摘要
该文通过文献分析附子在临床应用中产生不良反应的特点,为其临床安全使用提供借鉴,同时应用网络药理学技术预测其产生心脏毒性的机制,为有毒中药的毒性机制研究提供思路。通过检索附子不良反应的文献,建立数据库汇总附子产生的不良反应,分析发现临床使用附子产生不良反应主要原因在于超剂量使用、煎煮时间较短、食用药酒/药膳,另外还有外用及误服等。故临床中应严格规范附子用量,详细告知患者其煎煮方法,避免服用附子所泡药酒及药膳,以最大可能避免不良反应发生,使临床应用中尽其效而避其毒。同时基于文献汇总结果,应用网络药理学的技术方法,对附子产生心脏毒性进行网络构建及可视化分析,结果显示附子可作用于心肌细胞动作电位、心脏传导相关的细胞信号传导、心肌细胞收缩、参与收缩心肌细胞的动作电位、心房心肌细胞到房室结细胞的信号传导等8个生物进程及SCN5A,GJA1,GJA5等3个基因靶点,预测附子可能通过作用于SCN5A,GJA1,GJA5等3个基因靶点,调控钠离子通道蛋白、心脏缝隙连接蛋白的表达,影响心肌细胞除极及细胞间信息传递及物质交换,从而影响心脏节律及其结构和功能,产生心脏毒性。
The aim of this paper was to provide reference for the clinical safety use of aconite through the retrieval of literature about adverse reactions,predict its mechanism of cardiac toxicity by using network pharmacology,and provide ideas for the studies on toxicity mechanism of toxic Chinese medicines. The papers on adverse reactions of aconite were searched to established a database and summarize the adverse reactions of aconite. The results of literature review showed that the main causes for adverse reactions in clinical use of aconite included overdose use,short cooking time,consumption of medicinal liquor/medicinal diet,external use and misuse and so on. Therefore,the dosage of aconite should be strictly followed in clinical application,and the decoction method should be notified to the patients in detail to avoid taking the medicinal liquor and diet containing aconite,so as to prevent the occurrence of adverse reactions as much as possible,and make the best use of aconite in clinical application in avoid its toxicity. At the same time,based on the results of literature review,the network construction and visual analysis of cardio toxicity produced by aconite were carried out by using the network pharmacology technologies. Results showed that aconite can be applied to eight biological processes such as action potential of cardiac myocytes,cardiac conduction-related cell signal transduction,cardiac myocytes contraction,action potential involved in cardiac myocytes contraction,and signal transduction from atrial myocardial cells to atrioventricular node cells,and three target genes(SCN5 A,GJA1,GJA5). It was predicted that Aconiti Lateralis Radix Praeparata may influence cardiomyocyte depolarization,intercellular information transmission and material exchange by acting on three target genes(SCN5 A,GJA1,GJA5) and regulating the sodium channel protein and the expression of gap junction protein,thus affecting the heart rhythm as well as its structure and function and causing cardiac toxicity.
作者
何健
吴萍
董宇
高蕊
HE Jian;WU Ping;DONG Yu;QAO Rui(Office of Drug Clinical Trial Institution,Guang' anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Institute of Clinical Pharmacology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)
出处
《中国中药杂志》
CAS
CSCD
北大核心
2019年第5期1010-1018,共9页
China Journal of Chinese Materia Medica
关键词
附子
不良反应
文献分析
网络药理学
心脏毒性
Aconiti Lateralis Radix Praeparata
adverse reactions
literature analysis
network pharmacology
cardiac toxicity
