用户名: 密码: 验证码:
静脉用鱼腥草注射剂致敏性评价和比较药理学研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
鱼腥草注射剂作为中药注射剂临床严重不良反应发生的代表药,其再研究和再评价工作具有非常重要的现实意义。对鱼腥草注射剂开展安全性再评价工作,必须从制剂工艺、质量标准、药理毒理、临床使用及药物经济学等方面进行全面的科学评估。本课题组对鱼腥草注射剂临床不良反应的原因进行系统分析研究,明确鱼腥草注射剂中的主要致敏物质,完善生产质量标准,改进鱼腥草注射剂制备工艺,从而提高了注射剂的安全性、有效性和稳定性,为其恢复生产和临床应用提供科学依据。本论文主要包括以下四个内容:
     1文献综述
     本论文文献综述部分系统论述了三个方面的内容:①鱼腥草及其制剂研究进展;②鱼腥草注射剂临床不良反应原因分析和对策;③注射用辅料吐温80和羟丙基-β-环糊精研究进展。以上这些论述为论文的整体研究奠定了理论基础。
     2鱼腥草注射液原、新制剂及其辅料的致敏性评价实验研究
     本研究分别采用小鼠、Beagle犬和食蟹猴对鱼腥草注射液原、新制剂及其辅料进行致敏性评价研究。类过敏实验以单次静脉恒速注射给药,观察给药后动物的行为变化和血中组胺含量。过敏实验为三次隔日静脉注射给药,此为致敏阶段,在首次给药后14天药量加倍激发给药。同样观察动物的行为学变化和血浆中组胺、IgE的含量,综合判定结果。结果表明类过敏反应以Beagle犬为最佳实验动物,以行为异常及组胺升高为主要判定指标,IgE作为辅助指标,结果准确可靠。食蟹猴在同样条件下不如上述动物敏感。小鼠行为表现更不典型,血液指标的检测误差较大,实验结果仅供参考。实验表明吐温80是诱发类过敏反应的代表性物质。羟丙基-β-环糊精类过敏和过敏反应结果均为阴性。以羟丙基-β-环糊精为增溶剂的鱼腥草注射液新制剂致敏性评价结果为阴性。
     3鱼腥草注射液新、原制剂比较药理学实验研究
     抗病毒实验采用流感病毒FM1和PR8病毒株体内感染小鼠肺炎模型,体外CPE法和神经氨酸酶荧光测定法、病毒载量检测和小鼠死亡保护实验方法,结果显示鱼腥草注射液新制剂对流感病毒感染引起的小鼠肺部炎症均有明显治疗和预防作用,可改善小鼠肺炎症状,降低肺指数,病毒载量,降低死亡率,延长小鼠存活时间;但其抗病毒作用并不是通过直接抑制或杀死病毒,对神经氨酸酶活力也不具有抑制作用。新制剂对二甲苯诱发小鼠耳肿胀有明显抑制作用,能降低醋酸导致的小鼠腹腔毛细血管通透性;同时,还能降低干酵母致大鼠体温升高,对脂多糖导致的家兔体温升高有明显的抑制作用。鱼腥草注射液抗炎、解热作用可能是通过抑制炎症因子TNF-α、IL-1β、IL-8和PGE2释放而发挥作用。鱼腥草注射液新、原制剂抗病毒、抗炎解热作用相当。
     4鱼腥草注射剂中吐温80的定性定量测定方法建立
     本研究采用硫氰酸钴铵显色法、薄层层析法和碘化铋钾法三种方法进行吐温80的定性鉴定,实验结果一致。吐温80的定量检测方法能准确的检测中药注射剂中吐温80含量。吐温80的定性定量方法的建立在实验室条件下可以随机抽取不同厂家、不同批次样品进行吐温80定性定量测定。
     本研究主要结论如下:
     1中药注射剂诱发过敏和类过敏反应的异同比较:中药注射剂导致临床严重不良反应70%以上为类过敏反应,与IgE介导的经典抗原抗体反应不同。主要特征为:首次注射药物即可出现严重不良反应及过敏性休克,与过敏反应症候群相似。属于非抗原抗体反应,IgE、IgG未见明显规律性变化,但体内组胺明显升高。其致敏物质为抗原或半抗原物质及某些可以为诱发组胺释放的多种物质。存在明显的量效关系,大剂量、高浓度可诱发严重不良反应。多种注射剂联合应用可提高发生率及严重性。类过敏反应以Beagle犬为最佳实验动物,以行为异常及组胺升高为主要判定指标,IgE作为辅助指标,结果准确可靠。因此,推荐采用Beagle犬致敏性评价方法作为中药注射剂出厂前的常规安全性检测方法。
     2鱼腥草注射剂中主要致敏物质为增溶剂吐温80,鱼腥草双蒸馏液无明显的毒副作用。中药注射剂引发不良反应的致敏原除了考虑药物本身因素,还有制剂外加辅料和制备、储存过程中内、外源性污染物,这为寻找和解决中药注射剂不良反应诱发因素提供了思路和方法。
     3吐温80国内外应用广泛。中药注射剂134品种中吐温80添加情况很不确定。如果这些品种全部换掉将事关几十个注射剂产品,数百家生产企业及几十万产业工人的生存,对社会稳定和经济影响是必须慎重考虑的问题。通过我们研究发现吐温80引起的类过敏反应存在着明显的量效关系。因此,优选最佳质量、最适用量和浓度的吐温80,既能保证助溶效果,又能最大限度的提高制剂安全性和制剂稳定性。
     4羟丙基-β-环糊精助溶效果好、稳定,无明显毒性、致敏性及溶血性,是目前比较理想的增溶剂。以羟丙基-β-环糊精替换掉吐温80的鱼腥草注射液新制剂,其溶解性、安全性和药效不受影响,为其恢复生产和临床应用提供了科研依据。
     5诱发鱼腥草注射剂临床严重不良反应因素除了药物自身因素,制剂工艺中加入吐温80以及临床不合理用药外,还存在很多偶发因素。因此,本研究只解决了中药注射剂安全性事件中的一个因素,而不是唯一因素,还需要深入开展多方面研究,为中药注射剂进行全面再评价和再研究提供思路和方法。
     本研究的创新点如下:
     1比较中药注射剂导致类过敏和过敏反应的异同,主要从临床反应、病机、诱发物质、给药次数、剂量、检测指标、非临床评价方法和配伍禁忌进行了概括和总结;
     2采用不同种属动物进行类过敏实验研究,优选实验动物、检测指标,优化致敏性评价方法,建立中药注射剂类过敏反应的评价方法和指标;
     3通过一系列药学、安全性和比较药理学研究,证实以羟丙基-β-环糊精为增溶剂的鱼腥草注射液新制剂的安全性显著提高,药效与原制剂相当,是比较有开发和应用前景的鱼腥草注射剂。
The re-evaluation and re-research of Houttuynia Cordata injection, as the CTMI clinical adverse reactions occurred representatives, are very practical significance. The safety re-evaluation of Houttuynia Cordata injection was be carried out on comprehensive scientific assessments, such as:preparation process, quality standards, pharmacology and toxicology, clinical use and drugs economics. Systematic analysis of the clinical adverse reaction causesd by Houttuynia injection, clear the main allergens, improve production quality standards and preparation process, inhance Houttuynia injection safety, effectiveness and stability, in order to restore production and provide scientific basis for clinical applications.
     1, Literature Review
     In the part of literature review, we discussed three aspects:①The reseach of Houttuynia and its preparations;②The analysis and strategy of clinical adverse reaction by Houttuynia injection;③Research for injection accessories of Tween 80 and hydroxypropyl-β-Cyclodextrin. These put forward the theoretical basis for the overall study.
     2, Study on evaluation of allergenicity of original, new Houttuynia injection and different auxiliaries
     This study on allergenicity evaluation the original, new Houttuynia injection and different auxiliaries for used mice, Beagle dogs and rhesus macaque. Anaphylactoid experiment, with single intravenous dose of constant injection, observed changes in behavior of animals after administration and the concentration of histamine. Allergy test was carried out, through intravenous injection of three times to Beagle dogs to immunize, and inject double doses of injections to stimulate in the 9 days after the last sensitized. Observe the allergy situation of Beagle dogs and measure the concentrationns of histamine, IgE in plasma with ELISA after administration in order to determine results. The results show that Beagle dogs to anaphylactoid reactions is the best experimental animal, behavior disorders and histamine concentration as the main index, IgE as the secondary indicator. Rhesus macaque under the same conditions is not sensitive. Atypical behavior and blood indexes in mice are not occurred, its results are not for reference. Tween 80 is the representation of substance-induced anaphylactoid reactions. The results of Hydroxypropyl-β-cyclodextrin in anaphylactoid and allergic reactions are negative. The results in allergenicity evaluation from new Houttuynia cordata injection with hydroxypropyl-β-cyclodextrin as solubilizer are also negative.
     3, Study on comparative pharmacology of new, original Houttuynia intravenous injections
     In this study, the model of infected mice with pneumonia influenza virus PR8 and FM1 strains in vivo, CPE in vitro and neuraminidase Fluorescence, viral load testing and death to protect experimental methods were used.The results show that the new Houttuynia injection had obvious effects of treatment and prevention for the pulmonary inflammation resuting form influenza virus infection in mice, improving the pneumonia symptoms, reducing the lung index and viral load, reducing mortality and prolong survival time; but its antiviral activity is not inhibited or killed by the virus directly, the neuraminidase activity is not inhibited. The new preparation could significantly inhibit the swelling degree of mice ear induced by dimethyl benzene and the effusion of Evans blue from capillary permeability induced by acetic acid in mice; they also could decrease the rectal temperature induced by yeast liquid in rats and LPS-induced in rabbit fever. Anti-inflammatory and antipyretic of Houttuynia injection may be inhibitied by the inflammatory cytokines TNF-α, IL-1β, IL-8 and PGE2. Anti virus, anti-inflammatory and antipyretic of new, original Houttuynia injection are quite.
     4, Establishment of qualitative and quantitative determination of Tween 80 in Houttuynia injection
     Ammonium cobalt thiocyanate color method, thin layer chromatography and bismuth potassium iodide was used to the qualitative identification of Tween 80, the results are consistent. Quantitative analysis of Tween 80 can accurately detect the concentration of Tween 80 in TCMI. Qualitative and quantitative methods of Tween 80 can at randomly detect the samples of different manufacturers and batches of TCMI containing Tween 80 under laboratory conditions.
     The conclusions
     1, Comparison the similarities and differences between allergy and anaphylactoid reactions induced by TCMI
     TCMI lead to serious adverse in clinical over 70%of anaphylactoid reactions, different to classical IgE-mediated antibody-antigen response. Main features of anaphylactoid reactions are:First injection, serious adverse reactions can be arised, such as anaphylactic shock, and similar syndrome with allergic reactions. It is non-antigen-antibody reaction, no significant changes in IgE and IgG, but histamine significantly increased in vivo. The allergenic substance is antigen or hapten as well as histamine-induced release substances. Obvious dose-effect relationship, it can induce serious adverse in high dose and concentrations. Combined with a variety of injections can increase the incidence and severity. Beagle dogs to anaphylactoid reactions is the best experimental animal, behavior disorders and histamine content as the main index, IgE as the secondary indicator. Therefore, assessment of sensitization in Beagle dogs should be a routine safety testing methods of TCMI in Pharmaceutical factory.
     2, The major allergenic substances in Houttuynia cordata injection is Tween 80, Houttuynia double-distilled liquid is no obvious side effects.
     The allergens triggerred adverse reactions of TCMI should account into the drug itself factors, plused accessories in preparation as well as the exogenous and endogenous contaminants in the torage process, which provide ideas in the identification of adverse drug reactions induced by TCMI.
     3, Tween 80 are widely used at home and abroad. Tween 80 in 134 varieties of TCMI added uncertain.
     If Tween 80 of all of these species will be replaced must affect the survival of hundreds of manufacturers and hundreds of thousands of industrial workers, social stability and economic impact must be carefully taken into account.
     4, Hydroxypropyl-β-cyclodextrin is the ideal solubilizer, which has the good solubilization effect, stability, and no significant toxicity, sensitization, hemolytic. New Houttuynia injection with Hydroxypropyl-β-cyclodextrin as solubilizer has good solubility, safety and efficacy, these provide scientific basis for restoring production and clinical applications.
     5, The factors of Houttuynia injection induced clinical serious adverse are not self-medication, adding Tween 80 in preparation process as well as clinical irrational drug use, but also many incidental one.
     This study only solve one of the factors of the safety incident of TCMI, but not the all, many studies also need in depth, which will put forward the further research ideas and methods for the comprehensive re-evaluation of CTMI.
     Innovation of this study
     1, Comparison with the differences in anaphylactoid and allergic reactions lead to by TCMI:clinical syndrome, pathogenesis, inducing substances, frequency of administration, dosage, test indicators, non-clinical evaluation methods and incompatibility;
     2, Using different animal experiments in the anaphylactoid research, purpose is the optimization of experimental animals, detection index and allergenicity evaluation method, which can establish the evaluation methods and indicators of anaphylactoid reactions by TCMI;
     3, Through a series of pharmacy, security research and comparative pharmacology, The new Houttuynia cordata injection with hydroxypropyl-β-cyclodextrin as solubilizer significantly improves the safety, the same efficacy with the original preparation, it has better prospects of development and application in the future.
引文
1 赵新先.中药注射剂学[M].广州:广东科技出版社,2000:1.
    2 黄小萍.3640例中药注射剂不良反应分析[J].现代医药卫生,2007,23(22):3461-3462.
    3 中国药典委员会,中华人民共和国药典一部[M].北京:化学工业出版社,2005,155.
    4 梁爱华,李连达.中药注射剂的发展现状和问题[J].中国中药杂志,2007,32(6):1118-20.
    5 国家食品与药品监督管理局.关于暂停使用和审批鱼腥草注射液等7个注射剂的通告[S].国食药监安[2006]218号.2006-06-01.
    6 肖培根.新编中药志(第三卷)[M].北京:化学工业出版社,2002:200-202.
    7 http://dashulin.com/yuxingcao.
    8 Isogai H. Science Papers Cool of Genal[M]. Education,1952:21.
    9 郑虎占,董泽宏,佘靖,等.中药现代研究与应用(第五版)[M].北京:学苑出版社,1998:2983-3903.
    10 曾虹燕,蒋丽娟,施风姿,等。超临界CO2萃取鱼腥草的挥发油成分[J].植物资源与环境学报,2003,12(02):10-13.
    11 孟江.鱼腥草化学成份及其指纹图谱的研究[D].成都中医药大学,2006年.
    12 吴卫.鱼腥草种质资源研究[D].四川农业大学.2002年.
    13 刘雷,吴卫,郑有良,等.峨眉山不同山峪和海拔高度鱼腥草居群挥发油成分的变化[J].时珍国医国药,2007,18(7):1601-1603.
    14 黄春燕,吴卫,郑有良,等.鱼腥草不同部位挥发油化学成分的比较[J].药物分析杂志,2007,27(1):40-44.
    15 郝小燕,易元芬.黔产野生鱼腥草挥发油成分分析[J].云南植物研究,1995,7(3):350-352
    16 杨亚玲,周强,刘东辉,等.固相萃取和高效液相色谱法测定鱼腥草中的黄酮[J].《云南大学学报(自然科学版),2006,28(2):157-164.
    17 中华人民共和国卫生部标准WS3-B-3264-98.鱼腥草注射液.中药成方制剂,第十七册:170.
    18 赖闻玲,么小江,张曼杰,等.鱼腥草注射液化学成分研究[J].赣南师范学院学报,2005,(3):47.
    19 曾聪彦,梅全喜.从“鱼腥草注射剂事件”看中药注射剂不良反应产生的根源[J].中国药房,2007,18(6):401.
    20 崔刚,李淑芳,常明,等.五厂家鱼腥草注射液质量评价[J].中国医院药学杂志,2004,24(12):784.
    21 陈硕,易伦朝,李博岩,等.鱼腥草注射液指纹图谱分析方法的建立[J].现代中药研究与实践,2004,18(增刊):10.
    22 江苏新医学院.中药大辞典[M].1984,1439-1440.
    23 李国利,庄玉辉,那学明,等.三种中药对分枝杆菌抗菌作用的研究[J].微生物学通报[J],1989,16(3):153-156.
    24 阎桂华.药学通报[J].1960.8(2):57.
    25 冯遇清.上海第一学院学报[J].1964,(2):241.
    26 侯远生.中国中药杂志[J].1990,15(4):29.
    27谭宝秀,段林东,王放银,等.鱼腥草挥发油的提取及其抑菌效果研究[J].邵阳学院学报(自然科学版),2005,2(1):80-82.
    28熊大胜,席在星,邓应威.鱼腥草提取物抑菌作用研究[J].常德师范学院报,2002,14(4):59-60.
    29小管卓夫他.J Pharm Soc Japan[D].1953,73(5):435.
    30卫生部五七干校药厂等.江西医药资料[D].1972,(2):12.
    31北京市结核病研究所细菌免疫学研究室药物组.药学论文摘要[J].1978,264.
    32邱翠琴.新医学[J].1979,10(2):22.
    33王浴生.中药药理与应用[M].北京:人民卫生出版社,1983,709.
    34李文.鱼腥草提取液抗流感、腮腺炎病毒效果观察[J].预防医学文献信息,1999,5(1):347-348.
    35朱宇同,杨汝才,苏章,等.鱼腥草非挥发油提取物抗病毒作用的初步研究[J].中草药,1983,1(7):25-26.
    36赵宇红,申昆玲,刘亚谊,等.鱼腥草注射液治疗呼吸道合胞病毒感染的体外实验研究[J].首都医科大学学报,2005,26(5):571-573.
    37郑宣鹤,廖晓鹏,苏先狮,等.14种中草药抑制出血热病毒的实验研究[J].湖南医科大学学报,1993,18(2):165.
    38郭惠,姚灿,何士勤.鱼腥草抗流感病毒诱导细胞凋亡的研究[J].赣南医学院学报,2003,23(6):615-616.
    39王昕荣,陈素华,刘海智,等.鱼腥草体外抗巨细胞病毒的实验研究[J].医药导报,2007,26(6):579-581.
    40郝莉,杨奎.鱼腥草注射液抗甲型流感病毒实验研究[J].中国中医急症,2007,7(16):713-714.
    41苏金祥,石磊.鱼腥草注射液的药理及临床应用[J].中国中西医结合杂志,2004,13(7):2360-2361.
    42李仪奎,姜名瑛.中药药理学[M].北京:中国中医药出版社,1992,68-69.
    43巩聿清等.鱼腥草的临床药理研究进展[J].中国药业2005,14(3):73-741.
    44李爽,于庆海,初正云.合成鱼腥草素的抗炎作用及其机制[J].中国药理学通报,1998,14(5):442-444.
    45李风雷,刘晓晴,柳青,等.鱼腥草对油酸性急性肺损伤大鼠肺组织TNF-α表达的影响[J].中国病理生理杂志,2003,19(4):547-548.
    46马红梅,张伯礼.鱼腥草的研究进展[J].中草药,2001,32(4):367-372.
    47周彦钢,任玉翠,凌文娟,等.鱼腥草抗辐射作用的初步研究[J].1998,29(增刊):107-108.
    48江苏新医学院.中药大辞典(下册)[M].上海:上海科学技术出版社,1985,1810.
    49邵兰等.合成鱼腥草对小鼠免疫功能的影响[J].沈阳药科大学学报,1999,16(3):209-211.
    50袁雪芬,王晓丹,杨鸿武,等.复方鱼腥草制剂对小鼠辐射损伤保护作用的实验研究[J].中国比较医学杂志,2007,17(8):59.
    51曹郡双,秦荣和.鱼腥草的药理作用及临床应用[J].现代中西医结合杂志,2001,10(6):572.
    52周大兴,张洪霞,李昌煜,等.鱼腥草油抗慢反应物质及平喘作用的研究[J].中成药,1991,13(6):31-32.
    53赵子凯.“复方养阴清肺汤”镇咳、祛痰、抗炎及抑菌作用的实验研究[J].中医药研究,1999,15(20):39-41.
    54项芬芳.鱼腥草药用概述[J].实用中医药杂志,2004,20(10):601.
    55雷蕾,蒲旭峰,杨奎,等.鱼腥草注射液静脉给药不良反应的实验研究[J].中国药理与临床,2007,23(5):131-133.
    56吴胜角.新鱼腥草素钠注射液药理毒理研究[J].引进与咨询,2005,(12):50-52.
    57黄珍定.广西中医药[J].1984,7(6):9.
    58张潮沧.浙江中医杂志[J].1984,(8):353.
    59黄洪坤.实用医学杂志[J],1986,2(2):38.
    60齐利辉.浙江中医杂志[J],1988,(12):536.
    61张秀珍.广西中医药[J].1980,(3):43.
    62刘崇达.云南中医杂志[J],1956,12(5):20.
    63李朝友.新鱼腥草素钠注射液治疗小儿上呼吸道感染疗效观察[J].现代中西医结合杂志,
    2005,14(19):2531-2531.
    64郑艳秋,张虹,夏清艳,等.鱼腥草滴眼液治疗细菌性结膜炎与流行性病毒性结角膜炎120例[J].吉林中医药,2005,25(1):23.
    65罗荣帮,吴志群,张建东,等.鱼腥草联合贝复舒治疗单纯疱疹性角膜炎[J].实用医学杂志,2006,22(5):594.
    66林炎宫.鱼腥草合剂治疗鼻渊400例观察[J].中国中西医结合杂志,1992,12(9):570.
    67黄国彪,倪宪法.鱼腥草穴位注射联合外用药治疗慢性化脓性中耳炎[J].中国中西医结合杂志,2006,(4):16.
    68黄美传,周悦英.鱼腥草注射液穴注治急慢性鼻炎[J].新中医,1996,(2):36.
    69谭凤君.鱼腥草注射液治疗慢性上颌窦炎的疗效观察[J].基层医学论坛,2007,11(6)575.
    70杜长河.鱼腥草注射液雾化吸入治疗慢性咽炎58例[J].中国中医药信息杂志,2002,9(7):52.
    71申秀英,王新萍.鱼腥草注射液穴封配合微波理疗治疗慢性盆腔炎100例.中医研究,2002,15(3):27.
    72王庆玲,姜宏.鱼腥草的药理及临床用药分析[J].时珍国医国药,2001,12(6):491.
    73马瑞芬,陆金霞,沈姚琴.宫腹腔镜联合中药治疗输卵管炎性阻塞性不孕症56例临床分析[J].现代中西医结合杂志,2007,16(11):76.
    74黄琼.鱼腥草外搽配合食疗治疗瘾疹35例疗效观察[J].云南中医中药杂志,2007,28(2):14.
    75毕海军.金黄膏合鱼腥草治疗带状疱疹82例[J].中国中医急症,2005,14(4):329.
    76刘丽英,刘青鹏.鱼腥草治疗扁平疣16例[J].中国民间疗法,2006,14(12):11-12.
    77王鹏等,迪丽努尔,高瑾,等.鱼腥草治疗寻常性银屑病疗效对比及远期随访观察[J].中国皮肤性病学杂志,2007,(7):41.
    78姜美香.鱼腥草治疗习惯性便秘[J].山东中医药杂志,1995,14(8):373.
    79周克聪.鱼腥草治疗功能性腹泻108例[J].浙江中医杂志,1992,27(6):247.
    80牛庆婷,鱼腥草注射液合思密达治疗小儿秋冬季腹泻病43例[J].中医药临床杂志,2004,16(2):139.
    81江学良,权启镇,孙自勤,等.鱼腥草治疗初发型溃疡性结肠炎的临床研究[J].世界华人消化杂志,2003,11(8):1207-1210.
    82柳尧花,王玉英.鱼腥草注射液治疗呼吸道及尿路感染449例[J].浙江中西医结合杂志,2000,10(12):744.
    83秦海光,于佐文.鱼腥草注射液配合西药局部封闭治疗21例急性化脓性睾丸炎[J].中国中医急症,2009,9(1):18.
    84刘守祥,崔应东.鱼腥草注射液治疗肾绞痛的疗效观察[J].医药导报,2002,21(9):554.
    85方公贤,林欣,周美秀.等.鱼腥草注射液替代抗生素在胃次全切除术的应用[J].福建中医药,1990,(4):27.
    86赵瑞勤.鱼腥草注射液治疗多发性疖肿60例疗效分析[J].实用中医药杂志,1994,10(1):25-26.
    87张树梅,张全意.鱼腥草注射液合五草汤治疗恶性胸腔积液观察[J].时珍国医国药,2000,11(12):119.
    88杨维泓.穴位治疗肺癌咯血40例[J].辽宁中医杂志,1992,19(2):30.
    89赵小青,王彩路,曲莉.鱼腥草注射液等中药治疗晚期肺癌16例[J].辽宁中医学院学报,2001,3(2):163.
    90杨胜平.鱼腥草治疗乙型肝炎病毒携带者40例临床研究[J].时珍国医国药,1995,6(增刊):21.
    91罗旭峰.鱼腥草注射液合黄芪注射液治疗病毒性心肌炎25例疗效观察[J].河北中医,2005,27(5):383-384.
    92于红芳.醒脑静配合鱼腥草治疗肺性脑病疗效观察[J].中国中医急症,2006,15(4):383,390.
    93顾静蓉,冯莉莉,罗建伟,等.鱼腥草的药理作用及临床应用新进展[J].海峡药学,2006,18(4):121-123.
    94国家食品与药品监督管理局.关于暂停使用和审批鱼腥草注射液等7个注射剂的通告[S].国食药监安[2006]218号.2006-06-01.
    95韩朝宏,梁月冬.155例鱼腥草注射液不良反应分析[J].药物流行病学杂志,2004,13(5):243-244.
    %王军,姜毅,华碧春.鱼腥草注射液致不良反应228例报告分析[J].医药产业资讯,2006,6(17):191-192.
    97谢娜,陈晖.265例鱼腥草注射液不良反应文献分析[J].中国药师,2006,9(7):660-661.
    98吴红卫.107例鱼腥草注射液不良反应的文献分析[J].广东药学院学报,2003,19(1):46-47.
    99田玉科.麻醉期间的过敏反应和类过敏反应[J].实用医学进修杂志,2004,32(3):129-134.
    100肖培根.新编中药志(第三卷)[M].北京:化学工业出版社,2002,200-202.
    101宋学华.鱼腥草的真伪鉴别[J].中草药通讯,1978,11:40.
    102卢红梅,梁逸曾,伍贤进,等.分别用鲜草和干草生长的鱼腥草注射液指纹图谱对比研究[J],分析化学研究简报,2006,34(6):813-816.
    103邱桂华.中药注射液的不良反应与其质量关系分析J].中国现代中药.2006,4:34,49.
    104蔡永敏,任玉让.最新中药药理与临床应用[M].北京:华夏出版社,1999,92.
    105梁雁,鲁云兰.药物致严重不良反应5例报告与分析[J].首都医药,2003,10(6):25-26.
    106曾茂法,张学斌,屈晓萍.对新鱼腥草素钠注射液稳定性与质量标准可控性的探讨[J].中国药品标准,2006,(4):21-23.
    107王庆利,彭健.吐温80的安全性研究进展[J].毒理学杂志,2006,20(4):262-263.
    108王小仙.静滴鱼腥草注射液致不良反应20例报告[J].中国中药杂志,2002,27(4):312-313.
    109李国豪,甄少立.鱼腥草注射液与常用输液配伍稳定性考察[J].广东药学,2000,10(3):30-32.
    110杨朋彬,徐艳,李喜桂,等.4种中药注射液过滤前后对输液微粒影响的实验研究[J].现代预防医学,2006,33(12):2431-2433.
    111游志红,张亦工,邴雅君.鱼腥草注射液与临床常用抗生素针剂配伍禁忌探讨[J].兰州医学院学报,2002,28(2):81-82.
    112鲍红荣,王珍华.鱼腥草注射液与临床常用药物的配伍考察[J].浙江中医学院学报.2003,27(3):76-77.
    113王珊,许淼.鱼腥草注射液致过敏反应文献分析[J].中国校医,2007,21(1):69-70.
    114简洁.临床输液反应的分析[J].中国医院药学杂志,21(9):573.
    115王瑞华,徐冰,米宏杰.几种中药注射剂的不良反应[J].中华临床医学研究杂志,2006,12(12):1666-1667.
    116 中华人民共和国卫生部.卫生部药品标准[S].中药成方制剂(1-20册).
    117 中华人民共和国国家药典委员会.中国药典[S].一部,北京:化学工业出版社,2005.
    118 EP[S]. ed6.0.2007.
    119 BP[S]. ed2008.2008.
    120 USP[S].ed31.2007.
    121 JP[S]..ed15.2006.
    122 Halpern HN, Samuel J, Prigal. Fundemental of Modern Allergy[J]. New York-Toronio-London, Mcgran Hil.1960,27.
    123 王宁,周远大,杨辉,等.吐温-80对大鼠心血管系统作用的影响[J].中国药房,2004,15(5):273-275.
    124 何永亮.含聚山梨酯-80中药注射液对犬致过敏的研究[J],中药药理与临床,2005,21(1):55.
    125 冯文宇,肖顺汉,刘明华.含吐温80中药注射剂对不同动物的过敏反应[J].泸州医学院学报,2007,30(2):92-94.
    126 L.V. Allen, RS Levinson, Casey robinson and A Lau, Effect of surfactant on tetracycline absorption across everted rat intestine[J]. J Pharm Sci,1981,70(3):269-271.
    127 王肖萱,郑茅梁.吐温80诱发人淋巴细胞姊妹染色体互换及对DNA的损伤[J].中国药理学与毒理学杂志,1990,4(1):270.
    128 韩大良,刘克清,郭少三,等.二甲亚砜、吐温80对小鼠骨髓来源细胞体外生长和活力影响的量效关系分析[J].中国实验血液学杂志,2008,16(2):32.
    129 Friche E, Jensen P B, Sehested M, et al. The solvelhs Cremophor El and Tween 80 modulate daunorubicin resistant cein the muhidrug resistant Ehrlich aseites tumor [J]. Cancer Commun, 1990, (2):297.
    130 彭楠,赵彼得,郭新娜.吐温80在深部脏器肿瘤热化疗中的应用研究[J].现代生物医学进展,2006,6(4):40-41,50.
    131 樊树峰,汝复明,童乾纲.吐温80温热灌注化疗栓塞治疗原发性肝癌的临床研究[J].临床放射学杂志,2003,22(12):93-96.
    132 Sun W, Xie C, Wang H, et al. Specific role of polysorbate 80 coating on the targeting of nanoparticles to the brain[J]. Biomaterials,2004,25:3065-3071.
    133 Gelperina SE, Khalansky AS, Skidan IN, et al. Toxicological studies of doxorubicin bound to polysorbate 80-coated poly(butyl cyanoacrylate)nanoparticles in healthy rats and rats with intracranial glioblastoma[J]. Toxicol Lett,2002,126:131-141.
    134 Gilles Cornaire, John Woodley, Philippe Hermann, et al. Impact of excipientson the absorption of P-glycoprotein substrates invitro and in vivo[J]. International Journal of Pharm aceutics,2004,278:119.
    135 Esther A, Hans F, Vera Mahler. Ann Allergy Asthma Immunol[J].2005,95:593-599.
    136 Walter B, Shelley, Nickolai Talanin, et al. Polysorbate 80 hypertensitivity[J]. The Lancet. 1313-1313.
    137 Epoetion therapy. New Engl J Med,2004,351:1403.
    138 Chemotherapy drugs. Allerg Immunol Clin,2000,15:161.
    139 In taxane pharmacology. Invert New Drugs,2001,19:125.
    140 闫位娟. 中药注射剂致敏性研究[D].广西医科大学,2009.
    141 Masini E, Planchenault J, Pezziardi F, et al. Histamine-releasing properties of Polysorbate 80 in vitro and in vivo:correlation with its hypotensive action in the dog[J]. Agents Actions,1985, 16:470-477.
    142 Ogilvie GK, Cockburn CA, Tranquilli WJ, et al. Hypotension anPMID22972235; Hypotension and cutaneous reactions associated with intravenous administration of etoposide in the dog[J]. Am J Vet Res,1988,49:1367-1370.
    143 孙立,刘晓萌.王欣,等.吐温-80引起动物类过敏反应的原因初步探索[J].毒理学杂志,2007,21(4):134.
    144 吴毅,梁成罡,沈连忠,等.鱼腥草类注射液临床严重不良反应的原因研究(Ⅰ)[J].药物分析杂志,2007,27(5):282-785.
    145 Esther A, Coors, Heidi Seybold, et al. Polysorbate 80 in medical products and nonimmunologic anaphylactoid reactions[J]. Annals of allergy, asthma and immunology,2005, 95:593-599.
    146 张嘉,李澎,李贻奎,等.吐温80诱导RBL-2H3细胞脱颗粒作用研究[J].现代免疫学,2009,29(3):240-244.
    147 Kellner A, Correll JW, Ladd AT. Sustained hyperlipemia induced in rabbits by means of intravenously injected surface active agents[J]. J Exp Med,1951,93:373-384.
    148 邹静,张青,唐冰,等.紫外分光光度法测定吐温80对人红细胞和兔红细胞的溶血度[J].西南国防医药,2004,14(3):255-256.
    149 张嘉.鱼腥草注射液不良反应研究[D].北京中医药大学,2009.
    150 Rhodes A, Eastwood JB, Smish SA. Early acute hepatitis with parenteral am iodarone:A toxic effect of the vehicle[J]. Gut,1993,34(4):563.
    151 温伟,纪立伟,张新超.胺碘酮静脉滴注致急性肝损害15例临床分析[J].药物不良反应杂志,2004,8(2):105.
    152 Reuter HD, Vitamins In, Beeley L, et al. Side effects of drugs annual 12[J]. Amsterdam: Elsevier,1988:327.
    153 Freilich RJ, Balnlaceda C, Seidrlan Anelal. Moto neuropathy due to docetaxel and paclitaxel[J]. Neurology,1996,47:115.
    154 VanTellingen O, Beijnen JH, Verwei J, et. al. Rapid esterasesensitive breakdown of polysorbate 80 and its impacton the plasma phal, Maco kinetics of docetaxel and metaboli tesinmice[J]. Clin Cancer Rcs,1999, (5):2918.
    155 GianniI, Vigano I, Locatelli A, et al. Huinan pharmacokinetic chatacterization and in vitro study of the interaction between doxorubicin and paclitaxelin patients with breast cancer[J]. J Clin Oneol,1997,(1):1906.
    156 Sparreboom A, van AsperenJ, Mayer U, et al. Limited oral bioavailability and active epithelial excretion of paclitaxel(Taxol) caused by P-glycoprotein in the intestine[J]. Proc Natl Acad Sci USA,1997,94:2031.
    157 Hanawa Takehisa, Endoh Naoko, Suzuki Masahiko, et al. Release behavior of diethylhexyl phthalate from the polyvinyl-chloride tubing used for intravenous administrationand the plasticized PVC membrane[J]. International Journal of Pharmaceutics,2005,297:30.
    158 Krantz J C, Culver P J, Carr C J, et al. Sugar alcohols XXVIII; Toxicologic, Pharmacodynamic and clinical observations on Tween 80[J]. Bull School Med, U of Maryland,1951,36:48-56.
    15 Varma RK, Kaushal R, J unnarkar AY, et al. Polysorbate 80:a pharmacological study[J]. Arzneimittel forschung,1985,35:804-808.
    160 Auletta CS, Reynolds DL, Kelly CM, et al. Adverse effects of Tween 80 in dogs[J]. Fundam Appl Toxicol,1996,30:101.
    161 Toxicology and Carcinogenesis Studies of Polysorbate 80 (CAS No.900526526) in F344ΠN Rats and B6C3F1 Mice(Feed Studies). Natl Toxicol Program Tech Rep Ser,1992,415:12-25.
    162 Gajdova M, Jakubovsky J, Valky J. Delayed effects of neonatal exposure to Tween 80 on female reproductive organs in rats[J]. Food Chem Toxicol,1993,31:183-190.
    163 Williams J, Odum J, Lewis RW, et al. The oral administration of polysorbate 80 to the immature female rat does not increase uterine weight[J]. Toxicol Lett,1997,91:19-24.
    164 Delvalle EM. Cyclodextrins and their uses:a review [J]. Process Biochem,2004,39(9): 1033-1046.
    165 Cyclodex. Hydroxypropylbeta cyclodextrin [EB/OL]. http://www. cyclodex. com/about, asp? page_id=4&n=4.
    166 Yoshida A, Yamamoto M, Itoh T, et al. Chem Pharm Bull,1990,38(1):176.
    167 Brewster ME, Simpkins JW, Singh HM, et al. J Parenter Sci Technol,1989,43(5):231.
    168 Simpkins JW. J Parenter Sci Technol,1991,45(6):266
    169 Chin J, Song HM, Lee KC. Int J Pharm,1994,106(2):135.
    170 Pitha J. J Parm Sci,1985,74(9):987.
    171 Yoshida A, Yamamoto M, Irie T, et al. Chem Pharm Bull,1989,37(4):1059.
    172 http://www.researchd.com/janssen/410200.htm.
    173 Holvoet C, Heyden YV, Vercammen JP. Inclusion complexation of diazepam with different cyclodextrins in formulations forparenteraluse[J]. Pharmazie,2005,60 (8):598-560.
    174 何仲贵,张天虹.β-环糊精及其衍生物:2-羟丙基-β-环糊精对布洛芬的增溶作用[J].沈阳药科大学学报,1998,15(4):235-237.
    175邵伟,王大庆,袁敏,等.黄芩甙-羟丙基-β-环糊精包合物的研究[J].中成药,2001,23(5):318-321.
    176陈勤,郭鹏.薄荷脑2-羟丙基-B-环糊精包合物的研究[J].中华医学丛刊,2004,4(4):31.
    177吴广通,张夏华,李凤前.改善中药挥发油稳定性的制剂学研究进展[J].药学服务与研究,2008,8(3):197-200.
    178 Brewstar ME, Loftsson T, Estes KS.-Effect of various cyclodextrinson solution stability and dissolution rate of doxorubicin hydrochloride[J]. Int J Pharm,1992,79:289-290
    179 Lin HS, Chean CS, Ng YY, et al.2-Hydroxypropyl-beta-cyclodexrin increases aqueous solubility and photostability of all-trans-retinoic acid[J]. J Chin Pharm Ther,2000,25(4):265.
    180谷福根,崔福德,高永良,等.前列腺素E1与羟丙基-β-环糊精在水溶液中包合作用的研究[J].药学学报,2004,39(9):742-746.
    181石远,石惠,姜同英,等.注射用丹参酮ⅡA包合物的制备及性质考察[J].沈阳药科大学学报,2008,25(10):765-771.
    182 Setern AM, Nguyen NB, BrandlAB, et al. Effect of hydroxypro-pyl-β-cyclodextrin and pH on solubility of camptothecin[J]. Int J Pharm,2004,284:61-68.
    183 Trapani G, Latrofa A, FrancoM, et al. Inclusion complexation of propofolwith 2-hydroxypropyl-β-cyclodextrin. Physicochemica, lnuclearmagnetic resonance spectroscopic studies, and anesthetic properties in rat[J]. J Pharm Sci,1998,87 (4):514-518.
    184 Chang SL, Banga AK. Transdermal iontophoretic delivery of hydrocortisone from cycclodextrin solutions[J]. J Pharm Pharmacol,1998,50(6):635-640.
    185 Brewstar ME, Loftsson T, Estes KS. Effect of various cyclodextrinson solution stability and dissolution rate of doxorubicin hydrochloride [J]. Int J Pharm,1992,79:289-299.
    186 Pitha J, Gerloczy, Olivi A. Parenteral hydroxypropyl cycodextrina; intravenous and intracerebral agministration of lipophiles[J]. J Parem Sci,1994,83(6):833-837.
    187 Franco CF, Pataro AL, Souza LC E, et al. In vitro effects of achlo rhexidine controlled delivery system[J]. A rtif Organs,2003,27(5):486.
    188 Szejtli. J Pharm Technol,1991,15(8):24,26,28,32,34,36,38.
    189 http://www.researchd.com/janssen/410200.htm.
    190 Monboliu J, Beijsterveldt V, Meuldermans Wet, et al. Minuter Int. Symp.Cyclodextrins 5th, 1990,514.
    191 Seller KU, Szathmary S, Huss HJ, et al. Minutes Int Symp Cycldextrins 5th,1990,518.
    192 Szathmary SC, Seiler KU, Luhmann L, et al. Minutes Int. Symp.Cyclodextrins 5th,1990,535.
    193何仲贵.羟丙基-β-环糊精对药物的包合作用及对体内药物动力学的影响[D].沈阳药科大学博士学位论文,2003:134-140.
    194 Carpenter TO, Gerloczy A, Pitha J. Safety of parenteral HP-β-CD[J]. J Pharm Sci,1995,84(2): 222.
    195 Frommi KH, Szejtli J. Pharmacokinetics and toxicology of cyclodextrins[C]//Szejtili J, Szente L. Proc. of the 8th Int. Symposium on Cyclodextrins.1996:33-45(Chapter3).
    196 Brewstar ME, Estes KS, Bodor N. An intravenous toxicity study of 2-hydroxypropyl-β-cyclodextrin, a useful drug solubiliser, in rats andmonkeys[J]. Int J Pharm, 1990,59(3):231-243.
    197 Coussement TW, Van Cautere NH, Vandenberghe J, et al. Toxicologic alprofile of HP-(3-CD in laboratory animals. [C]//Duchene, D. Minutes of the 5th International Symposium on Cyclodextrins. Editions de Sante,1990:522-524.
    Gould S, Scottrc.2-Hydroxypropyl-(3-cyclodextrin(HP-(3-CD):a toxicology review[J]. Food Chem Toxicol,2005,43(10):1451-1459.
    Stella VJ, Rajewskir A. Cyclodextrins:their future in drug formulation and delivery [J]. Pharm Res,1997,14(5):556-568.
    200 Pitha J, Gerloczy A, Olivi A. Parenteral hydroxypropyl cyclodextrins:intravenous and intracerebral administration of lipophiles[J]. J Pharm. Sci,1994,83:833-837.
    201 Irie T, OtagiriM, SunadaM, et al. Cyclodextrin-induced hemolysis and shape changes of human erythrocytes in vitro [J]. J Phar-macobio-Dyn,1982,5:741-744.
    202 Rajewski R.A, Traiger G, Bresnahan J, et al. Preliminary safety evaluation of parenterally administered sulfoalkyl ether-β-cyclodextrin derivatives [J]. J Pharm Sci,1995,84 (8): 927-931.
    203 Medlicott NJ, Foster KA, Audus KL, et al. Comparison of the effects of potential parenteral vehicles for poorly water soluble anti-cancerdrugs (organic cosolvents and cyclodextrin solutions) on cultured endothelial cells(HUV-EC)[J]. J Pharm Sci,1998,87(9):1138-1143.
    210 雷蕾,蒲旭峰,杨奎,等.鱼腥草注射液静脉给药不良反应的实验研究Ⅰ-犬静脉给药不良反应研究[J].中药药理与临床,2007,23(5):131.
    211 《中药、天然药免疫毒性(过敏性、光变态反应)研究的技术指导原则(第二稿)》[M].2004.3:19-21.
    212 HE S H, XIE H, ZHANG X J, et al. Inhibition of Histamine Release from Human Mast Cells by Natural Chymase Inhibitors[J]. Acta Pharmacol Sin,2004,25(6):822-826.
    213 张美玉,李贻奎,张嘉,等.鱼腥草注射液过敏及类过敏实验研究[J],中国现代应用药学2009,26(8):610-614.
    214 张嘉,李澎,李贻奎,等.吐温80诱导RBL-2H3细胞脱颗粒作用研究[J],现代免疫学.2009,29(3):240-245.
    215 田玉科.麻醉期间的过敏反应和类过敏反应.实用医学进修杂志[J],2004,32(3):129-134.
    216 Hao L, Yang K. The experimental study on the antiviruseffect of Houttuynia Cordata Injection on influenza virus in mice [J]. J Emerg Syndromes Tradit Chin Med(中国中医急症),2007,16:7132-7141.
    217 张均田.现代药理实验方法学[M].北京:北京医科大学中国协和医科大学联合出版社,1998.1452-1470.
    218 陈奇.中药药理研究方法学[M].北京:人民卫生出版社.1993,265.
    219 张俭,伍贤进,卢红梅,等.鱼腥草制剂抗炎动物模型的建立及研究[J].时珍国医国药,2007,18(6):1290-1291.
    220 袁吕江,李学刚,何红梅,等.鱼腥草素同系物对小鼠免疫影响的研究[J].中医药学报,2004,32(5):25-28.
    221 陈奇主编.中药药理研究方法学[M].第1版.北京:人民卫生出版社.1993:272.
    222 Dinarello CA, Cannon JG,Wolff SM, et al. New concepts on the pathogenesis of fever[J]. Rev Inf Dis,1998,10:168.
    223 《药品非临床研究质量管理规范》,2003年8月.
    224 陈奇.《中药药理研究方法学》(第1版).北京:人民卫生出版社,1993,271.
    225 陈奇.中药药理研究方法学[M].第1版.北京:人民卫生出版社.1993,298-302.
    226 Arnes RC. Role of prostaglandin E in the biphasic feverresponse to endotoxin. Journal of Experimental Medicine,1981,154:1212-1224.
    227 Ushikubi F, Narumiya S. The roles of the prostanoids played in the body. Nippon Yakurigaku Zasshi,2002,119(4):201-207.
    228 中华人民共和国卫生部药典委员会.中华人民共和国药典[M].北京:人民卫生出版社,2000版(二部):992.
    229 沈琦,陈继亭,刘大英.凝血因子制品中Tween80残留量测定方法的研究[J].中国生物制品学杂志,1999,12(2):111-113.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700