配伍甘草对大黄泻下作用影响研究进展.docVIP

配伍甘草对大黄泻下作用影响研究进展 　　[摘要]大黄是一味常用大宗药材，临床上配伍应用非常广泛。蒽醌类物质为其泻下作用主要活性成分，中医认为大黄泻下峻猛为大黄的毒性。有着“国老”美誉的甘草，一直被认为是解毒圣药，缓和药性，调和诸药。该文将大黄配伍甘草减毒作用分为煎煮过程、肠道代谢2个环节，分别从化学成分、肠道菌群、Ⅰ/Ⅱ相代谢、药物转运方面综述近年来大黄配伍甘草减毒的研究进展。二者配伍的物质基础和机制仍不完全清楚，甚至有相左的结果出现，有待深入研究。 　　[关键词]大黄;甘草;配伍;代谢 　　Advance in studies on effect of Glycyrrhizae Radix et Rhizoma in relieving 　　purgative activity of Rhei Radix et Rhizoma 　　SU Bin， LI Xiao-bo* 　　（School of Pharmacy， Shanghai Jiao Tong University， Shanghai 200240， China） 　　[Abstract]Rhei Radix et Rhizoma， as a commonly used traditional Chinese medicine， has been widely applied in clinic. Its major purgative constituent is anthraquinones， which are believed to be a toxic ingredient. Glycyrrhizae Radix et Rhizoma has been reputed as the best alexipharmic to moderate medicine natures. In this paper， the effect of Glycyrrhizae Radix et Rhizoma in relieving purgative activity of Rhei Radix et Rhizoma was studied in two aspects-the boiling process and intestinal metabolism; Studies on combined administration of Glycyrrhizae Radix et Rhizoma and Rhei Radix et Rhizoma in recent years were summarized according to chemical constituent， intestinal flora， I/II phase metabolism and drug transport. However， the material basis and mechanism for their compatibility remain unclear， further studies will be made in the future. 　　[Key words]Rhei Radix et Rhizoma; Glycyrrhizae Radix et Rhizoma; compatibility; metabolism 　　doi：10.4268/cjcm 　　大黄性寒、味苦，有泻下攻积、清热泻火，凉血解毒、逐瘀通经、利湿退黄功效lt;supgt;[1]lt;/supgt;。中医临床常用于实热便秘，食积痞满腹痛或泻痢里急后重，头痛目赤，牙龈肿痛，口舌生疮，吐血，衄血，瘀血经闭，产后瘀阻，?Y瘕积聚，黄疸，水肿，热淋，痈肿疮毒等病证。大黄自古就有“将军”之称，临床取其泻下攻积治疗便秘，广为人知。与不同药物配伍使用有更广的临床作用lt;supgt;[2]lt;/supgt;，与甘草配伍如《金匮要略》的大黄甘草汤（大黄、甘草）、《伤寒论》的调胃承气汤（大黄、芒硝、甘草） 。甘草味甘、性平，可缓急止痛，调和药性。《本经疏证》云：凡为方二百五十，甘草者百二十方，非甘草主病多，乃诸方必和甘草，始能曲当病情lt;supgt;[3]lt;/supgt;，故有“十方九草”之说。甘草“通经脉，利血气，解百药毒”，大黄配伍甘草，大黄峻猛之力可缓行，可治胃肠邪热积滞之大便不通、发斑、口齿咽痛等症，如《伤寒论》中的调胃承气汤lt;supgt;[4]lt;/supgt;。 　　大黄为蓼科植物掌叶大黄Rheum palmatum L唐古特大黄R tanguicum Maximex Balf，或药用大黄R officinale Baill的干燥根和根茎l