摘要
苓桂术甘汤出自汉代张仲景的《伤寒论》，此方用以治疗阳虚水饮所致短气、心胸满闷、气上冲胸、起则头眩等症，后世医家扩而广之，用以治疗胸痹心痛。本文主要对该方的抗心肌缺血及抗心律失常作用进行了研究。
实验结果表明：苓桂术甘汤提取物能明显延长小鼠在常压缺氧条件下的存活时间；缓解异丙肾上腺素、垂体后叶素所致的大鼠急性心肌缺血，增强缺血心肌的超氧化物歧化酶(SOD)活性，降低心肌丙二醛(MDA)含量；含药血清可显著增加离体豚鼠心脏的冠脉流量和心搏振幅；明显减少麻醉犬经N-BT染色所显示的梗塞区；可显著增加麻醉犬的冠脉流量，降低冠脉阻力和外周阻力，改善心肌的供血供氧；降低心率、氧利用率、耗氧指数，从而降低心肌耗氧量；降低左室舒张末期压、收缩压，降低心脏前后负荷，增加心脏血液灌流量。
苓桂术甘汤提取物对氯仿所致小鼠室颤有明显保护作用；能对抗氯化钙、氯化钡、肾上腺素所致的心律失常；并能够降低成年大鼠300／s、100／s、30／s、3／s四个切变率下的全血粘度，降低全血还原粘度、红细胞聚集指数、红细胞刚性指数、红细胞电泳时间；对红细胞压积、红细胞计数没有明显影响。
苓桂术甘汤提取物能显著抑制胶原蛋白—肾上腺素诱发小鼠体内血栓形成；并能显著抑制花生四烯酸诱导的家兔血小板聚集。
苓桂术甘汤提取物有明显的利尿作用；还有明显的抑制小肠推进的作用。
综上所述，苓桂术甘汤提取物具有较强的抗心肌缺血及抗心律失常作用，并有较强的抗血小板聚集的作用。
LingGuiZhuGanTang, a traditional formula from Shanghanlun, mainly used in the treatment of shortness of breath, fullness of chest, vertigo etc. due to the retention of fluid caused by yang-deficiency. Now it is often used as a remedy for cardiac bi-syndrome. The pharmacodynamics of anti-myocardial ischemia and anti-arrhythmia of LGZGT was studied in this paper.
The results showed that LGZGT could apparently prolong survival time in normobaric hypoxia in mice; obviously alleviate acute myocardial ischemia induced by pituitrin and isoprenaline in rats. In addition, the activity of SOD is increased and the content of MDA is decreased in ischemic myocardium caused by isoprenaline. It was found that coronary blood flow and stroke amplitude were dramatically increased by drug-containing serum in isolated hearts of guinea-pig . Furthermore, it was also found that coronary vascular resistance (CVR), total peripheral vascular resistance(TPVR), heart rate (HR), systolic arterial pressure (SAP), left ventricular end diastolic pressure (LVEDP), oxygen utility rate, oxygen consumption index were all remarkably decreased whereas coronary blood flow(CBF) was markedly increased in canines. Moreover, the infract area dyed by NB-T was also distinctly reduced.
LGZGT evidently protected mice from VF by chloroform. It also significantly antagonized arrthymias caused by calcium chloride, barium chloride and adrenaline. In hemorhelogy study, the data indicated that blood viscosity at high shear rate(HBV), blood viscosity at middle shear rate (MBV), blood viscosity at low shear rate (LBV), reduced blood viscosity(RBV), Erythrocyte aggregation
index(EAI), erythrocyte rigidity index(ERI), erythrocyte migration time(EMT) were obviously decreased.
LGZGT remarkably inhibited thromobogenesis induced by collagen-adrenaline in mice and obviously inhibited thrombocyte aggregation induced by arachidonic acid(AA) in rabbits.
LGZGT had duretic effect in rats and inhibited small intestinal transit in mice.
Taken together, these results suggested that LGZGT was a promising recipe in the treatment of some myocardial ischemia and arrthymia.
引文
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