Abstract: Aristolochic acids （AAs）, a series of nitrophenanthrene carboxylic acids, widely exist in plants of Aristolochiaceae, especially in Aristolochia and Asarum. Many species of these plants have been used as medicinal herbs in China, other Asian countries, and Latin America. The nephrotoxicity, carcinogenicity and mutagenicity of AAs have been well studied. In the end of last century, the “slimming pills” incident in Belgium and the “Longdanxiegan pills” incident in China made AAs and traditional Chinese medicine containing AAs come into the public view and become a part of social hot topics. After that, AAs and traditional Chinese medicine containing AAs have been studied extensively by researchers in various fields. This paper collected the poisoning cases caused by traditional Chinese medicine containing AAs, and reviewed the research progress of the toxicity and toxicology of AAs in recent years. The paper aims at calling the attention of clinical and forensic toxicologists to related traditional Chinese medicine, and providing reference for the diagnosis and forensic expertise of poisoning cases caused by traditional Chinese medicine containing AAs.

Key words: forensic toxicology, aristolochic acids, aristolochic acid nephropathy, renal toxicity

摘要： 马兜铃酸是马兜铃科植物，尤其是马兜铃属和细辛属所含有的一系列硝基菲类羧酸，有明确的肾毒性、致癌和致突变性。这两个属的多种植物在亚洲以及拉美地区有着悠久的药用历史。20世纪发生的比利时“苗条丸”事件，以及我国的“龙胆泻肝丸”事件，使得马兜铃酸以及含马兜铃酸的中药进入了公众视野，一度成为中药毒性的代名词，也引发了各领域专家对其毒性毒理的广泛研究。通过对含马兜铃酸中草药造成的中毒病例报道进行简要梳理，并对近年来其毒性与毒理学的研究进展进行综述，以期引起临床及法医毒物鉴定人员对相关中药的关注，并为含马兜铃酸中药中毒的诊断及鉴定提供参考。

关键词: 法医毒理学, 马兜铃酸, 马兜铃酸肾病, 肾毒性