文献类型：期刊文献

中文题名：基于“量-效-毒”探讨仝小林教授使用黄药子治疗甲亢临床经验

英文题名：Exploration of Dioscorea bulbifera L. in Treatment of Hyperthyroidism by Professor TONG Xiaolin Based on ‘Dose-Effect-Toxicity’

作者：胡诗宛[1,2];陈科宇[1,2];于晓彤[1];张伟[1,3]

第一作者：胡诗宛

机构：[1]中国中医科学院广安门医院,北京100053;[2]北京中医药大学,北京100029;[3]甘肃中医药大学,甘肃兰州730000

第一机构：中国中医科学院广安门医院,北京100053

年份：2023

卷号：51

期号：1

起止页码：89

中文期刊名：中医药学报

外文期刊名：Acta Chinese Medicine and Pharmacology

收录：CSTPCD

基金：中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者;中国中医科学院科技创新工程项目(CI2021A01611);中国中医科学院科技创新工程项目(CI2021A01605)。

语种：中文

中文关键词：黄药子;甲状腺功能亢进;量效;毒性;临床应用

外文关键词：Dioscorea bulbifera L.;Hyperthyroidism;Dose-effect;Toxicity;Clinical application

摘要：黄药子对甲状腺功能亢进症、亚急性甲状腺炎和甲状腺癌等疾病具有较好疗效,但由于黄药子具有肝毒性,使其在临床应用中受到极大限制。本文通过从古籍溯源到现代药理、毒理及抗毒研究,对黄药子治疗甲亢的“量-效-毒”进行全面认识。基于此,仝小林教授以黄药子作为治疗甲亢的核心靶药;在临床用量方面,仝教授常使用黄药子的剂量为9~15 g,且首次使用剂量一般不超过15 g;使用前需先查肝功能,肝功正常者方可用药;在用药过程中,常佐以茵陈、赤芍、五味子等“保肝靶药”对抗黄药子的肝毒性,并定期复查肝功能,一旦出现肝功能异常,应及时减量或停药。
Dioscorea bulbifera L.(Huangyaozi) has a good curative effect on hyperthyroidism, subacute thyroiditis and thyroid tumor, but its clinical application is greatly limited due to its hepatotoxicity. Through tracing ancient books, modern pharmacology, toxicology, and antitoxic researches on Huangyaozi, the ‘dose-effect-toxicity’ of Huangyaozi in treatment of hyperthyroidism has achieved a comprehensive recognition. Professor TONG Xiaolin considers Huangyaozi as the core target drug for hyperthyroidism. In terms of clinical dosage, Professor TONG often uses Huangyaozi at the dose of 9~15 g, and the initial dosage was usually no more than 15 g;liver function will be checked before medication, and only those with normal liver function can be given Huangyaozi. In the course of treatment, it is often supplemented with ‘liver protecting target drugs’ including Herba Artemisiae(Yinchen), Paeonia Rubra radix(Chishao) and Schisandra Chinensis(Wuweizi) to resist the liver toxicity of Huangyaozi. While taking Huangyaozi, it is necessary to monitor liver function regularly and reduce dose or stopped taking it in time in case of abnormal liver function.