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雄黄作为传统中药已有2000余年历史,并为1963年至2005年的各版《中国药典》收载。雄黄主要用于治疗蛇虫咬伤、虫积腹痛、惊痫及疟疾。近年研究表明,雄黄有抗菌、镇痛消炎和提高机体免疫力的作用;雄黄制剂能有效治疗白血病。雄黄的剂量为0.05~0.1g/d。实际上,据不完全统计,约有66种雄黄制剂的常用量超过《中国药典》规定。雄黄的主要成分为二硫化二砷(As2S2)。尽管二硫化二砷的毒性较小,但雄黄大量长期应用可引起急、慢性中毒,这可能与其所含可溶性三氧化二砷(As2O3)有关。雄黄所致严重不良反应有出血、肝肾衰竭、呼吸中枢麻痹,甚至死亡。作者认为,雄黄临床应用的利弊应在对雄黄及其制剂的有效性和安全性作深入调查研究的基础上再进行科学评价。
Realgar has been used as a traditional Chinese medicine for more than 2,000 years and was included in various editions of the Chinese Pharmacopoeia from 1963 to 2005. Realgar is mainly used for the treatment of snake bites, abdominal mass accumulation, epilepsy and malaria. Recent studies have shown that realgar has antibacterial, analgesic, anti-inflammatory and immune-enhancing effects; realgar preparations can effectively treat leukemia. The realgar dose is 0.05 to 0.1 g/d. In fact, according to incomplete statistics, there are about 66 common realgars that exceed the Chinese Pharmacopoeia requirements. The main component of realgar is arsenic disulfide (As2S2). Although the toxicity of arsenic disulfide is relatively small, a large number of long-term use of realgar can cause acute and chronic poisoning, which may be related to the content of soluble arsenic trioxide (As2O3). Severe adverse reactions caused by realgar include bleeding, liver and kidney failure, respiratory center paralysis, and even death. The author believes that the advantages and disadvantages of clinical application of realgar should be based on a thorough investigation and research on the effectiveness and safety of realgar and its preparations, and then make a scientific evaluation.