基于药物相互作用探讨中药七情合和相反/相恶/相畏配伍禁忌作用模式与机制

摘要

This paper proposed three kinds of action patterns of traditional Chinese medicine (TCM) incompatibility based on the cognitions for theories of seven ways of compatibility and drug interaction. These are toxication and potentiation toxicity action pattern embodied the characteristic of antagonism, efficiency reduction and decrease effect action pattern reflected the characteristic of mutual inhibition/restraint, and toxic-effect multiple action pattern embodied the complex characteristics of antagonism and mutual inhibition/restraint. In addition, we exploringly put forward eight possible mechanisms of TCM incompatibility. They are potentiation toxicity by promoting the release of toxic substances, potentiation toxicity by producing new toxic components, potentiation toxicity because of increased toxic components resulted from mutual transformation of chemical constituents, efficiency reduction through inhibiting the dissolving of active components, efficiency reduction through inactivating the active components, toxication resulted by toxic metabolite generated in vivo based on drug interaction, adverse effects caused by affecting the physiological disposition of incompatibility combinations, and adverse effects caused by regulating and controlling the drug metabolic enzymes. Furthermore, the authors discussed the correlations between the different action patterns and mechanisms and relationships of seven ways of compatibility. These opinions would be providing references for understanding and researching the essences of TCM incompatibility.%本文通过对中药七情合和配伍理论与药物相互作用理论学习认知,以及对中药配伍禁忌研究成果进行较为系统的梳理分析基础上,提出中药配伍禁忌的3类作用模式:表征相反配伍特征的致毒增毒作用模式;表征相恶/相畏配伍特征的降效减效作用模式;表征相反/相恶/相畏多元配伍特征的毒效复合作用模式.探索性地提出导致中药配伍禁忌的8个可能机制:药物相互作用促进毒性物质的溶出释放而增毒;药物相互作用产生新的毒性成分而致毒;成分间相互转化致使毒性成分含量增加而增毒;药物相互作用抑制功效物质的溶出释放而降效;药物相互作用导致某功效物质的破坏或失活而减效;药物在体内相互作用产生毒性代谢产物而致毒;药物相互作用对药物体内过程产生不利影响;药物与机体相互作用对药物代谢酶系的活性及其调控产生不利影响.并探讨了不同作用模式及其可能机理与七情配伍关系的相互关联,为中药配伍禁忌本质特征的认识与科学实质的揭示提供借鉴.