(records of Guangxi Traditional Chinese Medicine)
[source] it is the seed of Hedysarum indicum. For plant morphology, please refer to "yangjiaoao".
[collection] from August to September, the mature fruits were collected, the seeds were peeled, the hair was removed and dried in the sun.
[herbal medicine] the dried seeds are spindle shaped and flat, about 2 cm long and 5 mm wide. The base is blunt, the apex is sharp, and the top has traces of white filamentous long hair. The navel is slightly below the seed hair, and the seed ridge is on one side. It is white linear, slightly convex, with brown surface, longitudinal lines and slight distortion. It is easy to break, with gray section, horny, squeezed by fingers, and oil spilled.
[chemical constituents] it contains 9-11% of total cardiac glycosides, or about 2% of total cardiac glycosides. It is a mixture of various cardiac glycosides and can be divided into lipophilic glycosides and weakly lipophilic glycosides. The lipophilic glycosides with known structure are lanjiaoaoside, lanjiaoaoisoside, sinoside, sinoisoside, cordoside, cordoside and salidroside, of which lanjiaoaoside has more content and stronger effect; the weak lipophilic glycosides are d-toxotrichoside - Ⅰ and d-toxotrichoside - Ⅲ, of which the former has more content and stronger effect than lanjiaoaoside.
All parts of the plant contain cardiac glycosides, and the seeds contain more cardiac glycosides with the highest potency. The proportion of strong heart potency of each part of plant body is as follows: seed 100, pericarp 15.4, leaf 8.1, branch 7.8, stem 2.5, root 1.9.
Among the cardiotonic glycosides of seeds, the main one is lanolin, which is produced by acidolysis. In the past, the so-called Lanjiao aoling a has been proved to be β - dehydrated salmonenin, which may be the dehydrated product of salmonenin during acidolysis.
The seed contains 30-40% fat oil.
[pharmacological action] 1. Action on heart
Yangjiaoao mixed glucoside can strengthen the heart contraction, slow down the heart rate and block the conduction of cold-blooded and warm-blooded animals. It has therapeutic effect on heart failure caused by chloral hydrate, sodium pentobarbital, sodium cyanide and dinitrophenol. It can not only strengthen the myocardial contractility, but also increase the output and decrease the venous pressure. It has no effect on the failure caused by iodoacetic acid. Its cardiotonic effect is similar to that of strobiloside K, but slightly weak and lasting. The cardiotonic effect of d-picroside-i was also confirmed. The effect of yangjiaoao mixed glycosides on ECG is similar to that of general cardiac glycosides. In general, the effect on coronary artery is less affected by the dose, but the toxic dose makes it contract significantly. In clinical application, patients with severe coronary artery disease should pay attention to it.
② Other functions
Yangjiaoao mixed glucoside has sedative effect and diuretic effect on anesthetized dogs and normal rats. It has been proved in the experiments of rabbit uterus and uterine fistula in vitro and in vivo that it has the similar effect with strobiloside K. It can excite the uterus and increase the tension and movement of isolated intestinal tube.
③ Absorption, accumulation and elimination
The absorption in gastrointestinal tract was slow and irregular, and the absorption amount was the most at 4 and 5 hours after administration. The accumulation of yangjiaoao mixed glucoside was very low, and there was no accumulation after 5 days. The liver plays a role in detoxification. Its destruction in vivo is slightly slower than that of strophantin g, and its elimination rate is 0.006 mg / kg / h
④ Biological potency
The toxicity of yangjiaoao mixed glucoside is about 1 / 2 less than that of mucilaginoside g, and its therapeutic index and safety range are slightly narrow. However, from the clinical point of view, the width of therapeutic dose (the distance between effective dose and toxic dose) is wider than that of the latter. Due to different extraction methods and other reasons, the biological potency of each batch of yangjiaoao mixed glycosides may be different. Therefore, it is necessary to select a standard method for verification. It is suggested that pigeon method is better than cat method.
[nature and taste] Guangxi Traditional Chinese medicine annals: "it tastes bitter and has great poison. "
Functions and indications: promoting blood circulation and detumescence, relieving itching and killing insects. Treatment of rheumatism, scabies, falls, sore swelling.
① "Medicine science": "it has cardiotonic effect. The treatment of vascular sclerosis can strengthen the contraction of the heart. "
② "List of Guangxi plants": "strengthen the heart, reduce swelling, stop itching and kill insects. For external use, it is used to treat traumatic injuries, tinea scabies, rheumatism, sequelae of poliomyelitis, multiple abscesses, snakebite, fractures and warts. "
[usage and dosage] external use: tamping. Oral administration should be cautious.
[clinical application] yangjiaoao glucoside, extracted from the seeds of yangjiaoao, has been proved to have cardiotonic effect similar to that of helianthin K. Good therapeutic effect has been obtained in all places. For example, for 22 patients with congestive heart failure, 14 cases had good effect after medication, most of them began to take effect within 5 minutes, including shortness of breath, chest tightness, chest distension, cough, sitting breathing, jugular vein distention, cyanosis, edema, etc. all disappeared completely, vital capacity and urine volume increased, jugular vein pressure decreased, and circulation time shortened; 5 cases were effective, most of the above symptoms disappeared or improved, and some symptoms disappeared No change was found in 3 cases. After treatment, 39 cases were good, 16 cases were effective, the effective rate was 93%. In most cases, symptoms improved or disappeared, pulse and respiration decreased, vital capacity increased, blood pressure increased, venous pressure decreased, circulation time shortened and urine volume increased within 3 hours after treatment, but it had no significant effect on ECG. In addition, 56 cases and 42 cases were observed with small dose and large dose respectively, and the effective rates were 89% and 81% respectively. In addition, it has been used in 78 children with small focus pneumonia complicated with heart failure, and good results have been obtained. Cyanosis disappeared in most cases after 2 days of treatment, heart rate and respiration slowed down, and liver shrinked. The standard of dosage and usage is not uniform. In some cases, a small dose of 0.125-0.25 mg was used in the first trial, and the daily total dose was not more than 0.5 mg in principle. Later, through practice, it was considered that the above dose might be too small. Instead, the split dose was increased to 0.5 mg, twice a day at the beginning, and the total amount was not more than 1 mg. After the condition improved, it was changed to once a day. After diluted with 25% glucose solution, it was slowly injected intravenously within 5 minutes. Although the incidence of arrhythmia was higher, all toxic reactions disappeared quickly after drug withdrawal, and there was no case of poisoning death. It is also believed that the daily use of 0. 5 mg, add 2% glucose 50 ml, and slowly inject it into the vein at the speed of more than 10 minutes, which can be used as the guideline of dosage and usage. It is pointed out that there is a risk of poisoning with more use, and the effect is not good with less use. The dosage is not directly proportional to the effect. If the dosage is about 5.0 mg and the effect is still not effective, it will not be much better even if the dosage is increased. The dosage of small focus pneumonia with heart failure was 0.05 mg for infants within 1 month, 0.1 mg for infants from 6 to 12 months, 0.15 mg for infants from 1 to 3 years old, 0.2 to 0.3 mg for infants from 5 to 8 years old, and 0.3 to 0.5 mg for infants from 8 to 12 years old. Once a day, intramuscular injection. Side effects and toxic reactions: it is generally believed that there are few side effects, especially gastrointestinal reactions. Among the 65 patients with low dose, only one patient's heart rate increased from 71 beats / min to 118 beats / min after injection due to the high injection speed; one patient developed duplex pulse and continued to inject without stopping the drug. As a result, he suddenly fainted 2.5 hours after injection, and his whole body became cyanotic with weak pulse, and eventually died. Among the 42 cases with high dose, a small number of them developed dizziness and arrhythmia, which were proved by ECG to be ventricular premature contraction (3 cases were multiple ventricular premature contraction, 2 cases had atrial fibrillation, 1 case had atrioventricular block); arrhythmia generally occurred when the total dose was 1.5 mg (the earliest was 0.5 mg, the latest was 3 mg), so it was considered to be related to myocardial injury There was no significant correlation between the cumulative dose and the severity of the injury. However, 58 adults and 78 children reported had no significant side effects. According to the introduction, the main application of cornucoside in acute heart failure, for the following cases can not be applied: heart outer membrane disease, toxic myocardial damage, such as diphtheria, rheumatic fever, thyrotoxicosis, syphilis caused by heart failure. 2. Circulatory failure caused by shock and acute infectious diseases. Three acute and subacute endocarditis.
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