《中华人民共和国药典》2025版有毒中药肾毒性机制与减毒策略研究进展OA

Toxic Chinese herbal medicines play a role in treating diseases by"attacking pathogenic factors and repeatedly curing intractable ailments using poison".However,their clinical applications are limited by toxicities of these medicines,such as hepatotoxicity,nephrotoxicity and cardiotoxicity.Based on the classification of toxic Chinese herbal medicines stipulated in the 2025 edition of the Pharmaco-poeia of the People's Republic of China,this paper begins by demonstrating the central role of dosage and syndrome differentiation in the manifestation of drug toxicity.The mechanisms of nephrotoxicity of toxic Chinese herbal medicines and methods for reducing toxicity are explored.Four common toxic pathways associated with drug-induced nephrotoxicity are summarized:oxidative stress damage,acti-vation of inflammatory pathways,disruption of metabolic pathways,and apoptosis.Based on mechanistic research,the paper expands the toxicity-reducing strategy from the traditional two-dimensional frame-work of"processing and formulation"to a four-dimensional system comprising"processing,formulation,syndrome differentiation and dosage"in the hope of providing a reference for safe and rational clinical applications of toxic Chinese herbal medicines,as well as for enhancing their efficacy while reducing toxicity.