大黄首载于我国现存最早的中药学专著《神农本草经》，其临床应用范围涉及内、外、妇、儿等各临床学科。随着大黄的广泛应用，如何更好地发挥大黄的治病防病疗效，避免和减少其毒副作用，越来越受到人们的关注。本文主要从大黄的肝毒性、肾毒性、胃肠毒性以及"三致"作用等几个方面对大黄毒副作用进行论述，并提出了减毒增效的对策，特别是在临床肾脏疾病中的合理应用，从而为临床安全应用大黄提供参考。

Rhubarb was first recorded in the earliest Chinese medicine monograph "Shen Nong′s Materia Medica", with its clinical application involving internal, external, women, children, and other clinical disciplines. With the wide application of rhubarb, it is getting more and more people′s attention how to better play the curative and preventive effects of rhubarb, and prevent and reduce its toxic and side effects. This article mainly reviewed the side effects of rhubarb from several aspects such as hepatotoxicity, nephrotoxicity, enterotoxicity, and the triple effects (mutagenesis, carcinogenesis, and teratogenesis) of rhubarb, and put forward the countermeasures of attenuating toxicity and increasing efficacy, especially its reasonable application in clinical kidney diseases, so as to provide a reference for the safe clinical use of rhubarb.