矿物类中药止血药理作用及临床应用研究进展
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摘要
矿物药是我国传统中医药不可缺少的重要组成部分,药用矿物资源的研究与利用已有几千年的历史,是各族人民生存过程中无数次试用、观察、积累的实践医疗经验总结,极具特色。目前,矿物药的治疗范围涉及内科、外科、妇科、儿科、五官科等。矿物药对多种出血病症的临床应用广泛、用药经验丰富且疗效显著,但现代研究文献较少,主要集中在1970—1990年代。本文对近40年来临床具止血作用矿物药的药理作用及临床应用进行综述,以期为临床治疗出血病症合理用药、对矿物类中药资源的进一步开发利用、物质基础及作用机制的深入研究以及更好地挖掘矿物药资源宝库提供参考。通过对主要著作的统计,记载有止血作用的矿物药共27味。矿物类中药止血药理作用研究主要集中在对矿物药的元素分析及相关元素对止血作用的影响,以及相关止血作用的药理实验研究加以证实,但研究尚不深入和全面。矿物类中药止血的临床应用主要包括消化道出血、咯血、鼻衄、牙龈出血、颅脑出血、流产后出血、血崩、子宫出血、血便及外用止血等。
Mineral Chinese medicine is an indispensable part in traditional Chinese medicine,with a history of several thousand years in research and utilization of medicinal mineral resources. It is a summary of the medical experience accumulated in numerous trials, observations and practices during the survival process of people of all nationalities,showing distinctive characteristics. At present,the scope of mineral medicine treatment involves internal medicine, surgery, gynecology, pediatrics, facial features and so on. The mineral Chinese medicine has broad clinical application in many kinds of hemorrhagic diseases,with rich experience in medication and remarkable curative effects. However,there are few papers in modern research,mainly concentrated in the1970 s—1990 s. In this paper, the pharmacology and clinical application of mineral Chinese medicine with hemostatic effects in the last 40 years were reviewed,aiming to provide references for its clinical rational use in bleeding diseases,further development and utilization of mineral Chinese medicine resources of traditional Chinese medicine,in-depth study of material basis and action mechanism,and further exploration of mineral Chinese medicine resources. According to the statistics of the major Chinese medicine works,27 kinds of mineral drugs have hemostatic effects. The researches on hemostatic pharmacology of mineral Chinese medicine mainly focus on the analysis of mineral medicine elements and the effect of related elements on hemostasis, as well as the pharmacological experimental study on hemostasis,but the research is not deep-going and comprehensive. The clinical application of mineral Chinese medicine for hemostasis mainly includes digestive tract hemorrhage,hemoptysis, epistaxis, gingival hemorrhage, cerebral hemorrhage, post-abortion hemorrhage, metrorrhagia,uterine bleeding,hematochezia and external hemostasis.
Mineral Chinese medicine is an indispensable part in traditional Chinese medicine,with a history of several thousand years in research and utilization of medicinal mineral resources. It is a summary of the medical experience accumulated in numerous trials, observations and practices during the survival process of people of all nationalities,showing distinctive characteristics. At present,the scope of mineral medicine treatment involves internal medicine, surgery, gynecology, pediatrics, facial features and so on. The mineral Chinese medicine has broad clinical application in many kinds of hemorrhagic diseases,with rich experience in medication and remarkable curative effects. However,there are few papers in modern research,mainly concentrated in the1970 s—1990 s. In this paper, the pharmacology and clinical application of mineral Chinese medicine with hemostatic effects in the last 40 years were reviewed,aiming to provide references for its clinical rational use in bleeding diseases,further development and utilization of mineral Chinese medicine resources of traditional Chinese medicine,in-depth study of material basis and action mechanism,and further exploration of mineral Chinese medicine resources. According to the statistics of the major Chinese medicine works,27 kinds of mineral drugs have hemostatic effects. The researches on hemostatic pharmacology of mineral Chinese medicine mainly focus on the analysis of mineral medicine elements and the effect of related elements on hemostasis, as well as the pharmacological experimental study on hemostasis,but the research is not deep-going and comprehensive. The clinical application of mineral Chinese medicine for hemostasis mainly includes digestive tract hemorrhage,hemoptysis, epistaxis, gingival hemorrhage, cerebral hemorrhage, post-abortion hemorrhage, metrorrhagia,uterine bleeding,hematochezia and external hemostasis.
引文
[1]楼彩霞,庞宗然,张婉,等.止血中药及复方的实验研究与作用机制探讨[J].辽宁中医药大学学报,2009,11(10):59-61.
[2]刘淑花,毕俊英.生或煅赭石微量元素含量及药理作用比较[J].微量元素与健康研究,2003,20(1):6-7.
[3]裴学文,佟军,吴庆刚,等.微量元素与冠心病关系初探[J].中国公共卫生,2001,17(4):302-304.
[4]李钢,潘俊伟,王克宇,等.矿物中药白矾的结构测定与分析[J].江苏中医药,2008,40(4):61-63.
[5]郭广义,郭瑛,王少杰.我国动矿物药的药理与临床研究新进展(一)[J].中成药,1999,21(3):145-147.
[6]江腊梅.部分矿物药的药理作用和临床应用[J].药学研究,1990,9(4):35-37.
[7]高锦飚,李祥.花蕊石止血作用物质基础的研究[J].吉林中医药,2007,27(3):47-48.
[8]胡魁.禹余粮的医药地质学研究[J].中国矿业,2004(12):5-9.
[9]熊南燕,王永艳,姜燕. 3种不同性状赭石的药理作用研究[J].时珍国医国药,2010,21(5):1133-1134.
[10]刘丹,高婵,李俊松,等.赭石止血作用及其机制研究[J].中药新药与临床药理,2009,20(2):131-133.
[11]丁望,李大同,周洪雷.花蕊石止血作用的实验研究[J].实用医药杂志,2005(12):1109.
[12]吴德康,陆平成,王春根,等.禹粮石不同炮制品的抑菌、止血实验研究[J].中药材,1991,14(4):27-28.
[13]江南.禹余粮的传奇及药用[J].东方药膳,2006(9):43-44.
[14]吴超颖,刘圣金,房方,等.不同矿物成因禹余粮矿物成分分析及止血作用研究[J].中国中药杂志,2017,42(15):2989-2994.
[15]禹志领,窦昌贵,刘保林,等.赤石脂对凝血系统作用的初步研究[J].中药药理与临床,1992,8(4):23-25.
[16]彭智聪,张少文,康重阳,等.花蕊石炮制前后止血作用的比较[J].中国中药杂志,1995,20(9):538.
[17]张福康,韩乃皓,杨鸣,等.赤石脂合剂凝血止血作用的药理研究[J].中国中药杂志,1992,17(9):562-563.
[18]孙雅婷,刘伟芳,黄晓瑾,等.硅酸盐类矿物中药的临床研究进展[J].江苏中医药,2013,45(3):75-77.
[19]崔树德.中药大全[M].哈尔滨:黑龙江科学技术出版社,1989:726.
[20]戈瑞庭,潘家旺.石矾液治疗急性上消化道出血42例[J].河北中医,1998,20(2):74.
[21]韩进庭.白矾的药理作用及临床应用研究进展[J].现代医药卫生,2006,22(24):3763-3764.
[22]孙海潮,董海峰.补络补管汤加赭石治疗上消化道出血[J].黑龙江中医药,2000(1):17.
[23]郑舜华.灶心土加味治疗急性远血症40例疗效观察[J].上海中医药杂志,1994(8):30.
[24]白建民.中西医结合治疗急性胃黏膜病变上消化道出血30例临床观察[J].江苏中医药,2011,43(7):50-51.
[25]韩景泰.“蛇年”话“蛇药”—镇惊安神蛇含石[J].开卷有益:求医问药,2013(6):30.
[26]史文郁.白矾在临床上的应用[J].辽宁中级医刊,1979(2):44.
[27]王纯伟.补骨脂赤石脂配合三七治疗小儿鼻出血50例临床观察[J].中国医药指南,2014,12(24):40-41.
[28]刘文成.代赭石六用[J].实用医技,2000,7(9):33-34.
[29]马云珍.生化汤加减治疗药物流产后阴道出血50例[J].河北中医,1998,20(6):36.
[30]李新凤,刘长钟.花蕊石汤治疗流产后出血45例体会[J].海峡药学,2001,13(5):34.
[31]谢德聪.蜂花合剂治疗62例阴道出血[J].福建中医学院学报,1997,7(4):6-7.
[32]冉青珍.赤石脂止崩汤治疗年老血崩58例[J].陕西中医,2004,25(11):971-972.
[33]黄亚君,陈宏.血竭与花蕊石为主药治疗“崩中”62例[J].浙江中西医结合杂志,2005,15(12):110-111.
[34]刘正鉴,黄丽光.擅用花蕊石大黄辨治青春期崩漏[J].辽宁中医杂志,1997,24(4):172.
[35]毛世友.代赭石治颅内血肿[J].湖南中医杂志,1998(6):8.
[36]朱明华,龚荣.珍珠琥珀散治疗新生儿头颅血肿86例[J].蚌埠医学院学报,1995,20(6):417-418.
[37]陈武,耿晓文.麦饭石固齿牙粉对牙周炎辅助治疗临床效果观察[J].南京医科大学学报,1994,14(2):280.
[38]邱春生.花蕊石散治疗重症咯血临床体会[J].中国中医急症,2007,16(2):233.
[39]熊成熙.自拟赤石脂汤治疗脾阳不足型血便30例[J].湖北中医杂志,1992,14(3):25.
[40]肖冬香.代赭石镇冲止血法的应用[J].中国中医药现代远程教育,2013,11(19):111-112.
[41]卓世金.牛角大黄赭石止血汤临床应用[J].中国临床医生,2003(8):54-55.
[42]王元德.白矾在外科应用的体会[J].四川中医,1988(8):40.
[43]牛忻群.灶心土的临床运用[J].甘肃中医,1994,7(6):39-40.
[44]昝冬梅,靳华,李秀英.代赭石为主治疗出血性疾病[J].中医研究,1989,2(4):35-36.
[45]潘家琦.止血机制[M].北京:中国大百科全书出版社,1993.
[46]王汉斌,刘龙斌,史寅奎,等.凝血酶受体结构与功能的研究现状[J].军事医学科学院院刊,1997,21(4):300-303.
[47]李静,许亚茹,元小冬,等.纤维蛋白原Bβ-455G/A、-854G/A基因多态性及其功能表达与脑梗死类型的关系[J].中国神经免疫学和神经病学杂志,2009,16(6):424-427,463.
[48]明晶,陈龙,陈科力,等.白矾、硼砂等6种白色结晶矿物药鉴别[J].中国实验方剂学杂志,2016,22(20):33-38.
[49]闫蔚,曾柏淋,王淑美,等. 6种硫酸盐类矿物药中红外鉴别[J].中国实验方剂学杂志,2015,21(20):63-66.
[50]陈新梅,王集会.无名异的质量控制[J].中国实验方剂学杂志,2013,19(17):107-109.
[51]陈龙,袁明洋,陈科力.常见矿物药近红外漫反射光谱特征归纳与分析[J].中国中药杂志,2016,41(19):3528-3536.
[2]刘淑花,毕俊英.生或煅赭石微量元素含量及药理作用比较[J].微量元素与健康研究,2003,20(1):6-7.
[3]裴学文,佟军,吴庆刚,等.微量元素与冠心病关系初探[J].中国公共卫生,2001,17(4):302-304.
[4]李钢,潘俊伟,王克宇,等.矿物中药白矾的结构测定与分析[J].江苏中医药,2008,40(4):61-63.
[5]郭广义,郭瑛,王少杰.我国动矿物药的药理与临床研究新进展(一)[J].中成药,1999,21(3):145-147.
[6]江腊梅.部分矿物药的药理作用和临床应用[J].药学研究,1990,9(4):35-37.
[7]高锦飚,李祥.花蕊石止血作用物质基础的研究[J].吉林中医药,2007,27(3):47-48.
[8]胡魁.禹余粮的医药地质学研究[J].中国矿业,2004(12):5-9.
[9]熊南燕,王永艳,姜燕. 3种不同性状赭石的药理作用研究[J].时珍国医国药,2010,21(5):1133-1134.
[10]刘丹,高婵,李俊松,等.赭石止血作用及其机制研究[J].中药新药与临床药理,2009,20(2):131-133.
[11]丁望,李大同,周洪雷.花蕊石止血作用的实验研究[J].实用医药杂志,2005(12):1109.
[12]吴德康,陆平成,王春根,等.禹粮石不同炮制品的抑菌、止血实验研究[J].中药材,1991,14(4):27-28.
[13]江南.禹余粮的传奇及药用[J].东方药膳,2006(9):43-44.
[14]吴超颖,刘圣金,房方,等.不同矿物成因禹余粮矿物成分分析及止血作用研究[J].中国中药杂志,2017,42(15):2989-2994.
[15]禹志领,窦昌贵,刘保林,等.赤石脂对凝血系统作用的初步研究[J].中药药理与临床,1992,8(4):23-25.
[16]彭智聪,张少文,康重阳,等.花蕊石炮制前后止血作用的比较[J].中国中药杂志,1995,20(9):538.
[17]张福康,韩乃皓,杨鸣,等.赤石脂合剂凝血止血作用的药理研究[J].中国中药杂志,1992,17(9):562-563.
[18]孙雅婷,刘伟芳,黄晓瑾,等.硅酸盐类矿物中药的临床研究进展[J].江苏中医药,2013,45(3):75-77.
[19]崔树德.中药大全[M].哈尔滨:黑龙江科学技术出版社,1989:726.
[20]戈瑞庭,潘家旺.石矾液治疗急性上消化道出血42例[J].河北中医,1998,20(2):74.
[21]韩进庭.白矾的药理作用及临床应用研究进展[J].现代医药卫生,2006,22(24):3763-3764.
[22]孙海潮,董海峰.补络补管汤加赭石治疗上消化道出血[J].黑龙江中医药,2000(1):17.
[23]郑舜华.灶心土加味治疗急性远血症40例疗效观察[J].上海中医药杂志,1994(8):30.
[24]白建民.中西医结合治疗急性胃黏膜病变上消化道出血30例临床观察[J].江苏中医药,2011,43(7):50-51.
[25]韩景泰.“蛇年”话“蛇药”—镇惊安神蛇含石[J].开卷有益:求医问药,2013(6):30.
[26]史文郁.白矾在临床上的应用[J].辽宁中级医刊,1979(2):44.
[27]王纯伟.补骨脂赤石脂配合三七治疗小儿鼻出血50例临床观察[J].中国医药指南,2014,12(24):40-41.
[28]刘文成.代赭石六用[J].实用医技,2000,7(9):33-34.
[29]马云珍.生化汤加减治疗药物流产后阴道出血50例[J].河北中医,1998,20(6):36.
[30]李新凤,刘长钟.花蕊石汤治疗流产后出血45例体会[J].海峡药学,2001,13(5):34.
[31]谢德聪.蜂花合剂治疗62例阴道出血[J].福建中医学院学报,1997,7(4):6-7.
[32]冉青珍.赤石脂止崩汤治疗年老血崩58例[J].陕西中医,2004,25(11):971-972.
[33]黄亚君,陈宏.血竭与花蕊石为主药治疗“崩中”62例[J].浙江中西医结合杂志,2005,15(12):110-111.
[34]刘正鉴,黄丽光.擅用花蕊石大黄辨治青春期崩漏[J].辽宁中医杂志,1997,24(4):172.
[35]毛世友.代赭石治颅内血肿[J].湖南中医杂志,1998(6):8.
[36]朱明华,龚荣.珍珠琥珀散治疗新生儿头颅血肿86例[J].蚌埠医学院学报,1995,20(6):417-418.
[37]陈武,耿晓文.麦饭石固齿牙粉对牙周炎辅助治疗临床效果观察[J].南京医科大学学报,1994,14(2):280.
[38]邱春生.花蕊石散治疗重症咯血临床体会[J].中国中医急症,2007,16(2):233.
[39]熊成熙.自拟赤石脂汤治疗脾阳不足型血便30例[J].湖北中医杂志,1992,14(3):25.
[40]肖冬香.代赭石镇冲止血法的应用[J].中国中医药现代远程教育,2013,11(19):111-112.
[41]卓世金.牛角大黄赭石止血汤临床应用[J].中国临床医生,2003(8):54-55.
[42]王元德.白矾在外科应用的体会[J].四川中医,1988(8):40.
[43]牛忻群.灶心土的临床运用[J].甘肃中医,1994,7(6):39-40.
[44]昝冬梅,靳华,李秀英.代赭石为主治疗出血性疾病[J].中医研究,1989,2(4):35-36.
[45]潘家琦.止血机制[M].北京:中国大百科全书出版社,1993.
[46]王汉斌,刘龙斌,史寅奎,等.凝血酶受体结构与功能的研究现状[J].军事医学科学院院刊,1997,21(4):300-303.
[47]李静,许亚茹,元小冬,等.纤维蛋白原Bβ-455G/A、-854G/A基因多态性及其功能表达与脑梗死类型的关系[J].中国神经免疫学和神经病学杂志,2009,16(6):424-427,463.
[48]明晶,陈龙,陈科力,等.白矾、硼砂等6种白色结晶矿物药鉴别[J].中国实验方剂学杂志,2016,22(20):33-38.
[49]闫蔚,曾柏淋,王淑美,等. 6种硫酸盐类矿物药中红外鉴别[J].中国实验方剂学杂志,2015,21(20):63-66.
[50]陈新梅,王集会.无名异的质量控制[J].中国实验方剂学杂志,2013,19(17):107-109.
[51]陈龙,袁明洋,陈科力.常见矿物药近红外漫反射光谱特征归纳与分析[J].中国中药杂志,2016,41(19):3528-3536.