《中(zhong)國藥(yao)(yao)典》和中(zhong)藥(yao)(yao)學教科(ke)書上，除了少數毒(du)(du)性峻烈、含有(you)(you)較(jiao)大毒(du)(du)性成分的(de)(de)(de)中(zhong)藥(yao)(yao)明確標注為有(you)(you)大毒(du)(du)、小毒(du)(du)外，絕大多數中(zhong)藥(yao)(yao)并未(wei)標明其有(you)(you)毒(du)(du)，通常認(ren)(ren)為是無(wu)毒(du)(du)藥(yao)(yao)。然而，無(wu)毒(du)(du)中(zhong)藥(yao)(yao)是否一定就是安全的(de)(de)(de)，可以隨(sui)意服(fu)用呢？這是一個(ge)需要認(ren)(ren)真對(dui)(dui)待的(de)(de)(de)問題。不但(dan)普(pu)通民眾(zhong)，就連(lian)一些(xie)醫藥(yao)(yao)專業(ye)人士也對(dui)(dui)無(wu)毒(du)(du)中(zhong)藥(yao)(yao)的(de)(de)(de)認(ren)(ren)識(shi)不足，片面地認(ren)(ren)為沒有(you)(you)標明毒(du)(du)性的(de)(de)(de)中(zhong)藥(yao)(yao)就是絕對(dui)(dui)安全的(de)(de)(de)。然而事(shi)實卻并非如此，無(wu)毒(du)(du)中(zhong)藥(yao)(yao)是不能等同于普(pu)通的(de)(de)(de)食(shi)物和營養(yang)物質的(de)(de)(de)。
藥物偏性謂之毒
《類經》云，“藥(yao)(yao)(yao)(yao)(yao)(yao)以(yi)(yi)治(zhi)病，因毒(du)為能，所謂毒(du)藥(yao)(yao)(yao)(yao)(yao)(yao)，是(shi)(shi)以(yi)(yi)氣味(wei)之有偏(pian)(pian)(pian)(pian)也(ye)”。人(ren)之為病，在(zai)乎陰(yin)陽(yang)(yang)有偏(pian)(pian)(pian)(pian)，藥(yao)(yao)(yao)(yao)(yao)(yao)之效(xiao)，在(zai)于(yu)糾其偏(pian)(pian)(pian)(pian)也(ye)。古人(ren)也(ye)說；“是(shi)(shi)藥(yao)(yao)(yao)(yao)(yao)(yao)三分(fen)毒(du)”。此“毒(du)”是(shi)(shi)特指藥(yao)(yao)(yao)(yao)(yao)(yao)物的(de)(de)(de)(de)(de)作(zuo)用(yong)偏(pian)(pian)(pian)(pian)性(xing)，也(ye)是(shi)(shi)藥(yao)(yao)(yao)(yao)(yao)(yao)物的(de)(de)(de)(de)(de)特性(xing)。藥(yao)(yao)(yao)(yao)(yao)(yao)物的(de)(de)(de)(de)(de)偏(pian)(pian)(pian)(pian)性(xing)可(ke)以(yi)(yi)糾正人(ren)體(ti)(ti)失衡的(de)(de)(de)(de)(de)陰(yin)陽(yang)(yang)狀態(tai)，治(zhi)療(liao)對(dui)應(ying)的(de)(de)(de)(de)(de)病癥(zheng)。偏(pian)(pian)(pian)(pian)性(xing)就是(shi)(shi)藥(yao)(yao)(yao)(yao)(yao)(yao)物作(zuo)用(yong)于(yu)人(ren)體(ti)(ti)后產生的(de)(de)(de)(de)(de)對(dui)應(ying)效(xiao)應(ying)后的(de)(de)(de)(de)(de)特征表現(xian)。偏(pian)(pian)(pian)(pian)性(xing)從現(xian)代(dai)生理(li)(li)學(xue)(xue)(xue)和(he)(he)藥(yao)(yao)(yao)(yao)(yao)(yao)理(li)(li)學(xue)(xue)(xue)角(jiao)度來說，就是(shi)(shi)藥(yao)(yao)(yao)(yao)(yao)(yao)理(li)(li)作(zuo)用(yong)和(he)(he)生理(li)(li)活性(xing)。盡管多(duo)數中藥(yao)(yao)(yao)(yao)(yao)(yao)并沒有明(ming)確其是(shi)(shi)有毒(du)有害的(de)(de)(de)(de)(de)，但是(shi)(shi)毫無(wu)疑問，從現(xian)代(dai)藥(yao)(yao)(yao)(yao)(yao)(yao)理(li)(li)學(xue)(xue)(xue)角(jiao)度來說，多(duo)數中藥(yao)(yao)(yao)(yao)(yao)(yao)盡管無(wu)毒(du)，但是(shi)(shi)卻對(dui)人(ren)體(ti)(ti)有著(zhu)(zhu)顯著(zhu)(zhu)的(de)(de)(de)(de)(de)藥(yao)(yao)(yao)(yao)(yao)(yao)理(li)(li)作(zuo)用(yong)。中醫(yi)學(xue)(xue)(xue)的(de)(de)(de)(de)(de)陰(yin)陽(yang)(yang)五行理(li)(li)論是(shi)(shi)在(zai)古代(dai)樸(pu)素的(de)(de)(de)(de)(de)唯(wei)物主義哲學(xue)(xue)(xue)觀(guan)指導下建(jian)立(li)起來的(de)(de)(de)(de)(de)，并在(zai)此理(li)(li)論上形成了獨具(ju)特色的(de)(de)(de)(de)(de)中醫(yi)藥(yao)(yao)(yao)(yao)(yao)(yao)性(xing)理(li)(li)論。包括四氣五味(wei)、歸經、升降浮沉、有毒(du)無(wu)毒(du)等認識(shi)。對(dui)于(yu)藥(yao)(yao)(yao)(yao)(yao)(yao)物毒(du)性(xing)的(de)(de)(de)(de)(de)認識(shi)，受限于(yu)古代(dai)的(de)(de)(de)(de)(de)科學(xue)(xue)(xue)技術水平，不可(ke)能從分(fen)子細胞和(he)(he)化學(xue)(xue)(xue)成分(fen)等微(wei)觀(guan)層面去(qu)分(fen)析(xi)和(he)(he)探討其藥(yao)(yao)(yao)(yao)(yao)(yao)理(li)(li)毒(du)理(li)(li)作(zuo)用(yong)。只能從藥(yao)(yao)(yao)(yao)(yao)(yao)物運用(yong)于(yu)人(ren)體(ti)(ti)后產生的(de)(de)(de)(de)(de)相應(ying)作(zuo)用(yong)來解釋其藥(yao)(yao)(yao)(yao)(yao)(yao)性(xing)特征。總體(ti)(ti)上來說，這(zhe)是(shi)(shi)一種建(jian)立(li)在(zai)經驗(yan)認識(shi)基礎(chu)上的(de)(de)(de)(de)(de)宏(hong)觀(guan)藥(yao)(yao)(yao)(yao)(yao)(yao)性(xing)理(li)(li)論。
正確認識藥物的毒性
一(yi)(yi)(yi)些毒(du)(du)性(xing)較為(wei)(wei)(wei)劇烈(lie)的(de)(de)(de)(de)(de)(de)中(zhong)(zhong)藥(yao)(yao)(yao)已經引起了(le)人(ren)(ren)們(men)(men)的(de)(de)(de)(de)(de)(de)重視，如(ru)附子、半夏(xia)、蟾酥等含有劇烈(lie)毒(du)(du)性(xing)成分的(de)(de)(de)(de)(de)(de)藥(yao)(yao)(yao)物(wu)，其(qi)應用(yong)稍有不(bu)慎，即可(ke)引起中(zhong)(zhong)毒(du)(du)甚至導致人(ren)(ren)體(ti)死亡。目前(qian)醫學界普遍認識(shi)并且注(zhu)意到了(le)毒(du)(du)性(xing)中(zhong)(zhong)藥(yao)(yao)(yao)的(de)(de)(de)(de)(de)(de)應用(yong)和管理(li)。然而(er)，絕(jue)大多(duo)數無毒(du)(du)中(zhong)(zhong)藥(yao)(yao)(yao)中(zhong)(zhong)存(cun)在的(de)(de)(de)(de)(de)(de)化(hua)學物(wu)質成分，其(qi)對人(ren)(ren)體(ti)產生(sheng)(sheng)的(de)(de)(de)(de)(de)(de)藥(yao)(yao)(yao)理(li)作用(yong)和可(ke)能造成的(de)(de)(de)(de)(de)(de)機體(ti)損害(hai)，并未引起專業人(ren)(ren)士的(de)(de)(de)(de)(de)(de)重視。除了(le)少(shao)數精通中(zhong)(zhong)醫藥(yao)(yao)(yao)學的(de)(de)(de)(de)(de)(de)專業人(ren)(ren)士，多(duo)數人(ren)(ren)很難理(li)解無毒(du)(du)中(zhong)(zhong)藥(yao)(yao)(yao)的(de)(de)(de)(de)(de)(de)藥(yao)(yao)(yao)性(xing)特點。一(yi)(yi)(yi)般會(hui)想當然地將其(qi)理(li)解為(wei)(wei)(wei)是(shi)(shi)絕(jue)對安(an)全無害(hai)的(de)(de)(de)(de)(de)(de)。這(zhe)(zhe)是(shi)(shi)一(yi)(yi)(yi)種錯誤的(de)(de)(de)(de)(de)(de)認識(shi)。一(yi)(yi)(yi)些藥(yao)(yao)(yao)食(shi)兩用(yong)的(de)(de)(de)(de)(de)(de)中(zhong)(zhong)藥(yao)(yao)(yao)，如(ru)生(sheng)(sheng)姜(jiang)、大棗(zao)、蜂蜜(mi)等一(yi)(yi)(yi)類中(zhong)(zhong)藥(yao)(yao)(yao)。實踐(jian)證明其(qi)一(yi)(yi)(yi)般情況下確(que)實不(bu)具(ju)備毒(du)(du)副作用(yong)，可(ke)以作為(wei)(wei)(wei)食(shi)療方法長(chang)期服用(yong)。然而(er)這(zhe)(zhe)類中(zhong)(zhong)藥(yao)(yao)(yao)畢(bi)竟(jing)是(shi)(shi)少(shao)數的(de)(de)(de)(de)(de)(de)。中(zhong)(zhong)藥(yao)(yao)(yao)中(zhong)(zhong)的(de)(de)(de)(de)(de)(de)大部分藥(yao)(yao)(yao)物(wu)，都沒有標明出(chu)其(qi)是(shi)(shi)有毒(du)(du)的(de)(de)(de)(de)(de)(de)。只(zhi)標注(zhu)出(chu)其(qi)具(ju)有寒(han)熱溫(wen)涼的(de)(de)(de)(de)(de)(de)作用(yong)偏性(xing)和在人(ren)(ren)體(ti)內產生(sheng)(sheng)的(de)(de)(de)(de)(de)(de)升降(jiang)浮沉作用(yong)趨勢。缺乏作用(yong)于人(ren)(ren)體(ti)后完整(zheng)的(de)(de)(de)(de)(de)(de)藥(yao)(yao)(yao)代動力(li)學研究。也缺乏長(chang)期的(de)(de)(de)(de)(de)(de)藥(yao)(yao)(yao)理(li)學、毒(du)(du)理(li)學跟(gen)蹤研究。絕(jue)大多(duo)數標注(zhu)為(wei)(wei)(wei)無毒(du)(du)的(de)(de)(de)(de)(de)(de)中(zhong)(zhong)藥(yao)(yao)(yao)，給人(ren)(ren)們(men)(men)的(de)(de)(de)(de)(de)(de)認識(shi)造成了(le)誤區。不(bu)少(shao)人(ren)(ren)認為(wei)(wei)(wei)其(qi)只(zhi)要不(bu)是(shi)(shi)標注(zhu)為(wei)(wei)(wei)是(shi)(shi)有毒(du)(du)的(de)(de)(de)(de)(de)(de)就(jiu)可(ke)以放心隨意服用(yong)。
實(shi)(shi)際上(shang)，許(xu)多(duo)(duo)中藥(yao)盡管是(shi)(shi)無(wu)(wu)(wu)毒(du)(du)的(de)(de)(de)(de)，但是(shi)(shi)偏(pian)性(xing)(xing)很強，即(ji)具(ju)有(you)(you)(you)(you)顯(xian)(xian)著(zhu)的(de)(de)(de)(de)藥(yao)理(li)(li)(li)活性(xing)(xing)。會對人體(ti)的(de)(de)(de)(de)生(sheng)(sheng)(sheng)(sheng)(sheng)理(li)(li)(li)以(yi)及生(sheng)(sheng)(sheng)(sheng)(sheng)化(hua)代謝產(chan)生(sheng)(sheng)(sheng)(sheng)(sheng)明顯(xian)(xian)的(de)(de)(de)(de)作用(yong)(yong)(yong)(yong)。從化(hua)學(xue)成(cheng)(cheng)(cheng)分(fen)角度來分(fen)析，中藥(yao)中含有(you)(you)(you)(you)多(duo)(duo)種具(ju)有(you)(you)(you)(you)生(sheng)(sheng)(sheng)(sheng)(sheng)理(li)(li)(li)藥(yao)理(li)(li)(li)活性(xing)(xing)的(de)(de)(de)(de)成(cheng)(cheng)(cheng)分(fen)。例如(ru)生(sheng)(sheng)(sheng)(sheng)(sheng)物堿、蒽醌、黃酮、皂(zao)苷、香(xiang)豆素、揮發油等化(hua)學(xue)成(cheng)(cheng)(cheng)分(fen)。這些(xie)成(cheng)(cheng)(cheng)分(fen)都具(ju)有(you)(you)(you)(you)顯(xian)(xian)著(zhu)的(de)(de)(de)(de)生(sheng)(sheng)(sheng)(sheng)(sheng)理(li)(li)(li)藥(yao)理(li)(li)(li)活性(xing)(xing)。不(bu)能(neng)等同(tong)于(yu)普通食物中的(de)(de)(de)(de)營養物質。這些(xie)成(cheng)(cheng)(cheng)分(fen)對于(yu)特定的(de)(de)(de)(de)疾病(bing)可以(yi)起到治療(liao)和改(gai)善作用(yong)(yong)(yong)(yong)。而(er)對于(yu)正常人和病(bing)癥不(bu)符的(de)(de)(de)(de)人群，短期內應用(yong)(yong)(yong)(yong)或(huo)許(xu)并無(wu)(wu)(wu)大(da)礙，然而(er)長期服(fu)用(yong)(yong)(yong)(yong)，就可能(neng)會產(chan)生(sheng)(sheng)(sheng)(sheng)(sheng)多(duo)(duo)種毒(du)(du)副作用(yong)(yong)(yong)(yong)。如(ru)黃連，盡管典籍中并沒有(you)(you)(you)(you)記(ji)載其有(you)(you)(you)(you)毒(du)(du)，可是(shi)(shi)作為一味具(ju)有(you)(you)(you)(you)大(da)苦(ku)大(da)寒偏(pian)性(xing)(xing)的(de)(de)(de)(de)清(qing)熱燥(zao)濕藥(yao)，只可暫用(yong)(yong)(yong)(yong)，不(bu)宜久服(fu)。否則由于(yu)過于(yu)苦(ku)寒，多(duo)(duo)用(yong)(yong)(yong)(yong)會敗(bai)壞脾胃，貽害(hai)無(wu)(wu)(wu)窮。而(er)現代藥(yao)理(li)(li)(li)研究(jiu)也證實(shi)(shi)了其含有(you)(you)(you)(you)黃連素等多(duo)(duo)種生(sheng)(sheng)(sheng)(sheng)(sheng)物堿類成(cheng)(cheng)(cheng)分(fen)，具(ju)有(you)(you)(you)(you)顯(xian)(xian)著(zhu)的(de)(de)(de)(de)藥(yao)理(li)(li)(li)活性(xing)(xing)。其盡管“無(wu)(wu)(wu)毒(du)(du)”，多(duo)(duo)用(yong)(yong)(yong)(yong)卻是(shi)(shi)有(you)(you)(you)(you)害(hai)的(de)(de)(de)(de)。
“無毒”中藥不能濫服
自(zi)古至今，盲目進(jin)補(bu)滋(zi)補(bu)中(zhong)(zhong)(zhong)(zhong)藥的(de)(de)(de)人(ren)士絡(luo)繹不(bu)(bu)絕(jue)。超(chao)量濫用(yong)(yong)補(bu)藥造(zao)成(cheng)了(le)一系(xi)列的(de)(de)(de)問題，由此引發(fa)的(de)(de)(de)關于中(zhong)(zhong)(zhong)(zhong)藥是否有(you)(you)毒的(de)(de)(de)討論不(bu)(bu)斷。甚至導(dao)(dao)致(zhi)(zhi)中(zhong)(zhong)(zhong)(zhong)藥飽受(shou)詬病。誠然(ran)，大多(duo)數補(bu)益(yi)類(lei)中(zhong)(zhong)(zhong)(zhong)藥中(zhong)(zhong)(zhong)(zhong)確實含有(you)(you)一定的(de)(de)(de)營養(yang)成(cheng)分，可(ke)以(yi)作(zuo)(zuo)為(wei)體(ti)(ti)(ti)質(zhi)虛弱者的(de)(de)(de)有(you)(you)效(xiao)補(bu)充。然(ran)而(er)(er)(er)，許多(duo)補(bu)益(yi)類(lei)中(zhong)(zhong)(zhong)(zhong)藥具有(you)(you)強烈的(de)(de)(de)生(sheng)理活(huo)性(xing)和(he)藥理作(zuo)(zuo)用(yong)(yong)。這(zhe)些復雜(za)成(cheng)分可(ke)以(yi)同(tong)時興(xing)奮人(ren)體(ti)(ti)(ti)多(duo)器官(guan)多(duo)系(xi)統(tong)，產(chan)生(sheng)機體(ti)(ti)(ti)功能(neng)(neng)亢進(jin)，如出現咽喉痛等(deng)“上(shang)火”癥狀。因(yin)此不(bu)(bu)能(neng)(neng)等(deng)同(tong)于一般的(de)(de)(de)營養(yang)物(wu)質(zhi)。如鹿茸具有(you)(you)顯(xian)著(zhu)促進(jin)骨(gu)髓(sui)造(zao)血功能(neng)(neng)的(de)(de)(de)作(zuo)(zuo)用(yong)(yong)，然(ran)而(er)(er)(er)其(qi)同(tong)時會(hui)對(dui)人(ren)體(ti)(ti)(ti)的(de)(de)(de)其(qi)它系(xi)統(tong)產(chan)生(sheng)復雜(za)的(de)(de)(de)興(xing)奮刺激(ji)作(zuo)(zuo)用(yong)(yong)，初次(ci)服用(yong)(yong)過量，將會(hui)導(dao)(dao)致(zhi)(zhi)流(liu)鼻血等(deng)副(fu)作(zuo)(zuo)用(yong)(yong)。淫羊藿含有(you)(you)皂(zao)苷(gan)類(lei)成(cheng)分，服用(yong)(yong)后可(ke)以(yi)興(xing)奮人(ren)體(ti)(ti)(ti)性(xing)腺(xian)、腎上(shang)腺(xian)等(deng)系(xi)統(tong)，產(chan)生(sheng)明顯(xian)的(de)(de)(de)機體(ti)(ti)(ti)功能(neng)(neng)亢進(jin)作(zuo)(zuo)用(yong)(yong)。中(zhong)(zhong)(zhong)(zhong)藥典(dian)籍記載(zai)其(qi)久(jiu)服可(ke)以(yi)“令人(ren)無(wu)子”，可(ke)能(neng)(neng)是長期服用(yong)(yong)對(dui)人(ren)體(ti)(ti)(ti)的(de)(de)(de)內分泌(mi)和(he)生(sheng)殖系(xi)統(tong)產(chan)生(sheng)了(le)一定的(de)(de)(de)損害作(zuo)(zuo)用(yong)(yong)。因(yin)而(er)(er)(er)，無(wu)毒的(de)(de)(de)滋(zi)補(bu)中(zhong)(zhong)(zhong)(zhong)藥也(ye)不(bu)(bu)應(ying)隨意濫用(yong)(yong)。清代名醫徐靈胎說：“雖(sui)甘(gan)草(cao)、人(ren)參(can)，誤用(yong)(yong)致(zhi)(zhi)害，亦毒藥之類(lei)”。雖(sui)然(ran)二(er)藥在典(dian)籍中(zhong)(zhong)(zhong)(zhong)均記載(zai)為(wei)無(wu)毒，然(ran)而(er)(er)(er)其(qi)并非就是絕(jue)對(dui)安全的(de)(de)(de)。其(qi)具有(you)(you)顯(xian)著(zhu)的(de)(de)(de)藥理生(sheng)理活(huo)性(xing)。甘(gan)草(cao)雖(sui)然(ran)被稱(cheng)之為(wei)“國老”，運用(yong)(yong)極(ji)其(qi)廣泛，一般不(bu)(bu)會(hui)產(chan)生(sheng)明顯(xian)的(de)(de)(de)毒副(fu)反(fan)應(ying)。然(ran)而(er)(er)(er)由于其(qi)具有(you)(you)腎上(shang)腺(xian)皮(pi)質(zhi)激(ji)素樣作(zuo)(zuo)用(yong)(yong)，長期大劑量服用(yong)(yong)，會(hui)導(dao)(dao)致(zhi)(zhi)人(ren)體(ti)(ti)(ti)水鈉滯留，產(chan)生(sheng)高血壓等(deng)副(fu)作(zuo)(zuo)用(yong)(yong)。人(ren)參(can)被稱(cheng)為(wei)“百(bai)藥之王”，在拯(zheng)救危急重癥以(yi)及食療滋(zi)補(bu)虛弱疾病上(shang)具有(you)(you)顯(xian)著(zhu)的(de)(de)(de)療效(xiao)，從而(er)(er)(er)備受(shou)推崇，然(ran)而(er)(er)(er)，長期超(chao)量服用(yong)(yong)卻會(hui)導(dao)(dao)致(zhi)(zhi)失眠、頭痛、兒童性(xing)早熟(shu)等(deng)“人(ren)參(can)濫用(yong)(yong)綜(zong)合癥”的(de)(de)(de)發(fa)生(sheng)。
前些(xie)年國外(wai)報道的(de)所(suo)謂中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)毒(du)(du)(du)副作(zuo)用(yong)(yong)(yong)，多數就是(shi)(shi)(shi)無(wu)視(shi)中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)的(de)藥(yao)(yao)(yao)(yao)物(wu)偏性(xing)(xing)，忽視(shi)其具有(you)(you)(you)的(de)藥(yao)(yao)(yao)(yao)理(li)生理(li)活(huo)性(xing)(xing)，片(pian)面地認為無(wu)毒(du)(du)(du)中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)是(shi)(shi)(shi)絕對(dui)安(an)全、無(wu)任何害處(chu)的(de)，從而(er)長期任意(yi)地大劑量濫用(yong)(yong)(yong)。其結果(guo)就是(shi)(shi)(shi)導致產生了一(yi)(yi)些(xie)毒(du)(du)(du)副作(zuo)用(yong)(yong)(yong)，損(sun)害了機(ji)體健康,于是(shi)(shi)(shi)他們又轉(zhuan)而(er)認為中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)是(shi)(shi)(shi)有(you)(you)(you)毒(du)(du)(du)有(you)(you)(you)害的(de)。這種(zhong)觀點是(shi)(shi)(shi)片(pian)面的(de)。中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)不(bu)應(ying)單(dan)純地理(li)解成(cheng)(cheng)是(shi)(shi)(shi)純天然物(wu)質，是(shi)(shi)(shi)絕對(dui)安(an)全無(wu)害的(de)。同(tong)時也不(bu)應(ying)該(gai)片(pian)面地認為所(suo)有(you)(you)(you)中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)一(yi)(yi)定都是(shi)(shi)(shi)含有(you)(you)(you)毒(du)(du)(du)性(xing)(xing)成(cheng)(cheng)分，具有(you)(you)(you)毒(du)(du)(du)副作(zuo)用(yong)(yong)(yong)。特別(bie)是(shi)(shi)(shi)無(wu)毒(du)(du)(du)中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)，應(ying)該(gai)認識到(dao)其中(zhong)(zhong)(zhong)都含有(you)(you)(you)具有(you)(you)(you)藥(yao)(yao)(yao)(yao)理(li)作(zuo)用(yong)(yong)(yong)和生理(li)活(huo)性(xing)(xing)的(de)成(cheng)(cheng)分。服用(yong)(yong)(yong)后均會(hui)對(dui)人體產生相應(ying)的(de)藥(yao)(yao)(yao)(yao)理(li)作(zuo)用(yong)(yong)(yong)。有(you)(you)(you)些(xie)作(zuo)用(yong)(yong)(yong)是(shi)(shi)(shi)積極地，而(er)有(you)(you)(you)些(xie)作(zuo)用(yong)(yong)(yong)則是(shi)(shi)(shi)消(xiao)極的(de)。不(bu)能(neng)(neng)認為無(wu)毒(du)(du)(du)中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)是(shi)(shi)(shi)絕對(dui)安(an)全的(de)，可以隨意(yi)服用(yong)(yong)(yong)。更(geng)不(bu)能(neng)(neng)將無(wu)毒(du)(du)(du)中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)特別(bie)是(shi)(shi)(shi)一(yi)(yi)些(xie)補益類中(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)簡單(dan)地等(deng)同(tong)于蛋白質、淀(dian)粉、葡萄糖(tang)等(deng)營養成(cheng)(cheng)分食用(yong)(yong)(yong)。
無毒(du)(du)中藥(yao)并不(bu)等(deng)于(yu)是(shi)絕對(dui)安全(quan)的物質，更不(bu)能簡單地等(deng)同于(yu)營養物質。服(fu)用(yong)無毒(du)(du)中藥(yao)，應(ying)該(gai)在專(zhuan)業人員指導下(xia)服(fu)用(yong)。不(bu)要為了(le)追求療效，擅自盲目地大劑量長期(qi)濫用(yong)，以免產(chan)生毒(du)(du)副作用(yong)危害人體健(jian)康。
附子，川烏，草(cao)烏，雄(xiong)黃，砒霜(shuang)，蟾酥(su)，鉛丹，細辛，雷丸，鶴虱，苦楝皮(pi)，吳茱萸，朱砂，蟅蟲(chong)，水蛭，半夏，南星，白附子，皂(zao)莢，仙茅(mao)，輕(qing)粉，升藥，硫磺，常山，守宮，全蝎，蜂房，商陸，大(da)戟(ji)，芫(yan)花，甘(gan)遂，牽牛，虻蟲(chong)，僵蠶，蜈蚣，黑鉛，硇砂，水銀，番木(mu)鱉，大(da)楓子，蚤休(xiu)。
藥品是一種特殊商品，它有商品的一般屬性，又有其特殊性，即它只能是用來治病救命的，不能治病的不能稱作藥品。然而，藥品的慨念有時又是模糊的。在我國，自古就有“藥食同源”之說，在藥品、食品甚至有毒品之間的區別概念是交叉含糊的。如蝎子，既是藥品又是食品也是有毒品。即使是《藥典》里公認的藥品也有 “是藥三分毒“的問題。藥品的毒性暫且不談，因為《藥典》里規定了它的安全使用范圍。但藥品的不良反應，卻是個值得關注的大問題。界定藥品不良反應的前提應該除卻三種情況，一是不懂藥瞎吃藥；二是用藥不當，患了甲病而吃了治乙病的藥；三是超量服藥。什么事物都要有個度，超出了那個合適的度，量變就會成為質變。當前不少人聽了廣告宣傳的誤導，認為中藥是純天然制劑，沒有不良反應，沒有毒副作用，可以趟量吃，這是絕對錯誤的。藥物再好，再管用，它也是攝人身體內的外來物質(包括中藥)，都必須經過肝臟、腎臟代謝處理，過量服用必定要加重肝腎的負擔，使得藥物本身的毒性增大而增加毒害作用。以上三種情況都不屬于藥品的不良反應。
那么，什么叫藥品的不良反應呢?我國將藥品不良反應定義為，“合格藥品在正常用法用量下出現與用藥目的無關或意外的有害反應“。因此，人們應該認識到，藥品是可能引起不良反應的，即使是經過嚴格審批的藥品，在檢驗合格、正常用法用量的情況下，仍會在部分人身上引起不良反應。
中西藥品都可能出現不良反應。但是，人們往往對西藥的不良反應比較注意，而且西藥在藥品說明書上也將不良反應標注得比較清楚。而對中藥的不良反應，人們則不太關注。所以，中藥的不良反應與毒害作用反而成為一個突出的問題擺在了社會面前。據已經披露的藥品不良反應報告顯示，抗生素、解熱鎮痛藥、中藥已經成為藥品不良反應的“三大禍首“。據1993-1999年期間北京地區的5 900份藥品不良反應報表分析表明，在引起不良反應的藥品種類中，抗生素占48．2％，中藥以 13．4％的比例位居第二。因此，人們必須改變長期以來認為中藥安全無毒的舊觀念。
近年來，有關中藥不良反應的報道屢見報端。國家藥品不良反應監測中心第四期藥品不良反應通報的24種藥品中涉及了8種中藥制劑。2002年出版的《中國中藥雜志》l～9期刊登的有關中藥不良反應的文章就有24篇。上海地區自1998年l2月至2001年9月從自愿呈報系統收集到了中藥不良反應報告112 份，涉及中藥品種 40個。在天津地區報告的10例中藥不良反應病例中，有2例是已通報的魚腥草注射液和清開靈注射液，另外，還涉及未通報的中藥注射劑3種。
對于以上中藥不良反應，要具體問題具體分析。有些中藥制劑實際上是含有西藥成分的中成藥，并非純中藥制劑。日常購藥，一定要當心含有西藥成分的中成藥，避免由于忽視其中所含西藥成分的作用及使用禁忌而導致重復用藥、過量用藥后引起不良反應的發生。
在我國《藥典》2000版及部頒標準1～20冊中含西藥成分的中成藥有200余種，其中所含西藥成分主要有8類。第一，一些治療糖尿病的藥物中含有格列本脲(優降糖)，它可促進胰島B細胞分泌胰島素，可降低空腹血糖與餐后血糖，但磺胺過敏、白細胞減少的病人禁用，孕婦及哺乳期婦女不宜服用，肝腎功能不全，體虛高熱、甲狀腺功能亢進者慎用。服用過量易導致低血糖。第二，感冒藥中含有解熱鎮痛藥、抗過敏藥、抗病毒藥等。患者患了感冒常常自我購藥，往往急于求好，既服中藥又服西藥，若不了解中成藥中的西藥成分，會造成重復用藥的不安全隱患。第三，一些平喘止咳藥含有氯化銨、鹽酸克侖特羅。第四，降壓藥中含有氫氯噻嗪、鹽酸可樂定、蘆丁。第五，消化系統用藥中含有普魯卡因、阿托品、次硝酸鉍、硫糖鋁等。第六，有些藥中含有抗生素。第七，含有維生素及礦物質。第八，外用藥含有水楊酸甲酯、鹽酸普魯卡因、氯苯那敏(撲爾敏)、苯海拉明等。經常服用非處方中成藥者尤應引起注意。
另一個問題，足正確認識中藥的毒性。在去年10月15日開幕的中國國際保健竹上，一項重要活動內容是“大黃與人類健康” 論壇，圍繞著“大黃究竟是否對人體無毒”、“其性味是否溫良”、“其中藥成分及其制品有無不良反應“等問題有關人士展開了激烈的爭論。當主持人要通過一份事先打好的結論為“大黃性味溫良，對人體無毒性”的文件時，當即有人質疑：大黃無毒嗎?2002年版的《中藥及其制劑不良反應大典》與《中藥現代研究與應用》等書籍均有記載，不同品質的大黃，對腸胃道，對生殖系統，對血液系統等有不同程度的毒性。而大黃的特殊毒性中包含了“致誘變“(提取物致誘變，有效成分致誘變)及“細胞毒性”等。爭論的結果也是有關大黃無毒無不良反應的話欠妥。有關專家認為，大黃的主要作用是消炎，也有一定的瀉下作用，但絕對不能長期服用。此類中藥在某種程度上像毒品一樣，長期服用會“成癮”，產生依賴性，一旦停藥，就會出現繼發性便秘。大黃足一味中藥，足藥就應該讓服約者認識它的毒副作用與不良反應。
其實，許多中藥本身就具有毒性，除了人們已經關注的關木通之外，番木鱉、漢防已、烏頭、莪術、斑蝥等中藥都帶有生物堿毒性，用量過大、炮制不當、煎煮不得法或人的機體對該藥敏感性過高等都可發生中毒．．中藥發揮療效，有靠其“一性之偏”之說，如麻黃辛溫、大黃苦寒、附子辛熱等，有四氣直味的小同藥性。《黃帝內經》有大毒、小毒之說，《神農本草經》將中約分成上、中、下三品，以區別藥物作用及毒性大小。但是中醫用藥講究君臣佐使的配伍，講究一藥可殺另一藥之毒，一藥又可促進另一藥的作用。相輔相成，相反相助，最人限度地發揮了療效．也最大限度地減低了毒性。因不懂中醫或僅有一知半解就使用中藥，未辨證用藥，都可引起不良反應。
中藥產牛不良反應還有諸多原岡值得探討。我國藥物資源豐富，但由于歷史原因，同名異物，同物異名現象很多，導致品種復雜混亂，容易引起中毒。此外，中藥大多來自自然環境，從環境土壤中或水源中吸收有毒元素或農藥殘留的可能性很大，也會降低藥物質艟，產生毒性。再者，還有一個重要的炮制加工環節。中藥炮制得當可降低毒副作用，如果不合理炮制反而會增加毒副作用(特別是劇毒藥)。如雄黃有毒，但經過水飛(一種炮制方法)后可使藥粉達到極細，不僅降低毒性，而且便于制劑；但如果對其加熱就會增加毒性。
假藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)之害(hai)也給“中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)不(bu)(bu)(bu)(bu)(bu)(bu)安全”之說(shuo)推波助(zhu)瀾。據一位老(lao)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)師介(jie)紹，中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)材黃(huang)柏(bo)本(ben)(ben)應(ying)該(gai)是(shi)(shi)(shi)黃(huang)果(guo)樹和(he)黃(huang)皮(pi)樹的(de)(de)(de)(de)(de)(de)樹皮(pi)，但(dan)是(shi)(shi)(shi)不(bu)(bu)(bu)(bu)(bu)(bu)法商(shang)販(fan)拿一般樹皮(pi)用(yong)(yong)(yong)(yong)染料(liao)(liao)染成(cheng)(cheng)黃(huang)色制成(cheng)(cheng)假黃(huang)柏(bo)，染料(liao)(liao)本(ben)(ben)身就(jiu)有(you)(you)(you)毒(du)(du)，吃(chi)下去如(ru)何(he)(he)(he)不(bu)(bu)(bu)(bu)(bu)(bu)產生(sheng)毒(du)(du)害(hai)?再(zai)如(ru)顏色鮮紅的(de)(de)(de)(de)(de)(de)枸杞子，是(shi)(shi)(shi)用(yong)(yong)(yong)(yong)硫(liu)磺熏過的(de)(de)(de)(de)(de)(de)舊(jiu)貨，這種(zhong)含(han)硫(liu)趟標的(de)(de)(de)(de)(de)(de)枸杞可(ke)損害(hai)人的(de)(de)(de)(de)(de)(de)臟器(qi)，舊(jiu)病(bing)(bing)沒去還(huan)(huan)(huan)會添新病(bing)(bing)。關于(yu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)的(de)(de)(de)(de)(de)(de)不(bu)(bu)(bu)(bu)(bu)(bu)良(liang)反(fan)(fan)(fan)應(ying)與毒(du)(du)害(hai)問題，歸根結(jie)蒂，我(wo)(wo)們(men)要(yao)有(you)(you)(you)個(ge)(ge)(ge)正(zheng)確(que)(que)的(de)(de)(de)(de)(de)(de)認識。既不(bu)(bu)(bu)(bu)(bu)(bu)要(yao)盲目地相信(xin)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)沒有(you)(you)(you)毒(du)(du)性，也不(bu)(bu)(bu)(bu)(bu)(bu)要(yao)認為(wei)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)都有(you)(you)(you)毒(du)(du)。關鍵在(zai)于(yu)我(wo)(wo)們(men)缺少像西(xi)約那樣嚴(yan)密的(de)(de)(de)(de)(de)(de)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)不(bu)(bu)(bu)(bu)(bu)(bu)良(liang)反(fan)(fan)(fan)應(ying)監(jian)測(ce)(ce)系統，使得應(ying)該(gai)讓大家(jia)明白(bai)的(de)(de)(de)(de)(de)(de)事(shi)(shi)，變成(cheng)(cheng)心明眼亮，透明度(du)高(gao)。中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)是(shi)(shi)(shi)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)同的(de)(de)(de)(de)(de)(de)國粹，是(shi)(shi)(shi)我(wo)(wo)們(men)民族(zu)千百年來(lai)賴(lai)以生(sheng)存的(de)(de)(de)(de)(de)(de)瑰寶之一。我(wo)(wo)們(men)說(shuo)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)好(hao)，怎么個(ge)(ge)(ge)好(hao)法?如(ru)何(he)(he)(he)有(you)(you)(you)效?我(wo)(wo)們(men)說(shuo)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)不(bu)(bu)(bu)(bu)(bu)(bu)好(hao)，又怎么個(ge)(ge)(ge)不(bu)(bu)(bu)(bu)(bu)(bu)好(hao)，毛病(bing)(bing)出(chu)在(zai)哪里(li)?我(wo)(wo)們(men)不(bu)(bu)(bu)(bu)(bu)(bu)能(neng)(neng)怪人家(jia)老(lao)外三四年前那場“馬兜鈴風波”，也不(bu)(bu)(bu)(bu)(bu)(bu)能(neng)(neng)怪日前許多老(lao)外對中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)還(huan)(huan)(huan)抱(bao)有(you)(you)(you)疑慮。問題很(hen)簡單，我(wo)(wo)們(men)自(zi)己(ji)不(bu)(bu)(bu)(bu)(bu)(bu)清楚的(de)(de)(de)(de)(de)(de)事(shi)(shi)，如(ru)何(he)(he)(he)去讓人家(jia)明白(bai)?因此，本(ben)(ben)著實(shi)事(shi)(shi)求是(shi)(shi)(shi)的(de)(de)(de)(de)(de)(de)態度(du)對待中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)，加速中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)現(xian)代化(hua)是(shi)(shi)(shi)一個(ge)(ge)(ge)刻小容緩的(de)(de)(de)(de)(de)(de)事(shi)(shi)情，而且(qie)是(shi)(shi)(shi)醫學(xue)、藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)學(xue)、生(sheng)物(wu)分子化(hua)學(xue)、社會學(xue)等諸多學(xue)科協同作戰才(cai)能(neng)(neng)完(wan)成(cheng)(cheng)的(de)(de)(de)(de)(de)(de)大課(ke)題。我(wo)(wo)們(men)欣然看(kan)到，現(xian)代科研(yan)已(yi)經(jing)有(you)(you)(you)了(le)(le)可(ke)喜的(de)(de)(de)(de)(de)(de)開(kai)端。中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)醫藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)已(yi)逐步跨上了(le)(le)“基因平臺”，使我(wo)(wo)們(men)以前開(kai)不(bu)(bu)(bu)(bu)(bu)(bu)明白(bai)的(de)(de)(de)(de)(de)(de)東西(xi)現(xian)在(zai)可(ke)以“看(kan)得見”了(le)(le)。但(dan)是(shi)(shi)(shi)，中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)醫強調(diao)“方(fang)(fang)”與“征”的(de)(de)(de)(de)(de)(de)對應(ying)，如(ru)補中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益氣(qi)湯、六味地黃(huang)湯可(ke)治多種(zhong)疾病(bing)(bing)。復方(fang)(fang)治病(bing)(bing)是(shi)(shi)(shi)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)醫的(de)(de)(de)(de)(de)(de)一大特色，對中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)醫 “君臣佐使”藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)性的(de)(de)(de)(de)(de)(de)量化(hua)標準(zhun)測(ce)(ce)試，恐怕還(huan)(huan)(huan)要(yao)各學(xue)科協作相當長的(de)(de)(de)(de)(de)(de)一個(ge)(ge)(ge)時期才(cai)能(neng)(neng)解決。我(wo)(wo)們(men)還(huan)(huan)(huan)欣聞(wen)，國家(jia)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)品(pin)不(bu)(bu)(bu)(bu)(bu)(bu)良(liang)反(fan)(fan)(fan)應(ying)監(jian)測(ce)(ce)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)心，已(yi)經(jing)實(shi)施(shi)了(le)(le)經(jing)常的(de)(de)(de)(de)(de)(de)發布(bu)制度(du)，最(zui)大可(ke)能(neng)(neng)地避免(mian)不(bu)(bu)(bu)(bu)(bu)(bu)良(liang)反(fan)(fan)(fan)應(ying)給患者帶來(lai)的(de)(de)(de)(de)(de)(de)傷(shang)害(hai)。但(dan)是(shi)(shi)(shi)，瀆者對于(yu)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)品(pin)不(bu)(bu)(bu)(bu)(bu)(bu)良(liang)反(fan)(fan)(fan)應(ying)還(huan)(huan)(huan)應(ying)該(gai)有(you)(you)(you)個(ge)(ge)(ge)正(zheng)確(que)(que)的(de)(de)(de)(de)(de)(de)認識，通報中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)不(bu)(bu)(bu)(bu)(bu)(bu)良(liang)反(fan)(fan)(fan)應(ying)并(bing)不(bu)(bu)(bu)(bu)(bu)(bu)意味著中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)不(bu)(bu)(bu)(bu)(bu)(bu)能(neng)(neng)吃(chi)了(le)(le)。醫學(xue)專家(jia)提(ti)倡(chang)盡(jin)量堅持處方(fang)(fang)用(yong)(yong)(yong)(yong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)，如(ru)果(guo)在(zai)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)店(dian)買非處方(fang)(fang)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)，也要(yao)盡(jin)量向駐(zhu)店(dian)的(de)(de)(de)(de)(de)(de)執業藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)師進行問詢(但(dan)愿別碰上“約托”)，用(yong)(yong)(yong)(yong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)前看(kan)清藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)品(pin)說(shuo)明托中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)的(de)(de)(de)(de)(de)(de)適應(ying)證(zheng)、注意事(shi)(shi)項、用(yong)(yong)(yong)(yong)法用(yong)(yong)(yong)(yong)量，自(zi)己(ji)是(shi)(shi)(shi)否屬于(yu)慎用(yong)(yong)(yong)(yong)、忌(ji)服的(de)(de)(de)(de)(de)(de)人群，并(bing)了(le)(le)解該(gai)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)的(de)(de)(de)(de)(de)(de)不(bu)(bu)(bu)(bu)(bu)(bu)良(liang)反(fan)(fan)(fan)應(ying)。弄不(bu)(bu)(bu)(bu)(bu)(bu)明白(bai)的(de)(de)(de)(de)(de)(de)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)下萬別吃(chi)，因為(wei)有(you)(you)(you)些時候把住入口關，避免(mian)出(chu)現(xian)不(bu)(bu)(bu)(bu)(bu)(bu)良(liang)反(fan)(fan)(fan)應(ying)，主要(yao)還(huan)(huan)(huan)得靠(kao)你自(zi)己(ji)。
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