段煜+裴科+蔡皓+范恺磊+刘晓+蔡宝昌

[摘要]药对具有复方配伍的最基本特点，是复方配伍中的最小单元。近年来，药对研究一直备受广泛关注，它是中医药现代化过程中不可或缺的一部分。随着新药创制效率的降低，如何从传统的中药药对中挖掘新药也一直是药物研发的难点之一。该文综述了近年的国内外文献，总结并归纳了药对研究的现状及问题。以此为基础，创新性地提出了“精准药对”的概念。“精准药对”不同于以往作用广和药效不明确的药对或复方，而是基于某种特定的疾病而开发的新的小药对，它作用明确且成分相对清楚。此外，作者还提出了“药对-结合柱色谱分离和细胞相关的成分谱筛选-模糊靶标识别药理学-精准药对再评价”的新策略，并成功将其应用于黄芪-山茱萸治疗糖尿病肾病的精准药对开发中。这种新策略简单、易操作且适用范围广，可为药对的现代研究及新药的研发提供借鉴和思考。

[关键词]药对； 精准药对； 新药创制； 新策略

[Abstract]As the smallest unit of traditional Chinese medicinal formula compatibility， herb-pair has the basic characteristic of traditional Chinese medicinal formula compatibility. In recent years， herb-pair investigation has attracted much attention， which is an indispensable part of modernization of traditional Chinese medicine. With the decrease of the efficiency in the discovery of new drug， how to discover new drugs from traditional Chinese medicinal herb-pair has also been a bottleneck for the research and development of drug. The authors reviewed the domestic and foreign literatures in the latest years and summarized the current situations and the existing problems of herb-pair study. Based on these investigations， the authors innovatively proposed a novel concept of "precision herb-pair". Difference from traditional Chinese medicinal herb-pair or formulae with extensive roles and unclear efficacies， "precision herb-pair" belongs to a developed new mini herb-pair formula with an exact treatment and a relatively clear composition based on a certain specific disease. In addition， the authors also proposed a new strategy of "herb-pair - screen of multiple constituents based on column separation andin vitro cell viability - fuzzy target recognition pharmacology - re-evaluation of precision herb-pair"， and successfully applied it to the development of a precision herb-pair from Astragali Radix-Corni Fructus in treatment of diabetic nephropathy. This proposed new strategy is simple， easy to carry out， and has a wide application， and can offer references and thoughts for the modern investigation of herb-pair and the research and development of new drug.

[Key words]herb-pair； precision herb-pair； discovery of new drug； new strategy

doi：10.4268/cjcmm20162106

“藥有个性之特长，方有合群之妙用”，复方配伍一直是中医临床用药的最大特色^[1]。众所周知，药对具有复方配伍的最基本特点，其组成简单，是复方配伍中的最小单元。近年来，药对研究一直受到高度关注和重视。药对作为复方和单味药之间的桥梁，对其透彻的研究将有助于盘活中医药的整体理论和推动中医药现代化的进程。然而，目前药对的研究方式较为混乱，没有一个统一的思路或标准。……