉經伴性欲減退，性激素水平下降，功能失調性子宮齣血，卵巢、子宮萎縮等；緻肝毒性文獻7篇，病例10例，主要臨床錶現為：納差、乏力、噁心、尿黃、黃疸、全身皮膚黏膜黃染、鞏膜黃染、皮疹、髮熱等；緻血液繫統毒性文獻19篇，病例25例，主要臨床錶現為：全身不適，腹痛，腹瀉，伴髮熱，重度貧血、鼻齣血、皮膚瘀斑等，嚴重者可緻急性再生障礙性貧血，純紅再生障礙性貧血及粒細胞缺乏癥、骨髓抑製、類白血病反應等。結論：雷公籐製劑具有肝毒性、生殖毒性和血液繫統毒性，應嚴格掌握其適應證和禁忌證，控製閤理的給藥時間，小劑量、短期用藥，關註配伍減毒和禁忌，選用新劑型如緩釋片、雙層栓劑等可以在一定程度上減少其不良反應的髮生。
목적：료해뢰공등제제소치간독성、생식독성、혈액계통독성불량반응발생적특점화규률，위촉진기안전사용제공삼고。방법：검색중국생물의학문헌수거고、중국기간전문수거고급중문과기기간수거고，수집뢰공등제제인기생식독성、간독성、혈액계통독성적병례，대기불량반응발생적특점진행귀납총결。결과：공검색도32편문헌，섭급병례43례。기중，치생식독성문헌6편，병례8례，주요림상표현위：폐경반성욕감퇴，성격소수평하강，공능실조성자궁출혈，란소、자궁위축등；치간독성문헌7편，병례10례，주요림상표현위：납차、핍력、악심、뇨황、황달、전신피부점막황염、공막황염、피진、발열등；치혈액계통독성문헌19편，병례25례，주요림상표현위：전신불괄，복통，복사，반발열，중도빈혈、비출혈、피부어반등，엄중자가치급성재생장애성빈혈，순홍재생장애성빈혈급립세포결핍증、골수억제、류백혈병반응등。결론：뢰공등제제구유간독성、생식독성화혈액계통독성，응엄격장악기괄응증화금기증，공제합리적급약시간，소제량、단기용약，관주배오감독화금기，선용신제형여완석편、쌍층전제등가이재일정정도상감소기불량반응적발생。
Objective: To investigate the characteristics and rules about liver injury, reproductive toxicity, and hematotoxicity caused by the tripterygium wilfordii herb and its preparations, in order to provide references for the safety use in clinic. Methods:The case reports on reproductive toxicity, liver injury and hematotoxicity caused by tripterygium wilfordii herb and its preparations were collected from China Biology Medicine disc, The Chinese Journal Full-text Database, and the VIP Chinese Scientific and Technical Periodicals Database. The characteristics of these ADR cases were analyzed. Results:There were 43 ADR cases reported in 32 articles. The main clinical manifestations of eight reproductive toxicity cases reported in six articles were amenorrhea with hypaphrodisia, decline of sex hormones level, dysfunctional uterine bleeding, atrophy of ovary and uterus. The main clinical manifestations of ten liver injury cases reported in seven articles were jaundice, icteric sclera, erythra, fever, and so on. The main clinical manifestations of twenty-ifve hematotoxicity cases reported in nineteen articles were general malaise, anemia, hemorrhinia, skin ecchymosis, acute aplastic anemia, pure red cell aplasia, etc. Conclusion:Tripterygium wilfordii preparations can induce the damage of reproductive system, liver and blood system, which can be alleviated by complying with its indication and contraindication, choosing rational medication time, small dose and short-time medication, paying more attention to the compatibility, selecting the new preparations, and so on.
