Article(id=1210517370184003586, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1210517366081975259, articleNumber=null, orderNo=null, doi=10.16438/j.0513-4870.2022-0586, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1657555200000, receivedDateStr=2022-07-12, revisedDate=1662912000000, revisedDateStr=2022-09-12, acceptedDate=null, acceptedDateStr=null, onlineDate=1766539431377, onlineDateStr=2025-12-24, pubDate=1668182400000, pubDateStr=2022-11-12, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1766539431377, onlineIssueDateStr=2025-12-24, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1766539431377, creator=13701087609, updateTime=1766539431377, updator=13701087609, issue=Issue{id=1210517366081975259, tenantId=1146029695717560320, journalId=1189982191388893191, year='2022', volume='57', issue='11', pageStart='3259', pageEnd='3450', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1766539430399, creator=13701087609, updateTime=1766539608198, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1210518111875363690, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1210517366081975259, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1210518111875363691, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1210517366081975259, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3365, endPage=3370, ext={EN=ArticleExt(id=1210517370712485926, articleId=1210517370184003586, tenantId=1146029695717560320, journalId=1189982191388893191, language=EN, title=A novel perspective of health risk assessment of heavy metals in Chinese herbal medicine—Probabilistic risk assessment, taking Plantago asiatica L. as an example, columnId=1190335348761793317, journalTitle=Acta Pharmaceutica Sinica, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=

In order to establish the probabilistic risk assessment method for heavy metals and harmful elements in line with the characteristics of traditional Chinese medicine (TCM) and provide guidance for the safe use of TCM, the contents of lead (Pb), cadmium (Cd), arsenic (as), mercury (Hg) and copper (Cu) in 21 batches of Plantago asiatica L. were determined by inductively coupled plasma mass spectrometry (ICP-MS). By the comprehensive use of investigation of TCM consumption pattern and Monte Carlo simulation technology, the non-carcinogenic and carcinogenic health risks of heavy metals and harmful elements in TCM were assessed by hazard quotient (HQ) and cancer risk (CR), respectively. The greatest risk contributors were screened through sensitivity analysis. The results revealed that the mean contents of Pb, Cd, As, Hg and Cu in Plantago asiatica L. were 9.01, 0.28, 3.83, 0.01 and 12.82 mg·kg-1, respectively. The P95, P99 and maximum values of HQ for males were 1.41, 2.83 and 10.97 mg·kg-1, respectively. The P95, P99 and maximum values of HQ for females were 1.27, 2.63 and 9.80 mg·kg-1, respectively. The P95, P99 and maximum values of HI for males were 1.44, 2.85 and 11.0 mg·kg-1, respectively. The P95, P99 and maximum values of HI for females were 1.29, 2.66 and 10.0 mg·kg-1, respectively. The P99 and maximum values for CRAs and total carcinogenic risk (TCR) were greater than 10-4 for both men and women. The risk assessment results indicated that the non-carcinogenic and carcinogenic health risks of high exposure population caused by arsenic exposure are needed to be concern. The results of sensitivity analysis showed that the exposure frequency of TCM and the arsenic concentrations in Plantago asiatica L. were the main risk contributors. Based on Monte Carlo simulation technology and considering the characteristics of TCM, this study puts forward the first example of probabilistic risk assessment of heavy metals and harmful elements in Chinese herbal medicine, which provides a novel perspective for health risk assessment of heavy metals in TCM.

, correspAuthors=Sheng WEI, Shuang-cheng MA, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2022 Acta Pharmaceutica Sinica. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Tian-tian ZUO, Jia-lin LIU, Yi-ling LI, Hong-yu JIN, Yi-qin FEI, Jing NIE, Sheng WEI, Shuang-cheng MA), CN=ArticleExt(id=1210517371089973319, articleId=1210517370184003586, tenantId=1146029695717560320, journalId=1189982191388893191, language=CN, title=中草药重金属及有害元素健康风险评估新视角——概率风险评估, 以车前草为例, columnId=1190335348896011050, journalTitle=药学学报, columnName=研究论文, runingTitle=null, highlight=null, articleAbstract=

建立符合中药使用特点的重金属及有害元素概率风险评估方法, 以期为中药的安全使用提供指导, 采用电感耦合等离子体质谱法(ICP-MS)对21批车前草中铅(Pb)、镉(Cd)、砷(As)、汞(Hg)和铜(Cu)的残留量进行测定; 结合中药消费模式调查, 基于蒙特卡洛模拟技术分别采用风险熵(HQ)和致癌风险(CR)对车前草中重金属及有害元素导致的非致癌性和致癌性健康风险进行概率评估; 通过敏感性分析筛选出风险贡献最为显著的因素。结果车前草中铅、镉、砷、汞、铜的均值分别为9.01、0.28、3.83、0.01和12.82mg·kg-1。男性HQAS的P95分位值、P99分位值和最大值分别为1.41、2.83和10.97;女性HQAS的P95分位值、P99分位值和最大值分别为1.27、2.63、9.80。男性HI的P95分位值、P99分位值和最大值分别为1.44、2.85、11.0;女性HI的P95分位值、P99分位值和最大值分别为1.29、2.66、10.0。无论男性还是女性, CRAs和总致癌风险(TCR)的P99分位值、最大值均大于10-4。风险评估结果说明砷暴露引起的高端暴露人群非致癌性和致癌性健康风险均需要被关注。敏感性分析结果显示, 中药服用频率和车前草中砷的浓度是最主要的风险影响因素。本研究基于蒙特卡洛模拟技术, 并考虑中药服用特点, 首次提出中草药重金属及有害元素健康风险概率风险评估范例, 为中药重金属及有害元素健康风险评估提供新视角。

, correspAuthors=魏晟, 马双成, authorNote=null, correspAuthorsNote=
*魏晟, E-mail: ;
马双成, Tel: 86-10-53852076, E-mail:
, copyrightStatement=版权所有©《药学学报》编辑部2022, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=a1FkLGFk4WwHmvA8lDfOEg==, magXml=sFXfQCTk6vbL/Y8zPcTeFg==, pdfUrl=null, pdf=rduGQEGalN00d8JKivqzqg==, pdfFileSize=557320, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=0ld8ybvHjge3dAkSpgGRkA==, mapNumber=null, authorCompany=null, fund=null, authors=

#共同第一作者.

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(1997-05-15)[2012-09-10]. https://www.epa.gov/risk/policy-use-probabilistic-analysis-risk-assessment-epa., articleTitle=null, refAbstract=null)], funds=[Fund(id=1210517378560029118, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210517370184003586, awardId=2018ZX09735006, language=CN, fundingSource=国家十三五“重大新药创制”课题(2018ZX09735006), fundOrder=null, country=null), Fund(id=1210517378664886723, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210517370184003586, awardId=2020A3, language=CN, fundingSource=中国食品药品检定研究院中青年基金资助项目(2020A3), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1210517371278717016, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210517370184003586, xref=null, ext=[AuthorCompanyExt(id=1210517371287105625, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210517370184003586, companyId=1210517371278717016, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1. 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No.Batch No.Content/mg·kg-1
PbCdAsHgCu
1QC0014.520.070.830.0115.04
2QC06913.920.3311.570.0131.08
3QC07011.890.957.060.0120.32
4QC0790.370.101.280.027.80
5QC0840.320.081.470.026.82
6QC0860.680.113.090.018.17
7QC0961.790.200.260.027.02
8QC1009.780.252.720.0110.34
9QC10138.560.294.900.0111.25
10QC1098.650.282.320.0116.34
11QC11847.120.6114.530.0212.55
12QC12010.440.3811.230.038.56
13QC1212.990.091.440.018.30
14QC1625.610.182.090.0114.06
15QC1697.010.163.060.0114.27
16QC1704.221.020.900.0113.10
17QC1844.630.182.650.0114.15
18QC1852.010.121.080.0110.95
19QC1863.980.152.110.0112.92
20QC1937.150.323.830.0114.48
21QC1943.540.112.050.0011.74
), ArticleFig(id=1210517376886501778, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210517370184003586, language=CN, label=Table 1, caption=

Contents of heavy metals in Plantago asiatica L.

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No.Batch No.Content/mg·kg-1
PbCdAsHgCu
1QC0014.520.070.830.0115.04
2QC06913.920.3311.570.0131.08
3QC07011.890.957.060.0120.32
4QC0790.370.101.280.027.80
5QC0840.320.081.470.026.82
6QC0860.680.113.090.018.17
7QC0961.790.200.260.027.02
8QC1009.780.252.720.0110.34
9QC10138.560.294.900.0111.25
10QC1098.650.282.320.0116.34
11QC11847.120.6114.530.0212.55
12QC12010.440.3811.230.038.56
13QC1212.990.091.440.018.30
14QC1625.610.182.090.0114.06
15QC1697.010.163.060.0114.27
16QC1704.221.020.900.0113.10
17QC1844.630.182.650.0114.15
18QC1852.010.121.080.0110.95
19QC1863.980.152.110.0112.92
20QC1937.150.323.830.0114.48
21QC1943.540.112.050.0011.74
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HQGenderMinP25P50P75P90P95P99MaxMean
HQPbMale1.56×10-61.56×10-36.06×10-32.38×10-26.55×10-20.110.230.702.37×10-2
Female2.95×10-61.72×10-35.99×10-32.21×10-26.02×10-20.100.220.832.22×10-2
HQCdMale1.20×10-52.58×10-49.41×10-43.57×10-39.36×10-31.48×10-22.97×10-20.163.33×10-3
Female1.33×10-52.83×10-49.61×10-43.29×10-38.20×10-31.30×10-22.68×10-20.173.04×10-3
HQAsMale2.58×10-40.020.090.330.891.412.8310.970.31
Female1.72×10-50.030.090.310.791.272.639.800.29
HQHgMale2.04×10-82.72×10-51.06×10-44.22×10-41.16×10-31.94×10-34.15×10-31.31×10-24.24×10-4
Female3.88×10-82.99×10-51.05×10-43.90×10-41.07×10-31.80×10-33.98×10-31.56×10-23.97×10-4
HQCuMale1.67×10-53.93×10-41.51×10-35.56×10-31.35×10-22.03×10-23.39×10-26.19×10-24.61×10-3
Female2.89×10-54.31×10-41.51×10-35.04×10-31.22×10-21.85×10-23.32×10-28.08×10-24.31×10-3
HIMale7.13×10-44.67×10-20.130.380.921.442.8511.00.35
Female1.67×10-34.80×10-20.120.340.831.292.6610.00.32
), ArticleFig(id=1210517378203513252, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210517370184003586, language=CN, label=Table 2, caption=

Probabilistic estimation of hazard quotient (HQ) and hazard index (HI) of heavy metals

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HQGenderMinP25P50P75P90P95P99MaxMean
HQPbMale1.56×10-61.56×10-36.06×10-32.38×10-26.55×10-20.110.230.702.37×10-2
Female2.95×10-61.72×10-35.99×10-32.21×10-26.02×10-20.100.220.832.22×10-2
HQCdMale1.20×10-52.58×10-49.41×10-43.57×10-39.36×10-31.48×10-22.97×10-20.163.33×10-3
Female1.33×10-52.83×10-49.61×10-43.29×10-38.20×10-31.30×10-22.68×10-20.173.04×10-3
HQAsMale2.58×10-40.020.090.330.891.412.8310.970.31
Female1.72×10-50.030.090.310.791.272.639.800.29
HQHgMale2.04×10-82.72×10-51.06×10-44.22×10-41.16×10-31.94×10-34.15×10-31.31×10-24.24×10-4
Female3.88×10-82.99×10-51.05×10-43.90×10-41.07×10-31.80×10-33.98×10-31.56×10-23.97×10-4
HQCuMale1.67×10-53.93×10-41.51×10-35.56×10-31.35×10-22.03×10-23.39×10-26.19×10-24.61×10-3
Female2.89×10-54.31×10-41.51×10-35.04×10-31.22×10-21.85×10-23.32×10-28.08×10-24.31×10-3
HIMale7.13×10-44.67×10-20.130.380.921.442.8511.00.35
Female1.67×10-34.80×10-20.120.340.831.292.6610.00.32
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CRGenderMinP25P50P75P90P95P99MaxMean
CRPbMale4.64×10-124.64×10-91.80×10-87.08×10-81.95×10-73.21×10-76.81×10-72.08×10-67.05×10-8
Female8.77×10-125.13×10-91.78×10-86.57×10-81.79×10-72.99×10-76.50×10-72.48×10-66.60×10-8
CRCdMale7.30×10-91.58×10-75.74×10-72.18×10-65.71×10-69.01×10-61.81×10-59.70×10-52.03×10-6
Female8.13×10-91.73×10-75.86×10-72.00×10-65.00×10-67.91×10-61.63×10-51.02×10-41.85×10-6
CRAsMale1.16×10-81.04×10-63.85×10-61.50×10-53.99×10-56.36×10-51.27×10-44.94×10-41.41×10-5
Female7.73×10-91.15×10-63.90×10-61.38×10-53.56×10-55.71×10-51.18×10-44.41×10-41.30×10-5
TCRMale8.06×10-82.33×10-66.53×10-61.82×10-54.22×10-56.62×10-51.29×10-44.94×10-41.62×10-5
Female9.71×10-82.43×10-66.21×10-61.63×10-53.83×10-55.94×10-51.21×10-44.44×10-41.50×10-5
), ArticleFig(id=1210517378425811381, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210517370184003586, language=CN, label=Table 3, caption=

Carcinogenic risk (CR) values of Pb, Cd and As. TCR: Total CR

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CRGenderMinP25P50P75P90P95P99MaxMean
CRPbMale4.64×10-124.64×10-91.80×10-87.08×10-81.95×10-73.21×10-76.81×10-72.08×10-67.05×10-8
Female8.77×10-125.13×10-91.78×10-86.57×10-81.79×10-72.99×10-76.50×10-72.48×10-66.60×10-8
CRCdMale7.30×10-91.58×10-75.74×10-72.18×10-65.71×10-69.01×10-61.81×10-59.70×10-52.03×10-6
Female8.13×10-91.73×10-75.86×10-72.00×10-65.00×10-67.91×10-61.63×10-51.02×10-41.85×10-6
CRAsMale1.16×10-81.04×10-63.85×10-61.50×10-53.99×10-56.36×10-51.27×10-44.94×10-41.41×10-5
Female7.73×10-91.15×10-63.90×10-61.38×10-53.56×10-55.71×10-51.18×10-44.41×10-41.30×10-5
TCRMale8.06×10-82.33×10-66.53×10-61.82×10-54.22×10-56.62×10-51.29×10-44.94×10-41.62×10-5
Female9.71×10-82.43×10-66.21×10-61.63×10-53.83×10-55.94×10-51.21×10-44.44×10-41.50×10-5
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中草药重金属及有害元素健康风险评估新视角——概率风险评估, 以车前草为例
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左甜甜 1, # , 刘佳琳 2, # , 李依玲 2 , 金红宇 1 , 费毅琴 3 , 聂晶 3 , 魏晟 2, * , 马双成 1, *
药学学报 | 研究论文 2022,57(11): 3365-3370
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药学学报 | 研究论文 2022, 57(11): 3365-3370
中草药重金属及有害元素健康风险评估新视角——概率风险评估, 以车前草为例
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左甜甜1, #, 刘佳琳2, #, 李依玲2, 金红宇1, 费毅琴3, 聂晶3, 魏晟2, * , 马双成1, *
作者信息
  • 1.中国食品药品检定研究院, 北京 100050
  • 2.华中科技大学同济医学院公共卫生学院, 湖北 武汉 430030
  • 3.湖北省药品监督检验研究院, 湖北 武汉 430075

通讯作者:

*魏晟, E-mail: ;
马双成, Tel: 86-10-53852076, E-mail:
A novel perspective of health risk assessment of heavy metals in Chinese herbal medicine—Probabilistic risk assessment, taking Plantago asiatica L. as an example
Tian-tian ZUO1, Jia-lin LIU2, Yi-ling LI2, Hong-yu JIN1, Yi-qin FEI3, Jing NIE3, Sheng WEI2, * , Shuang-cheng MA1, *
Affiliations
  • 1. National Institutes for Food and Drug Control, Beijing 100050, China
  • 2. School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
  • 3. Hubei Institute for Drug Control, Wuhan 430075, China
出版时间: 2022-11-12 doi: 10.16438/j.0513-4870.2022-0586
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建立符合中药使用特点的重金属及有害元素概率风险评估方法, 以期为中药的安全使用提供指导, 采用电感耦合等离子体质谱法(ICP-MS)对21批车前草中铅(Pb)、镉(Cd)、砷(As)、汞(Hg)和铜(Cu)的残留量进行测定; 结合中药消费模式调查, 基于蒙特卡洛模拟技术分别采用风险熵(HQ)和致癌风险(CR)对车前草中重金属及有害元素导致的非致癌性和致癌性健康风险进行概率评估; 通过敏感性分析筛选出风险贡献最为显著的因素。结果车前草中铅、镉、砷、汞、铜的均值分别为9.01、0.28、3.83、0.01和12.82mg·kg-1。男性HQAS的P95分位值、P99分位值和最大值分别为1.41、2.83和10.97;女性HQAS的P95分位值、P99分位值和最大值分别为1.27、2.63、9.80。男性HI的P95分位值、P99分位值和最大值分别为1.44、2.85、11.0;女性HI的P95分位值、P99分位值和最大值分别为1.29、2.66、10.0。无论男性还是女性, CRAs和总致癌风险(TCR)的P99分位值、最大值均大于10-4。风险评估结果说明砷暴露引起的高端暴露人群非致癌性和致癌性健康风险均需要被关注。敏感性分析结果显示, 中药服用频率和车前草中砷的浓度是最主要的风险影响因素。本研究基于蒙特卡洛模拟技术, 并考虑中药服用特点, 首次提出中草药重金属及有害元素健康风险概率风险评估范例, 为中药重金属及有害元素健康风险评估提供新视角。

车前草  /  重金属  /  有害元素  /  蒙特卡洛模拟  /  概率风险评估  /  敏感性分析

In order to establish the probabilistic risk assessment method for heavy metals and harmful elements in line with the characteristics of traditional Chinese medicine (TCM) and provide guidance for the safe use of TCM, the contents of lead (Pb), cadmium (Cd), arsenic (as), mercury (Hg) and copper (Cu) in 21 batches of Plantago asiatica L. were determined by inductively coupled plasma mass spectrometry (ICP-MS). By the comprehensive use of investigation of TCM consumption pattern and Monte Carlo simulation technology, the non-carcinogenic and carcinogenic health risks of heavy metals and harmful elements in TCM were assessed by hazard quotient (HQ) and cancer risk (CR), respectively. The greatest risk contributors were screened through sensitivity analysis. The results revealed that the mean contents of Pb, Cd, As, Hg and Cu in Plantago asiatica L. were 9.01, 0.28, 3.83, 0.01 and 12.82 mg·kg-1, respectively. The P95, P99 and maximum values of HQ for males were 1.41, 2.83 and 10.97 mg·kg-1, respectively. The P95, P99 and maximum values of HQ for females were 1.27, 2.63 and 9.80 mg·kg-1, respectively. The P95, P99 and maximum values of HI for males were 1.44, 2.85 and 11.0 mg·kg-1, respectively. The P95, P99 and maximum values of HI for females were 1.29, 2.66 and 10.0 mg·kg-1, respectively. The P99 and maximum values for CRAs and total carcinogenic risk (TCR) were greater than 10-4 for both men and women. The risk assessment results indicated that the non-carcinogenic and carcinogenic health risks of high exposure population caused by arsenic exposure are needed to be concern. The results of sensitivity analysis showed that the exposure frequency of TCM and the arsenic concentrations in Plantago asiatica L. were the main risk contributors. Based on Monte Carlo simulation technology and considering the characteristics of TCM, this study puts forward the first example of probabilistic risk assessment of heavy metals and harmful elements in Chinese herbal medicine, which provides a novel perspective for health risk assessment of heavy metals in TCM.

Plantago asiatica L.  /  heavy metal  /  harmful element  /  Monte Carlo simulation  /  probabilistic risk assessment  /  sensitivity analysis
左甜甜, 刘佳琳, 李依玲, 金红宇, 费毅琴, 聂晶, 魏晟, 马双成. 中草药重金属及有害元素健康风险评估新视角——概率风险评估, 以车前草为例. 药学学报, 2022 , 57 (11) : 3365 -3370 . DOI: 10.16438/j.0513-4870.2022-0586
Tian-tian ZUO, Jia-lin LIU, Yi-ling LI, Hong-yu JIN, Yi-qin FEI, Jing NIE, Sheng WEI, Shuang-cheng MA. A novel perspective of health risk assessment of heavy metals in Chinese herbal medicine—Probabilistic risk assessment, taking Plantago asiatica L. as an example[J]. Acta Pharmaceutica Sinica, 2022 , 57 (11) : 3365 -3370 . DOI: 10.16438/j.0513-4870.2022-0586
车前草是车前科植物车前Plantago asiatica L.的干燥全草。现代药理研究表明, 车前草具有抗菌消炎、抗病毒、祛痰、降血脂、利尿、抗氧化等作用, 且药源丰富, 廉价易得, 是一种极具发展价值的中草药[1, 2]。然而, 前期样品筛查中发现全草类植物药重金属及有害元素的残留量最高, 高于根茎类、花类、果实类、种子类中药材[3]。重金属及有害元素(Pb、Cd、As、Hg、Cu等) 是一类国际公认的环境污染物, 难以被降解, 中药材一旦被重金属及有害元素污染, 在人体中积蓄, 可能会严重危害人体健康, 影响中药材的安全用药[4-9]。那么, 精准识别中药中重金属及有害元素对人体健康造成的危害, 进而采取有效的外源性有害残留物风险控制措施尤为重要。
国内外众多专家学者及相关国际研究组织在环境、食品等领域对于风险评估进行了不断渐近的探索, 提出了“四步骤” (危害识别、危害特征描述、暴露评估和风险特征描述) 的确定性健康风险评估模型, 极大地促进了食品、环境等领域风险评估体系的发展[10-15]。然而, 中药材重金属及有害元素污染本身具有危害面广、持久性强的特点, 且不同年龄阶段或人群所经历的风险差异较大, 多变性和随机性贯穿中药材重金属及有害元素污染健康风险传递的全过程, 往往造成健康风险评估存在高度不确定性和潜在复杂性。因此, 如何处理重金属及有害元素污染健康风险评估中的不确定性, 成为风险评估领域的研究新焦点。基于此, 概率风险评估(probabilistic risk assessment) 应时而生, 成为风险评估领域的新趋势。
近年来, 基于蒙特卡罗模拟技术的概率风险评估模型已成功运用于工矿、土壤中重金属及有害元素污染的健康风险评估中[16-18]。然而, 迄今少有对于中药概率风险评估的报道, 亟需建立符合中药使用特点的概率风险评估模型。本研究以前期样品筛查中发现的重金属及有害元素残留量较高的全草类中药材车前草为研究对象, 首次采用蒙特卡罗模拟, 探索符合中药使用特点的概率风险评估模型, 以期为科学、客观地评价中药中重金属及有害元素的健康风险并为实现精准的风险控制和指导中药安全使用提供科学依据。
材料  车前草购买于药材市场和零售药店, 来自湖北(9批)、云南(2批)、河南(3批)、山东(1批)、辽宁(1批)、江西(1批)、甘肃(3批)、四川(1批) 等地区, 总计21批, 由湖北省药品监督检验研究院费毅琴副研究员鉴定为Plantago asiatica L.的干燥全草。
质谱条件  采用Agilent 7700X ICP-MS (美国Agilent公司) 对于样品中重金属及有害元素进行测定。等离子气流量: 15.0 L·min-1; 蠕动泵0.20 r·s-1; 雾化室温度: 2 ℃; 载气流量: 0.8 L·min-1; He气流量: 5 mL·min-1; 辅助气流量: 0.8 L·min-1; 射频功率: 1 550 W; 重复次数: 3次; 采样深度: 10 mm; 扫描次数: 100次。
样品测定和质量控制  车前草中重金属及有害元素残留量的测定由湖北省药品监督检验研究院完成, 参照《中华人民共和国药典》2020年版四部收录的“电感耦合等离子体质谱法(ICP-MS)”进行测定, 并采用随行质量控制(包括空白实验、精密度实验、同位素内标实验和随行回收实验) 来确认方法的适用性, 结果均符合残留检测要求。
风险评估  本研究采用蒙特卡罗模拟对于中药材车前草中Pb、Cd、As、Hg、Cu的健康风险进行概率评估。本研究通过软件Rv.4.1.0, 经过20 000次的迭代模拟计算车前草重金属及有害元素暴露量和健康风险。
暴露评估  每千克体重重金属及有害元素日暴露量按公式1计算。
$ {\rm{Exp}} = \frac{{\mathrm{E}}{\mathrm{F}}\times {\mathrm{E}}{\mathrm{d}}\times {\mathrm{I}}{\mathrm{R}}\times C\times t}{{\mathrm{W}}\times {\mathrm{A}}{\mathrm{T}}} $
公式1中Exp为每千克体重重金属及有害元素的日暴露量, 单位为μg·kg-1; Ed为一生服用中药的年限, 根据国家食品安全风险评估中心在全国11个省份范围内20 917名调查者的有效消费调查问卷, Ed为20年; t为经过煎煮等方式提取后Pb、Cd、As、Hg、Cu的转移率, 分别为14%、14%、35%、24%、14%[19]; AT为平均寿命天数= 365×70 = 25 550; W为个体体重(kg); EF为中药材的服用频率(天/年); IR为处方中药材的日摄入量; C为中药材中重金属及有害元素的残留量, 单位为mg·kg-1。分别赋予车前草中重金属及有害元素浓度(C)、日摄入量(IR)、服用频率(EF) 等参数概率分布, 首先对数据采用分布拟合, 再采用蒙特卡罗模拟技术进行20 000次迭代运算, 根据得到的一系列风险值输出概率分布。
非致癌性风险特征描述  采用危害熵(hazard quotient, HQ) 表征单一元素暴露产生的非致癌性健康风险, 按照公式2计算HQ。
$ {\mathrm{H}}{\mathrm{Q}}=\frac{{\mathrm{E}}{\mathrm{x}}{\mathrm{p}}\times 10}{{\mathrm{R}}{\mathrm{f}}{\mathrm{d}}} $
公式2中Exp为公式1计算得到的日暴露量(μg·kg-1); 10为安全因子; Rfd为重金属及有害元素的健康指导值(μg·kg-1)[20]。车前草中重金属及有害元素所产生的累积非致癌健康风险为各元素HQ之和。采用危害指数表征重金属及有害元素联合暴露产生的非致癌性健康风险, 按公式3计算危害指数(hazard index, HI)。若HI ≤ 1, 重金属及有害元素的健康风险较低; 若HI > 1, 风险应予以关注。
$ {\mathrm{H}}{\mathrm{I}}={\mathrm{H}}{{\mathrm{Q}}}_{{\mathrm{P}}{\mathrm{b}}}+{\mathrm{H}}{{\mathrm{Q}}}_{{\mathrm{C}}{\mathrm{d}}}+{\mathrm{H}}{{\mathrm{Q}}}_{{\mathrm{A}}{\mathrm{s}}}+{\mathrm{H}}{{\mathrm{Q}}}_{{\mathrm{H}}{\mathrm{g}}}+{\mathrm{H}}{{\mathrm{Q}}}_{{\mathrm{C}}{\mathrm{u}}} $
致癌性健康风险特征描述  致癌性风险是指个体一生中暴露某致癌物所产生的致癌概率, 其致癌性风险一般通过致癌风险(carcinogenic risk, CR) 来表征, 多个重金属及有害元素的联合暴露致癌性的风险通过总致癌风险(total carcinogenic risk, TCR) 来表征。按照公式4和5分别计算CR和TCR。
$ {\mathrm{C}}{\mathrm{R}}={\mathrm{E}}{\mathrm{x}}{\mathrm{p}}\times {\mathrm{C}}{\mathrm{S}}{\mathrm{F}} $
$ {\mathrm{T}}{\mathrm{C}}{\mathrm{R}}={\mathrm{C}}{{\mathrm{R}}}_{{\mathrm{P}}{\mathrm{b}}}+{\mathrm{C}}{{\mathrm{R}}}_{{\mathrm{C}}{\mathrm{d}}}+{\mathrm{C}}{{\mathrm{R}}}_{{\mathrm{A}}{\mathrm{s}}} $
其中CSF为致癌物斜率因子[mg·(kg·d)-1], 指致癌物对人群终生暴露带来的致癌概率风险。根据美国环保署(US EPA) 的技术报告, Pb、Cd、As的CSF分别为8.5×10-3、6.1、1.5 mg·(kg·d)-1, 一般认为CR值小于10-4, 其重金属及有害元素的致癌性风险可接[21]
敏感性分析  为评估模型中各个输入参数对输出结果HI的影响, 需要对各个输入变量进行敏感性分析, 以在诸多因素中识别出对结果具有显著影响的因素。通过软件Rv.4.1.0, 基于方差分析的敏感性分析(Sobol sensitivity approach, SSA) 可评估单个变量和其交互作用对输出结果的影响, 其结果用Sobol得分表示[22]
对于车前草中重金属及有害元素的测定结果可见, 车前草中铅、镉、砷、汞、铜的均值分别为9.01、0.28、3.83、0.01和12.82 mg·kg-1, 结果见表 1。参照中国药典(2020年版四部通则) 植物类中药材中重金属及有害元素一致性限量指导值(Pb ≤ 5 mg·kg-1; Cd ≤ 1 mg·kg-1; As ≤ 2 mg·kg-1; Hg ≤ 0.2 mg·kg-1; Cu ≤ 20 mg·kg-1), 9批车前草中铅、14批车前草中砷、1批车前草中铜超标; 车前草中铅(47.12 mg·kg-1) 和砷(14.53 mg·kg-1) 的最大值分别超标9倍和7倍。可见, 对于车前草中重金属及有害元素的科学风险评估大有必要。
根据公式2和3计算单一重金属及有害元素对不同暴露人群产生的非致癌性概率风险分布结果(表 2), 进一步计算出5种重金属及有害元素联合暴露的非致癌性概率风险分布结果。结果表明, 不同暴露人群铅、镉、汞、铜的HQ值均小于1, 非致癌性健康风险可接受。男性和女性HQAS均值分别为0.31和0.29, 说明对于一般暴露人群砷所产生的非致癌性健康风险可接受。然而, 男性HQAS的P95分位值、P99分位值和最大值分别为1.41、2.83和10.97, 女性HQAS的P95分位值、P99分位值和最大值分别为1.27、2.63、9.80, 表明砷对于高端暴露人群所产生的非致癌性健康风险需要被关注。男性和女性联合暴露风险HI平均值分别为0.35和0.32, 说明对于一般暴露人群所产生的总非致癌性健康风险可接受。然而男性HI的P95分位值、P99分位值和最大值分别为1.44、2.85、11.0; 女性HI的P95分位值、P99分位值和最大值分别为1.29、2.66、10.0, 表明对于高暴露人群所产生的总非致癌性健康风险需要被关注。
根据公式4和5计算铅、镉和砷的CR值(表 3), 结果显示不同暴露人群铅和镉的CR值均小于10-4, 致癌性健康风险可接受。然而, 无论男性还是女性, CRAs的P99和最大值均大于10-4, 并且男性和女性联合暴露致癌性风险的P99和最大值大于10-4, 表明砷暴露引起的高端暴露人群致癌性健康风险需要被关注。
敏感性分析结果显示, 中药的EF和车前草中砷的浓度是最主要的风险影响因素, 建议优先考虑优化服用频率和降低砷污染来降低车前草对不同人群产生的健康风险。
本研究以车前草为例, 探索概率评估方法, 结合中药消费模式调查确定概率评估关键参数, 计算不同暴露人群的铅、镉、砷、汞、铜的健康风险, 首次提出符合中药使用特点的非致癌性和致癌性概率风险评估模型, 为中药中外源性有害残留物的健康风险评估提供新视角。概率风险评估结果表明, 砷对于高端暴露人群产生的非致癌健康和致癌性健康风险均需要被关注。因此, 仍需控制车前草中重金属及有害元素的健康风险。分析车前草中重金属及有害元素富集的原因如下: ①环境中包括土壤、空气中含有重金属及有害元素, 并且全草类药材较其他药材更多暴露于空气中易于被污染; ②植物个体差异以及不同组织器官代谢特性的不同, 造成特定药材对于特定的元素具有富集作用。植物细胞器是呼吸作用和光合作用的主要场所, 其对重金属及有害元素的结合能力较强, 是重金属及有害元素与植物发生富集作用的主要场所。建议规范化种植车前草, 严选车前草栽培环境, 并减少含重金属农药、化肥等的使用; 建议改善车前草仓储、包装等条件, 避免引入不必要的重金属; 同时, 建议采取相应的措施对已污染的产地进行修复, 包括化学修复、物理修复、微生物修复等, 或将多种修复技术综合应用, 以期达到更加理想的效果[23, 24]
本研究采用蒙特卡罗模拟对于中药材车前草中Pb、Cd、As、Hg、Cu的健康风险进行概率评估。根据检测得到的车前草中重金属及有害元素浓度数据, 进行4种常见偏态分布(Weibull分布、Gamma分布、对数正态分布和指数分布) 的拟合优度检验。若不符合上述分布, 则对浓度原数据进行有放回抽样, 以进行后续暴露量的计算。结果铅、镉、砷、汞、铜的浓度分别符合Weibull分布、对数正态分布、Gamma分布、Weibull分布、Weibull分布; 车前草的IR参考中国药典(2020年版) 中推荐的日用量, 为9~30 g。根据中药的用药特点, 消费量符合离散型均匀分布; EF由在全国范围内开展的消费调查获得, 同时考虑同一个体在不同时间以及不同个体服用概率的变异性, 其符合贝塔二项分布。
本研究探索性采用概率风险评估, 与传统确定性风险评估相比较具有如下优势: 参数输入方面, 确定性风险评估将点估计值作为暴露评估模型的输入值, 其通常使用集中趋势值(例如均值), 来估计最大可能性风险值[25]。而概率风险评估的参数输入为暴露参数的可能值和范围, 并估计这些值出现的概率。评价方法方面, 确定性风险评估使用保守的“四步骤”健康风险评估模型, 基于单点值计算HQ和CR值。概率风险评估分别赋予中药中重金属及有害元素浓度(C)、中药的IR、EF等各参数概率分布, 使用蒙特卡罗模拟等技术进行上万次迭代运算, 根据得到的一系列风险值输出概率分布, 并可基于概率风险输出进行敏感性分析。结果输出方面, 确定性风险评估输出为暴露量及风险值的单点估计值, 风险结果简单易懂。相比之下, 概率风险评估输出暴露量及风险值的范围及可能性, 可以更好地表征风险评估中的不确定性和变异性, 适用于更精细的暴露人群、暴露途径的优先级识别。但是, 概率风险评估需专业的培训和指导来传达和应用概率风险结果[26]
科学的风险评估是针对污染物制定合理的限量标准的基础。目前, 关于符合中药使用特点的外源性有害残留物的确定性风险评估模型已初步形成[19], 该模型充分考虑中药使用特点, 将摄入量、服用频率、人类平均寿命、重金属及有害元素转移率等变量纳入模型。有别于以单点值为输出的传统确定性风险评估方法, 概率风险评估以尽可能量化表征不确定性及变异性对风险评估造成的影响为出发点, 提供了暴露风险范围和可能性的估计, 避免了高估或低估健康风险, 促进风险管理和决策的改进。常见的概率评估模型包括概率树法、泰勒简化法和蒙特卡罗模拟等。其中蒙特卡罗模拟是最常用的概率风险评估方法, 其可将风险事件发生的概率转变为频率, 在确定暴露参数先验分布下生成随机数进行迭代运算, 输出结果以概率分布的形式表达, 结合敏感性分析确定与模型输出变异高度相关的参数, 为风险值优化提供依据[27]
本研究采用蒙特卡洛模拟技术, 量化了在评估过程中不同暴露人群的潜在差异性和复杂性, 并考虑中药服用特点提出中药重金属及有害元素概率风险评估范例, 为中药重金属及有害元素健康风险评估提供新视角。概率风险评估是对传统确定性风险评估的有益补充, 应充分发挥两者在中药重金属及有害元素健康风险评估中的互补性。建议进一步探索符合中药使用特点的概率风险评估方法, 为制定更加科学、合理并切合实际的中药材重金属及有害元素限量标准提供依据, 为中药的安全使用提供临床指导, 实现公共卫生效益与中药产业健康发展的平衡。
作者贡献: 左甜甜、刘佳琳、李依玲负责风险评估, 马双成、魏晟、金红宇负责实验顶层设计, 费毅琴和聂晶负责样品收集和分析测定。
利益冲突: 没有利益冲突。
  • 国家十三五“重大新药创制”课题(2018ZX09735006)
  • 中国食品药品检定研究院中青年基金资助项目(2020A3)
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2022年第57卷第11期
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doi: 10.16438/j.0513-4870.2022-0586
  • 接收时间:2022-07-12
  • 首发时间:2025-12-24
  • 出版时间:2022-11-12
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  • 收稿日期:2022-07-12
  • 修回日期:2022-09-12
基金
国家十三五“重大新药创制”课题(2018ZX09735006)
中国食品药品检定研究院中青年基金资助项目(2020A3)
作者信息
    1.中国食品药品检定研究院, 北京 100050
    2.华中科技大学同济医学院公共卫生学院, 湖北 武汉 430030
    3.湖北省药品监督检验研究院, 湖北 武汉 430075

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*魏晟, E-mail: ;
马双成, Tel: 86-10-53852076, E-mail:
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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