With the wide application of traditional Chinese medicine (TCM) at home and abroad, the problem of toxicity reduction of toxic Chinese materia medica needs to be solved urgently. Rational compatibility of TCM is the basis for safe use of Chinese medicinal formulas, and herb pair is the smallest unit of TCM compatibility. By starting from toxicity reduction through herb pair compatibility, this study summarizes the mechanism of action of “toxic” TCM, the differences between ancient and modern dosages, and the typical theories of herb pair compatibility, to provide ideas and references for research on toxicity reduction in herb pairs. In addition, this study summarizes studies on chemical composition changes of individual herbs after pairing, in vivo pharmacokinetics, and pharmacological mechanisms of herb pair compatibility. It is concluded that under the guidance of basic theories of TCM, herb pairs can be studied at multiple levels and from multiple perspectives by combining multiple methods to investigate the mechanisms of their combinations in reducing toxicity. This approach helps to clarify the compatibility rules of Chinese medicinal formulas and provides a scientific reference for in-depth studies on the mechanisms of compatibility and detoxification of herb pairs, as well as for the clinical safe use of TCM.

herb pair  /  toxicity attenuation by compatibility  /  material base  /  pharmacokinetics  /  safe medication