中国中药杂志

2015, v.40(14) 2765-2773

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中药注射剂类过敏研究进展
Advance and prospect in studies on anaphylactoid reaction of traditional Chinese medicine injections

徐煜彬;窦德强;
XU Yu-bin;DOU De-qiang;College of Pharmacy,Liaoning University of Traditional Chinese Medicine;

摘要(Abstract):

中药注射剂由于起效迅速,生物利用度高,已被广泛应用在临床危急重症领域。近年来随着其临床不良反应报道的增多,已越来越引起人们重视,其中急性过敏反应为其主要的不良反应。急性过敏包括I型过敏和类过敏,其中后者占77%以上,为中药注射剂的主要不良反应,目前已发现多种中药注射剂包括鱼腥草注射液和生脉注射液等导致严重的类过敏反应的发生。但是国内外对类过敏反应产生的机制尚不完全清楚,均未建立评价中药致敏原的类过敏标准动物模型,有关中药注射剂类过敏反应的技术指导原则尚未制定,相关机制及类过敏成分尚不明确,相关研究方法也比较单一。该文主要从类过敏反应机制、评价指标及评价方法 3方面对中药注射剂类过敏进行综述。类过敏反应机制主要包括直接刺激途径、补体途径、凝血途径、激肽释放酶-激肽途径和急性过敏途径共5条途径;评价方法主要包括整体动物模型和体外细胞模型;综述评价指标主要分析了类过敏发生途径的特征指标及类过敏发生后效应物质指标。
Because of the rapid action and high bioavailability,traditional Chinese medicine injections( TCMIs) had been widely used in clinical critical field. In recent years,with the increasing reports of clinical adverse reaction,more and more attention was paid to them,and acute allergic reaction was the main adverse reaction. Acute allergic reaction included type-I anaphylaxis reaction and anaphylactoid reaction,the latter had been found in a variety of TCMIs and accounted for 77% of adverse reaction. But the mechanism of anaphylactoid reaction was not completely understood,the standard animal model for TCMIs was not established,and the technical guidance for anaphylactoid reaction was not formulated. Thus the three aspects included mechanism,evaluation index and evaluation methods of TCMIs for anaphylactoid were reviewed. Five ways including direct stimulating pathway,complement pathway,coagulation pathway,kallikrein-kinin pathway and acute allergic pathway were the main mechanism of anaphylactoid reaction; whole animal model and cell model were the main evaluation methods; the occurrence index and effect index were reviewed for the evaluation index analysis.

关键词(KeyWords): 中药注射剂;不良反应;类过敏反应
traditional Chinese medicine injections;adverse reactions;anaphylactoid reaction

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81373939);; 辽宁省高等学校创新团队项目(LT2013020)

作者(Authors): 徐煜彬;窦德强;
XU Yu-bin;DOU De-qiang;College of Pharmacy,Liaoning University of Traditional Chinese Medicine;

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