关键词:  , “大毒”中药；急性毒性；安全性

Abstract:

The literature on 10 “highly toxic” traditional Chinese medicinal materials included in the 2020 edition of Chinese Pharmacopoeia was investigated from four aspects： acute toxicity of single medicine，contraindications to compatibility，attenuating toxicity by processing， and attenuating toxicity by compatibility. It was found that there was a lack of studies on acute toxicity of Hydrargyri Oxydum Rubrum and Hyoscyami Semen， while the toxicity levels and safety risks of the other “highly toxic”traditional Chinese medicinal materials vary. Toxicity in descending order is Mylabris， Strychni Semen，Strychni Semen Pulveratum，Crotonis Fructus，Aconiti Kusnezoffii Radix，Crotonis Semen Pulveratum， Rhododendri Mollis Flos， Aconiti Radix.The safety risks of "highly toxic" traditional Chinese medicinal materials that can be taken internally， from large to small， are as follows： Strychni Semen Pulveratum， Rhododendri Mollis Flos，Mylabris，Crotonis Semen Pulveratum. Among them， the safety risk of Strychni Semen Pulveratum is the greatest. Some studies on the contraindications to compatibility of “highly toxic” traditional Chinese medicinal materials suggest that certain incompatibilities in the “eighteen incompatible medicaments” are not absolutely contraindicated， but it is necessary to pay attention to dosage and proportion in clinical use. Processing is a common method to reduce the toxicity of “highly toxic”traditional Chinese medicinal materials.There remains a significant safety risk for clinical use of Strychni Semen after processing. The other “highly toxic”traditional Chinese medicinal materials have reduced the safety risks to a large extent through processing. Some literature data show that the toxicity of "highly toxic" traditional Chinese medicinal materials is significantly reduced after rational compatibility based on syndrome differentiation.This study reviews the safety of 10 "highly toxic" traditional Chinese medicinal materials in order to provide reference for the clinical safe use of toxic traditional Chinese medicinal materials.

Key words: Highly toxic traditional Chinese medicinal materials； , Acute toxicity； , Safety