目的:本研究通过对芒硝化学成分的描述,综述芒硝在中药及各种制剂中的应用,处理方法,药理学,毒理学,和临床研究进展。方法:寻找芒硝在传统和现代中医著作中的应用和加工方法。以及关于化学成分的文章,药理作用,毒理学,并对芒硝及其组合在PubMed和中国知网的临床研究进行了综述,排序,并分析。结果:芒硝的主要化学成分为十水硫酸钠(Na2SO4·10H2O),其次是少量的氯化钠,硫酸镁,硫酸钙,和其他无机盐。本研究系统地整理了我国2000多年来芒硝的药用历史。这种矿物已被九个中国民族(汉族,戴,哈萨克,满族,蒙古语,土家族,小薇,Yi,和藏语)在大量的处方制剂中。中华人民共和国药典(2020年版)记载芒硝可用于腹胀,腹痛,便秘,肠道的碳水化合物,乳房carb的外部治疗,痔疮,和其他疾病。中国芒硝的传统加工方法包括精炼,沸腾,炒菜,热水起泡后过滤,和射击。自明朝以来,萝卜加工已成为芒硝的主流制备方法。芒硝可以通过抑制AMS表现出抗炎消肿作用,LPS,IL-6,IL-10,TNF-α,和NO水平并减弱TNF-α和NF-κB基因的上调。它可以通过增加细胞因子TGFβ1和VEGF-A的产生来促进细胞增殖和伤口愈合,并通过增加血管活性肠肽的释放来促进胃肠运动,P物质,还有胃动素.它可以通过上调胆汁酸合成基因来增加肝脏中低密度脂蛋白受体的表达和AKT磷酸化;降低肝脏中TRB3的表达,FGF15共受体KLB表达,在回肠中产生FGF15,和JNK信号转导;并增加CYP7A1的转录,达到降胆固醇作用。芒硝还具有多种药理作用,比如调节肠道菌群,抗肌肉麻痹,抗结肠癌,促进排水,和镇痛。只有少数关于芒硝的毒理学研究可用。芒硝外用会导致局部皮肤发红或发痒,口服对神经肌肉细胞有毒性。其代谢物的硫离子也可能对人体有毒。目前,尚未对芒硝作为单一药物进行药代动力学研究。这种矿物质已广泛应用于临床治疗炎症,水肿,伤口愈合,消化系统疾病,输液外渗,痔疮,皮肤病,乳房积聚,肌肉麻痹,显微镜检查前的肠道准备,以及其他疾病和症状。结论:芒硝在中药和民族医学中具有良好的应用前景。深入研究其加工方法,活性成分,质量控制,药代动力学,药理和毒理学机制,需要标准化的临床应用。为今后芒硝的应用和研究提供参考。
Purpose: This study reviews the use of mirabilite in traditional Chinese medicine and various preparations by describing its chemical composition, processing methods, pharmacology, toxicology, and clinical research progress. Methods: The applications and processing methods of mirabilite are searched in traditional and modern Chinese medical writings, and the articles on chemical composition, pharmacological effects, toxicology, and clinical studies of mirabilite and its combinations in PubMed and China Knowledge Network are reviewed, sorted, and analyzed. Results: The main chemical component of mirabilite is sodium sulfate decahydrate (Na2SO4·10H2O), followed by small amounts of sodium chloride, magnesium sulfate, calcium sulfate, and other inorganic salts. This study systematically organizes the history of the medicinal use of mirabilite in China for more than 2,000 years. This mineral has been used by nine Chinese ethnic groups (Han, Dai, Kazakh, Manchu, Mongolian, Tujia, Wei, Yi, and Tibetan) in a large number of prescription preparations. The Pharmacopoeia of the People\'s Republic of China (2020 edition) records stated that mirabilite can be used for abdominal distension, abdominal pain, constipation, intestinal carbuncle, external treatment of breast carbuncle, hemorrhoids, and other diseases. The traditional processing methods of mirabilite in China include refining, boiling, sautéing, filtration after hot water blistering, and firing. Since the Ming Dynasty, processing by radish has become the mainstream prepared method of mirabilite. Mirabilite can exhibit anti-inflammatory detumescence effects by inhibiting AMS, LPS, IL-6, IL-10, TNF-α, and NO levels and attenuating the upregulation of TNF-α and NF-κB genes. It can promote cell proliferation and wound healing by increasing the production of cytokines TGFβ1 and VEGF-A and gastrointestinal motility by increasing the release of vasoactive intestinal peptide, substance P, and motilin. It can increase the expression of low-density lipoprotein receptor and AKT phosphorylation in the liver by up-regulating bile acid synthesis genes; reduce TRB3 expression in the liver, FGF15 co-receptor KLB expression, and FGF15 production in the ileum, and JNK signal transduction; and increase the transcription of CYP7A1 to achieve a cholesterol-lowering effect. Mirabilite also has a variety of pharmacological effects, such as regulating intestinal flora, anti-muscle paralysis, anti-colon cancer, promoting water discharge, and analgesic. Only a few toxicological studies on mirabilite are available. External application of mirabilite can cause local skin to be flushed or itchy, and its oral administration is toxic to neuromuscular cells. The sulfur ions of its metabolites can also be toxic to the human body. At present, no pharmacokinetic study has been conducted on mirabilite as a single drug. This mineral has been widely used in the clinical treatment of inflammation, edema, wound healing, digestive system diseases, infusion extravasation, hemorrhoids, skin diseases, breast accumulation, muscle paralysis, intestinal preparation before microscopic examination, and other diseases and symptoms. Conclusion: Mirabilite has good application prospects in traditional Chinese medicine and ethnomedicine. In-depth research on its processing methods, active ingredients, quality control, pharmacokinetics, pharmacological and toxicological mechanisms, and standardized clinical application is needed. This paper provides a reference for the application and research of mirabilite in the future.