Article(id=1193877805130809802, tenantId=1146029695717560320, journalId=1190317699101192196, issueId=1193877800143777917, articleNumber=1001-2494(2025)02-0114-07, orderNo=null, doi=10.11669/cpj.2025.02.002, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1721577600000, receivedDateStr=2024-07-22, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1762572249919, onlineDateStr=2025-11-08, pubDate=1737475200000, pubDateStr=2025-01-22, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1762572249919, onlineIssueDateStr=2025-11-08, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1762572249919, creator=13701087609, updateTime=1762572249919, updator=13701087609, issue=Issue{id=1193877800143777917, tenantId=1146029695717560320, journalId=1190317699101192196, year='2025', volume='60', issue='2', pageStart='109', pageEnd='206', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=0, articleOrder=1, issueType=-1, specialIssue=null, createTime=1762572248731, creator=13701087609, updateTime=1762584852274, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1193930663289123481, tenantId=1146029695717560320, journalId=1190317699101192196, issueId=1193877800143777917, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1193930663289123482, tenantId=1146029695717560320, journalId=1190317699101192196, issueId=1193877800143777917, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=114, endPage=120, ext={EN=ArticleExt(id=1193877806003225043, articleId=1193877805130809802, tenantId=1146029695717560320, journalId=1190317699101192196, language=EN, title=Establishment of Traditional Chinese Medicine Standards Reflecting the Quality Characteristics of Chinese Herbal Pieces Based on Processing, columnId=null, journalTitle=Chinese Pharmaceutical Journal, columnName=null, runingTitle=null, highlight=null, articleAbstract=

OBJECTIVE To establish a Chinese medicine standard based onprocessing, reflect the quality characteristics of Chinese medicine decoction pieces and provide a basis forquality control andevaluation of Chinese medicine decoction piece. METHODS Encouraged by the Special Regulations on the Management of Traditional Chinese Medicine Standards, highlighting the characteristics of traditional Chinese medicine processing and emphasizing the research and inheritance of traditional processing experience as the guiding principle, taking Chinese medicine processing technology as the starting point for establishing quality standards for Chinese medicine decoction pieces, summarizing processing experience and technology, comprehensively proposing the items and indicators that should be paid attention to in the standard formulation process, and making suggestions based on the problems existing in the current Chinese medicine decoction piece quality standards.RESULTS Establishing Chinese medicine standards that meet the quality characteristics of traditional Chinese medicine decoction pieces should be able to explain the scientific connotation of processing, with a focus on the changes in chemical composition or component groups caused by different processing purposes. In addition, attention should be paid to the scientificity and specificity of indicators, their correlation with drug efficacy, and their content limits.CONCLUSION It is recommended to conduct comprehensive and in-depth research to grasp the changes in the material basis of traditional Chinese medicine decoction pieces before and after processing, establish scientific, reasonable, and feasible quality control projects and indicators, and achieve control and evaluation of the quality of traditional Chinese medicine.

, correspAuthors=Junning ZHAO, Shuangcheng MA, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, 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=Qi WANG, Yuxin ZHAO, Jie GU, Jiangyong YU, Hainan WANG, Feng WEI, Junning ZHAO, Shuangcheng MA), CN=ArticleExt(id=1193877806535901664, articleId=1193877805130809802, tenantId=1146029695717560320, journalId=1190317699101192196, language=CN, title=基于炮制建立反映中药饮片质量特点的中药标准, columnId=1193877802589061518, journalTitle=中国药学杂志, columnName=《中药标准管理专门规定》专栏, runingTitle=null, highlight=null, articleAbstract=

目的 依据《中药标准管理专门规定》,提出基于炮制建立反映中药饮片质量特点的中药标准的建议,为中药饮片质量控制和评价提供依据。方法 以《中药标准管理专门规定》鼓励突出炮制特色,注重传统炮制经验的研究和传承为指导原则,以中药炮制技术作为中药饮片质量标准建立的出发点,通过对炮制经验、技术的总结,综合提出标准制定过程中应关注的项目和指标,并根据现行中药饮片质量标准中存在的问题提出建议。结果 建立符合中药饮片质量特点的中药标准应能阐释炮制的科学内涵,重点关注不同炮制目的导致的化学成分或成分组的变化,此外还应关注指标的科学性、专属性,与药效的关联性,同时兼顾其含量限度。结论 建议在开展全面深入研究的基础上,掌握炮制前后中药饮片物质基础变化规律,建立科学、合理、可行的质控项目和指标,实现对中药材质量的控制和评价。

, correspAuthors=赵军宁, 马双成, authorNote=null, correspAuthorsNote=
*赵军宁,男,研究员 研究方向:中药监管科学;
马双成,男,博士,研究员,博士生导师 研究方向:中药质量控制、中药标准和中药安全性评价研究 Tel:(010)67079501
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汪祺,女,博士,研究员 研究方向:中药质量及安全性毒性评价

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汪祺,女,博士,研究员 研究方向:中药质量及安全性毒性评价

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汪祺,女,博士,研究员 研究方向:中药质量及安全性毒性评价

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基于炮制建立反映中药饮片质量特点的中药标准
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汪祺 1 , 赵宇新 2 , 顾杰 3 , 于江泳 4 , 王海南 4 , 魏锋 1 , 赵军宁 4, * , 马双成 2, 5, *
中国药学杂志 | 《中药标准管理专门规定》专栏 2025,60(2): 114-120
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中国药学杂志 | 《中药标准管理专门规定》专栏 2025, 60(2): 114-120
基于炮制建立反映中药饮片质量特点的中药标准
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汪祺1, 赵宇新2, 顾杰3, 于江泳4, 王海南4, 魏锋1, 赵军宁4, *, 马双成2, 5, *
作者信息
  • 1 中国食品药品检定研究院, 北京 102629
  • 2 国家药典委员会, 北京 100061
  • 3 国家药品监督管理局药品审评中心, 北京 100076
  • 4 国家药品监督管理局, 北京 100037
  • 5 药品监管科学全国重点实验室, 北京 100061
  • 汪祺,女,博士,研究员 研究方向:中药质量及安全性毒性评价

通讯作者:

*赵军宁,男,研究员 研究方向:中药监管科学;
马双成,男,博士,研究员,博士生导师 研究方向:中药质量控制、中药标准和中药安全性评价研究 Tel:(010)67079501
Establishment of Traditional Chinese Medicine Standards Reflecting the Quality Characteristics of Chinese Herbal Pieces Based on Processing
Qi WANG1, Yuxin ZHAO2, Jie GU3, Jiangyong YU4, Hainan WANG4, Feng WEI1, Junning ZHAO4, *, Shuangcheng MA2, 5, *
Affiliations
  • 1 National Institutes for Food and Drug Control, Beijing 102629, China
  • 2 Chinese Pharmacopeia Commission, Beijing 100061, China
  • 3 Center for Drug Evaluation NMPA, Beijing 100076, China
  • 4 National Medical Products Administration, Beijing 100037, China
  • 5 State Key Laboratory of Drug Regulatory Science, Beijing 100061, China
出版时间: 2025-01-22 doi: 10.11669/cpj.2025.02.002
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目的 依据《中药标准管理专门规定》,提出基于炮制建立反映中药饮片质量特点的中药标准的建议,为中药饮片质量控制和评价提供依据。方法 以《中药标准管理专门规定》鼓励突出炮制特色,注重传统炮制经验的研究和传承为指导原则,以中药炮制技术作为中药饮片质量标准建立的出发点,通过对炮制经验、技术的总结,综合提出标准制定过程中应关注的项目和指标,并根据现行中药饮片质量标准中存在的问题提出建议。结果 建立符合中药饮片质量特点的中药标准应能阐释炮制的科学内涵,重点关注不同炮制目的导致的化学成分或成分组的变化,此外还应关注指标的科学性、专属性,与药效的关联性,同时兼顾其含量限度。结论 建议在开展全面深入研究的基础上,掌握炮制前后中药饮片物质基础变化规律,建立科学、合理、可行的质控项目和指标,实现对中药材质量的控制和评价。

中药标准  /  中药标准管理专门规定  /  中药饮片  /  中药炮制  /  质量评价

OBJECTIVE To establish a Chinese medicine standard based onprocessing, reflect the quality characteristics of Chinese medicine decoction pieces and provide a basis forquality control andevaluation of Chinese medicine decoction piece. METHODS Encouraged by the Special Regulations on the Management of Traditional Chinese Medicine Standards, highlighting the characteristics of traditional Chinese medicine processing and emphasizing the research and inheritance of traditional processing experience as the guiding principle, taking Chinese medicine processing technology as the starting point for establishing quality standards for Chinese medicine decoction pieces, summarizing processing experience and technology, comprehensively proposing the items and indicators that should be paid attention to in the standard formulation process, and making suggestions based on the problems existing in the current Chinese medicine decoction piece quality standards.RESULTS Establishing Chinese medicine standards that meet the quality characteristics of traditional Chinese medicine decoction pieces should be able to explain the scientific connotation of processing, with a focus on the changes in chemical composition or component groups caused by different processing purposes. In addition, attention should be paid to the scientificity and specificity of indicators, their correlation with drug efficacy, and their content limits.CONCLUSION It is recommended to conduct comprehensive and in-depth research to grasp the changes in the material basis of traditional Chinese medicine decoction pieces before and after processing, establish scientific, reasonable, and feasible quality control projects and indicators, and achieve control and evaluation of the quality of traditional Chinese medicine.

traditional Chinese medicine standard  /  Special Regulations on the Management of Traditional Chinese Medicine Standard  /  traditional Chinese medicine herbal piece  /  traditional Chinese medicine processing  /  quality evaluation
汪祺, 赵宇新, 顾杰, 于江泳, 王海南, 魏锋, 赵军宁, 马双成. 基于炮制建立反映中药饮片质量特点的中药标准. 中国药学杂志, 2025 , 60 (2) : 114 -120 . DOI: 10.11669/cpj.2025.02.002
Qi WANG, Yuxin ZHAO, Jie GU, Jiangyong YU, Hainan WANG, Feng WEI, Junning ZHAO, Shuangcheng MA. Establishment of Traditional Chinese Medicine Standards Reflecting the Quality Characteristics of Chinese Herbal Pieces Based on Processing[J]. Chinese Pharmaceutical Journal, 2025 , 60 (2) : 114 -120 . DOI: 10.11669/cpj.2025.02.002
国家药监局发布的《中药标准管理专门规定》[1](以下简称《专门规定》),自2025年1月1日起施行。《专门规定》的制定和发布,对于加强中药标准管理,建立和完善符合中医药特点的标准体系,促进中医药传承创新发展具有重要意义。《专门规定》坚持中医药特色,着力构建符合中药特点的标准体系,中药材及饮片质量标准是中药质量控制和评价的重要依据,标准建立过程中应全面贯彻落实《专门规定》要求,充分反映中药材及饮片的质量特点。
中药炮制是中医药学的一大特色,是我国中医药文化的重要组成部分,蕴含着丰富的科学内涵。随着对中药饮片研究的不断深入,饮片标准的制定也更加科学合理。如,《中国药典》2015年版女贞子项下原药材及饮片酒女贞子采用同一指标特女贞苷进行质控,经研究后发现女贞子酒炙后,特女贞苷含量明显降低,红景天苷含量升高,《中国药典》2020年版作出了相应调整,原药材与酒炙饮片分别采用特女贞苷及红景天苷两个质控指标,突出体现了炮制“生熟异治”的特色。然而由于中药资源丰富,品种多,炮制技术也各具特色,中药饮片的控制项目和指标很难反映炮制过程中的炮制火候、炮制终点,以及使用不同辅料的炮制目的,因此中药饮片标准建立过程中,应对炮制经验、技术和传统加以研究,发现炮制对中药饮片质量产生影响的关键因素,以此为基础建立反映中药饮片质量特点的控制项目和指标。
中药材经加工炮制成饮片后常可达到减毒、增效、缓性及生熟异治等目的,在此基础上以中医理论为指导,根据临床辨证施治方可用于治疗疾病,因此在建立饮片的质控指标时可参考其炮制目的进行设置。
炮制减毒主要针对毒性中药,目的为降低或消除中药的毒性或副作用,保证用药安全。针对这类中药材饮片,应重点关注炮制前后,原药材和饮片毒性化学成分或化学成分组的变化;对于不同炮制方法应侧重比较临床应用针对的不同病症,挖掘其差异药效物质;如毒性成分同时也是药效成分,则应同时关注该类成分的上下限,制定合理的“窗口”。
如生半夏中毒性刺激性成分主要为“毒针晶”,其为蛋白与草酸钙的复合物,法半夏和清半夏的炮制工艺分别采用石灰液和8%白矾进行处理,可使针体晶型破坏,从而降低毒性;而姜半夏的炮制工艺主要是通过生姜中系列姜辣素成分直接拮抗毒针晶引发的炎症反应,从而较少刺激;针对不同炮制方法,所关注的毒性化学成分的含量应有不同侧重[2-3]
以草乌、川乌、附子等为代表的乌头类中药是典型的“毒效双性”中药,其主要药效成分[4-7]为二萜类生物碱,兼具显著的药效作用和极强的毒性。已知双酯型生物碱药效活性高,毒性大,包括乌头碱、次乌头碱等。炮制主要针对这类成分结构不稳定的特点,通过酸碱、加热等处理方法促进双酯型生物碱转化为单酯型生物碱,毒性降低至原来的1/50~1/500,但仍具较强药理活性,为临床应用的主要药用成分[8]。有关附子的炮制方法有多种[9],可分别得到盐附子、黑顺片、白附片及淡附片,各饮片中生物碱的含量及转化比例存在差异,因此不同炮制方法下毒性成分的含量及比例应加以考察。
马钱子毒性强,须严格炮制后方可使用。其中士的宁和马钱子碱既是活性成分又是主要毒性成分。研究显示[10],士的宁尤其是马钱子碱经高温处理后含量显著下降。马钱子碱的毒性是士的宁的20倍,但其疗效仅为士的宁的1/40,二者熔点分别为268 ℃(士的宁)和178 ℃(马钱子碱),由于存在温度差,砂烫温度为220~260 ℃时士的宁才开始下降,而此时马钱子碱含量已显著降低。此外,采用脱脂酸牛奶进行炮制的马钱子,可除去60%的马钱子碱,而对士的宁影响不大,可见不同炮制方法,以及对炮制火候终点的控制直接影响毒性成分的变化,应重点关注。
炮制增效主要指炮制过程中可能产生新成分或增加有效成分的含量,从而增强疗效。针对这类中药饮片应基于中医药临床用药理论,针对不同病症,不同炮制方法重点研究阐释差异药效成分及成分组。
栀子“治上宜生,治下宜炒”[11]。这与现代研究相一致,生用栀子可抑菌抗炎,治疗下焦疾病可发挥其凉血、止血的功效。研究表明,栀子苷(京尼平苷)作为栀子中环烯醚萜类的主要活性成分,具有显著的保肝利胆作用。藏红花素、藏红花酸糖苷Ⅲ和藏红花酸为二萜类成分,具有止血的功效[12]。栀子炒制过程中,藏红花酸糖苷-1、2 和3随加热时间和加热程度的不同,会失去不同数量的葡萄糖,转化为其苷元藏红花酸,凝血作用增强。此外,藏红花酸的体内吸收优于藏红花酸糖苷[13]。可见炮制使得栀子药效作用增加。然而,《中国药典》2020年版栀子[14]项下栀子药材及其饮片炒栀子和焦栀子均以栀子苷(京尼平苷)作为含量测定项质控指标,按干燥品计,分别不得少于1.8%(栀子),1.5%(炒栀子)和1.0%(焦栀子)。控制单一成分,同一成分,很难体现其炮制内涵及真实质量。
槐花经清炒和炭炒后得炒槐花及槐花炭饮片,止血作用增强。槐花炒炭过程中,黄酮类成分含量下降,黄酮苷元含量先上升后降低,随着加热时间的延长,产生了新化合物huaicarbon A /B,该成分可能为槐花炭止血的药效成分[15]。《中国药典》2020年版槐花项下原药材及饮片含量测定指标均为黄酮类成分,以芦丁计,均不得少于8.0%,原药材及饮片均采用同一成分同一限度进行质控,很难反映饮片的内在质量。此外,槐花炮制前后色谱值变化明显[16],以色度值L*,b*,E*可有效区分槐花炭和槐花生品及炒槐花,因此设置合理的质控项目也可有效反映炮制后饮片的质量。
炮制还可通过改变和缓和药物偏盛的性味,达到改变药物作用的目的,因此常有“甘能缓”“炒以缓其性”的说法。针对这类饮片应重点关注具有刺激性、毒副作用等成分的变化,及不同炮制方法对药效成分的影响。
《中国药典》2020年版黄精项下收载了黄精和酒黄精两个饮片,含量测定指标为多糖,以无水葡萄糖计,药材和黄精饮片不得少于7.0%,酒黄精不得少于4.0%。唐《食疗本草》记载,生食黄精会“刺人咽喉”[17]。黄精的炮制方法有切片干燥、清蒸、酒炖或酒蒸,九蒸九晒等[18-21]。经过炮制可消除其引发麻味的成分如黏液质、正己醛和莰烯等[22]。研究表明[23],不同炮制方法对黄精不同类成分作用各不相同,药理作用也产生了差异。①糖类成分:酒制和九蒸九制前后,3种黄精(黄精、滇黄精和多花黄精)的多糖含量显著降低,单糖和寡糖含量也发生了明显变化;在炮制时间相同的情况下,多糖含量减少值由高至低为煮制黄精>蒸制黄精>酒制黄精[24]。②皂苷类成分:炮制前后3种黄精总皂苷均相应增加,但因炮制次数和方法不同,总皂苷含量呈现波动性变化。③挥发性成分:黄精在炮制过程中呋喃类、醛类和烷烃类等挥发性成分均发生了显著变化,据统计[25-27],炮制后17种挥发性成分消失,同时新产生52种成分。因此,针对黄精炮制前后刺激性成分及发生变化的药效成分应开展进一步研究,建立客观全面的质控指标。
苍术药效成分主要为苍术素、苍术醇、苍术酮等挥发油类成分。《中国药典》2020年版收录的苍术饮片为苍术和麸炒苍术,除此以外炮制方法还有蜜麸炒、炒焦、米泔水制等20余种。苍术生品具有抗炎、抗肿瘤及免疫调节等功效,可燥湿祛风。研究表明[28-32],麸炒后苍术中苍术素醇和苍术素升高,α-蒎烯,β-桉叶醇,邻苯二甲酸二异丁酯等挥发性成分降低,目的是缓和其药性,增强健脾和胃的作用。炒焦后鞣质含量升高,可发挥固肠止泻的作用。可见不同炮制方法临床应用各异。因此苍术饮片质量评价应与炮制方法相关联,对多成分多指标进行控制,系统评价。
“生熟异治”是中药炮制的一大特色,如“生泻熟补”“生行熟止”“生散熟疏”等,中药材经过不同方法炮制后,其外观性状、性味归经和功能主治等均发生了变化,形成了功用不同的饮片,从而达到一药多用的目的。药效物质基础的变化势必引发药理作用的改变,针对这类饮片在进行质量评价时应注重炮制前后能反映不同药效作用的化学成分或成分组,同时应兼顾指标成分的稳定性及其含量水平。
地黄为玄参科植物地黄的新鲜或干燥根。生地黄清热凉血,养阴生津,熟地黄补血滋阴,益精填髓,为“生熟异治”的中药。《中国药典》2020年版以梓醇和地黄苷D控制生地黄质量,仅以地黄苷D作为熟地黄的质控指标。药典规定,熟地黄经生地黄酒炖或蒸制而得。研究表明,加工炮制后熟地黄与生地黄相比化学成分发生了显著变化。清蒸、酒蒸、酒炖制得的熟地黄环烯醚萜苷元、单糖、游离寡糖、呋喃醛衍生物、连翘酯苷E及异毛蕊花糖苷等含量均上升,环烯醚萜苷、苯乙醇苷、水苏糖和棉子糖等则显著下降[33]。生地黄清热凉血的物质基础为环烯醚萜和糖类成分[34],熟地黄养阴生津、益精填髓的物质基础为地黄苷A[35-36]和毛蕊花糖苷、甘露三糖、梓醇、苯丙素、苯乙醇苷类等。目前的质控指标与生地黄、熟地黄功效关联性不强,指标单一且含量极低,无法表征炮制的科学性。因此应进一步研究,明确药效成分(群),建议构建多指标且具有专属性和整体性的标准。
何首乌为蓼科植物何首乌的干燥块根。《中国药典》2020年版收录饮片为何首乌和制何首乌,原药材和饮片含量测定共两项质控指标:①二苯乙烯苷:何首乌原药材和何首乌饮片限度相同,均为不得少于1.0%;制何首乌不得少于0.70%。②结合蒽醌:以大黄素和大黄素甲醚的总量计,何首乌原药材和制何首乌限度相同,均为不得少于0.10%;何首乌饮片不得少于0.05%。何首乌生用润肠通便,熟用补益精血,为典型的“生熟异治”中药。古代强调何首乌的炮制为“制非九次,勿寝其毒”[37],可见古人发现了何首乌生品的毒副作用,通过适宜的炮制方法一方面降低其毒性,另一方面扩大了临床使用范围。现代研究证明,何首乌生品润肠通便的功效与蒽醌类成分相关[38],该类成分具有泻下作用[39],本课题组前期研究[40-50]发现何首乌中存在大量的蒽醌和蒽酮类成分,这类成分与大黄素具有相同的母核结构,或经体内代谢可相互转化。这些系列化合物具有单一成分含量低总量高的特点,且可表现出不同强度的肝毒性,其中大黄素-8-O-β-D-葡萄糖苷及二蒽酮类成分已被证明毒性作用明显,现有药典方法通过水解蒽醌糖苷成其苷元,测定总蒽醌含量无法做到真实反映何首乌及其炮制后饮片质量的变化及多化学组分间的含量及比例。此外,二苯乙烯苷为何首乌中特有成分,具有生品中含量高,炮制后降低明显的特点[51],本研究曾收集不同产地64批何首乌药材,其中二苯乙烯苷含量相差悬殊,含量高的可达5.2%,低的0.04%不符合药典规定。制何首乌中规定二苯乙烯苷含量不得少于0.70%,因此存在部分生产企业为了防止饮片不符合规定而炮制不到位的现象,由于加热炮制过程可促使蒽醌及其糖苷间的相互转化与含量变化[52-53],炮制不到位也直接影响了这部分成分组。对于这类中药材,只有深入研究炮制前后物质基础的变化规律,通过控制系列成分的含量及比例才能降低其安全用药风险,充分发挥临床治疗疗效。
炮制前后物质基础的变化对药效作用会产生影响,因此中药炮制机制方面的研究多从化学成分和药理作用两方面入手。近年来科学技术的进步推动了检测技术的发展,多维度的组学技术联合运用尝试阐明炮制机制,同时研究思路和方法上也趋向多学科综合,如采用计算机模拟进行成分毒性和药效的预测,采用体外3D肝细胞模型、肠肝细胞共培养、微流控芯片等模型研究炮制前后药物的吸收、转运、代谢变化规律作用靶点等,从成分变化到体内过程再到药效作用,全过程研究更加系统科学地对中药炮制的内涵进行了解读,也对炮制前后质控指标的提出提供了大量的科学依据,使得所建立的方法更合理全面地反映饮片质量。
Wu等[54]开展了生、熟大黄“生泻熟缓、生熟异治”炮制机制方面的研究。首先通过细胞实验和热结便秘模型动物明确生、熟大黄的药效差异,再通过考察给药后模型动物体内内源性成分的变化推测药理作用机制为影响了水通道蛋白AQP2、3、4的基因表达,最终将生、熟大黄的差异化学成分与药效作用靶点相关联,提出炮制前后应控制的关键指标成分为大黄素甲醚-8-O-β-D-吡喃葡萄糖苷、番泻苷B、没食子酸、儿茶素和大黄素甲醚。研究采用化学成分识别、细胞模型与模型动物联动,将化学成分与靶点直接关联,明确阐释了生、熟大黄的炮制内涵。
淫羊藿为传统补益中药,主要成分为黄酮,Cui等[55]聚焦这类成分,重点考察了炮制前后该类成分的体内吸收、代谢差异。结果发现,体内、外多级黄酮糖苷的吸收小于次级糖苷,朝藿定A、B、C<淫羊藿苷<宝霍苷Ⅰ,加热炮制过程使淫羊藿产生了更多易于吸收的黄酮类成分。为了进一步阐明炮制后黄酮成分的药效作用,以及该成分作为药效成分的合理性,研究人员采用肾阳虚大鼠模型,测算了该类成分的药动学参数,同时采用Caco-2单层细胞模型和大鼠在体肠灌流表征了淫羊藿苷和宝霍苷Ⅰ的吸收差异,进一步阐明了采用羊脂油炮制的科学内涵。
中药饮片经由中药材采用适宜的炮制加工技术制得,中药材作为源头直接影响中药饮片的质量。随着时代的发展,中药材逐渐由人工种植取代了野生采集,大量种植品成为市场的药材主流,来源的变化对中药饮片的品质产生了直接影响,如种源,种植的环境、技术、采收之后的产地加工,以及后续的贮存运输等环节均可导致药材质量参差不齐。此外,中药材还存在如下问题,种植过程中违规使用农药、化肥、膨大剂等;种植区域方面忽视道地产地,南药北种等;部分中药材品种产地加工过程中,为了保持药材不被虫蛀、不易发霉,同时展现良好的外观卖得高价,对药材采用硫黄熏蒸;更有不法分子,采用染色增重、掺杂使假等手段,使得伪劣药材流入市场。有报道[55],采用硫熏的中药材,为了达到药典中二氧化硫残留量的限度要求,使用脱硫剂对药材进行处理,由于脱硫剂含酸或碱性成分,这种处理方法对中药材中的有效成分势必产生潜在影响,同时对用药安全也存在隐患。有研究[56]考察了不同炮制方法对何首乌药材质量的影响,不同来源的何首乌药材,首先在外观性状及化学成分间存在明显的差异,而该差异直接影响了炮制后何首乌饮片的质量。因此,只有以质量稳定可靠的中药材为基础,进行符合中医药理论体系的炮制加工,采用合理的指标进行质控,才能获得高质量的中药饮片。
中药饮片生产存在“后继乏人,后继乏术”的现状,从业人员普遍文化教育水平低,劳动强度大,工作环境差,缺乏对中药炮制重要性和复杂性的认识,对炮制关键技术掌握不足势必导致炮制不规范、加工不到位,影响中药饮片的临床疗效,给中药饮片质量带来隐患,如,姜半夏炮制不加干姜,有的加入过量白矾;炒栀子未按规定将原料碾碎;醋香附未按规定切厚片或碾碎后醋制等。此外,实验室中的炮制研究与实际生产脱节,部分饮片品种为符合药典规定简化炮制工艺或不按工艺生产,如地黄、何首乌等减少蒸制时间;盐附子、黑顺片、白附片的炮制工艺复杂,是重要的减毒环节,部分产地农户为获得更多利益减少漂洗次数来增加饮片质量,还有以干附子加工品冒充制川乌、黑顺片等现象。
基于上述现象,建议加强中药炮制技术人员培训,实施职业技术能力认证,提高从业水平;此外加强中药饮片标准与产地加工、炮制工艺及辅料的综合研究,并进行产业化的生产验证;最后建立科学监管体系,推动监管机制长效运行。
现行中药饮片质量标准存在的问题有:①中药饮片质量标准中的含测指标专属性不强。原药材及其饮片质控指标化学成分相同,限度要求一致。经辅料炮制,或经加热炮制的中药饮片,其化学成分无论是种类还是含量均发生了变化,相同的指标很难对炮制工艺、炮制过程及炮制火候进行控制,更无法体现饮片的内在质量。因此,应根据炮制过程中所用辅料和炮制火候等因素提出控制项目和指标。②中药饮片质量标准中质控指标与其药效作用关联弱。如莱菔子为典型的“生熟异治”“生升熟降”中药,《中国药典》2020年版中,莱菔子原药材及其饮片炒莱菔子含量测定指标均为芥子碱硫氰酸盐,限度要求也一致。传统中医理论认可生莱菔子味辛辣,可主散风寒,通鼻窍,炒莱菔子则主要起到引气下泻化痰、止咳平喘的作用,原药材及饮片的质控指标应各有侧重。③中药质量标准中指标成分含量较低。如冬虫夏草含腺苷不得少于0.01%,含量较低,以此为评价指标很难反应且成分也不是冬虫夏草的专属成分。④饮片中毒性成分应重点关注。如川楝子,原药材及其饮片质控指标均为川楝素,该成分具有较强的毒理活性,炮制后的饮片仍进行低限控制是否合理。此外如马兜铃酸A,吡咯里西啶生物碱等毒性作用明确的成分均应制定合理的限度值。⑤中药饮片质量标准多为单一指标,很难反映炮制后药材质量的内在变化,建议在开展系列研究的基础上,对炮制后的饮片掌握其物质基础变化规律,建立合理、科学、可行的多组分指标加以控制。
《专门规定》是一部根据中药特点制定的规范性文件,将遵循中医药理论、尊重中医药传统,体现中药特色作为根本原则。中药炮制是中医药理论体系的重要组成部分,中药炮制技术是祖国的瑰宝,是具有自主知识产权的传统制药技术,中药材及中药饮片标准研究是系统复杂的工程,在中药饮片标准制定过程中,应坚持《专门规定》中相关要求,以中医药理论为指导,突出中医药特色,既尊重传统炮制经验和技术的传承,又结合现代先进的检验检测技术和评价方法,最终建立符合中医药特点的中药标准。
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2025年第60卷第2期
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doi: 10.11669/cpj.2025.02.002
  • 接收时间:2024-07-22
  • 首发时间:2025-11-08
  • 出版时间:2025-01-22
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  • 收稿日期:2024-07-22
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    1 中国食品药品检定研究院, 北京 102629
    2 国家药典委员会, 北京 100061
    3 国家药品监督管理局药品审评中心, 北京 100076
    4 国家药品监督管理局, 北京 100037
    5 药品监管科学全国重点实验室, 北京 100061

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*赵军宁,男,研究员 研究方向:中药监管科学;
马双成,男,博士,研究员,博士生导师 研究方向:中药质量控制、中药标准和中药安全性评价研究 Tel:(010)67079501
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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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