ABSTRACT
Zhigancao decoction recorded in Treatise on Febrile Disease by Zhang Zhongjing in the Han dynasty have been widely used in treating palpitation and irregular pulse by traditional Chinese medicine physicians for thousands of years. It is all known that Zhigancao Decoction is used to treat consumptive disease. However,why it has been used to treat exogenous febrile disease? According to studies,Fumai Decoctions in Treatise on Differentiation and Treatment of Epidemic Febrile Disease,that was modified based on Zhigancao Decoction,have their names without reality. Serious defects,including unclear diagnosis,curative effect,and prognosis,have been found in ancient and modern medical records about Zhigancao Decoction. The indications of Zhigancao Decoction include atrial premature beats,ventricular premature beats,and viral myocarditis; tachyarrhythmia( supraventricular tachycardia,atrial fibrillation)with long interval or conduction block,during or after severe infection or high fever; chronic consumptive disease due to tumor after radiotherapy and chemotherapy,malignant fluid state of tumor,hematopathy,terminal stage of heart failure after major operation,and acute hemorrhage after control of severe infection and other major diseases; cough,phlegm and asthma due to chronic obstructive pulmonary disease,pulmonary interstitial fibrosis,lung cancer,after lung cancer surgery; increased heart rate and decreased blood pressure due to insufficient capacity after acute blood loss; the symptoms included palpitation,chest tightness,sweating,lassitude,lacking in strength,shortness of breath,syncope,sudden death,cough,expectoration,excessive phlegm,clear and dilute sputum,emaciation,dry and haggard skin,constipation,haemorrhagic,uterine bleeding,enjoy sweet taste,red tongue without moss,knotted pulse,intermittent pulse,thready rapid pulse,and weak pulse. Besides,Zhigancao Decoction has effect on cardioversion and maintenance of sinus rhythm without thrombosis in persistent atrial fibrillation and permanent atrial fibrillation. Zhigancao Decoction could stop bleeding soon for acute upper gastrointestinal bleeding,and achieve positivity of occult blood test; Zhigancao Decoction could promote thrombocytopenia for idiopathic thrombocytopenic purpura,with the number of platelets 1×109/L. Zhigancao Decoction could promote the rise of granulocytic,erythroid and megakaryocytic hematopoietic lines in unexplained severe anemia,thrombocytopenia,and leukocyte reduction. Zhigancao Decoction could treat cough,asthma,and chest tightness in lung cancer and after lung cancer surgery; chronic consumptive disease due to lung cancer after lung cancer surgery,hematopathy and acute blood loss,which all belonged to the scope of consumptive disease. Zhigancao Decoction could ascend platelets,which was considered as " oriental interleukins" for the ancients. Zhigancao Decoction possesses dual-directional regulation on anticoagulant and hemostasis,which was considered as " oriental low molecular heparin" and " oriental proton pump inhibitors". Large dose of Rehmannia glutinosa is the key of the efficacy of Zhigancao Decoction. This study is expected to enrich the guidelines for modern medical diagnosis and treatment. However,the clinical evidence,relevant genes and targeting network need to be deepened in future studies. In conclusion,it may be a shortcut to restore and explain Zhigancao Decoction formula syndromes based on modern pathophysiology and severe cases of critical care.
Subject(s)
Humans , Arrhythmias, Cardiac/drug therapy , Blood Platelets/cytology , Critical Care , Drugs, Chinese Herbal/pharmacology , Electric Countershock , Hemostasis , Phytotherapy , Platelet Count , Treatment OutcomeABSTRACT
Zhigancao Decoction is from Shang Han Lun,which is widely used to treat cardiovascular diseases nowadays,such as arrhythmia,myocarditis,heart failure and so on.Moreover,according to records in Wai Tai Mi Yao:Zhigancao Decoction can also be used to treat lung"atrophy". This article introduced application of Zhigancao Decoction in treating respiratory diseases with good efficacy, which could provide new ideas for the TCM treatment of advanced respiratory diseases.
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Objective:To optimize the chitosan flocculation purification process of Zhigancao decoction. Methods:With the total content of ginsenoside Rg1 , Re and Rb1 and the impurity removal rate as the evaluation indices, an orthogonal test was used to investi-gate the effects of concentration of solution, amount of chitosan and standing temperature on the purification process. Results:The op-timum conditions of chitosan flocculation clarification process of Zhigancao decoction were as follows:the concentration of extraction so-lution was 0. 25 g·ml-1 , the standing temperature was 25℃, and the amount of chitosan was 12% . Conclusion:The optimum con-ditions of purification process are promising with high impurity removal rate and active ingredients retention rate, which provide refer-ence for the dosage form reformation of Zhigancao decoction.
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Objective To compare the effect of Zhigancao Decoction and Zhenwu Decoction on hemodynamics, matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) and myocardial enzyme of elderly patients with chronic heart failure.Methods 40 elderly patients with chronic heart failure in the first affiliated hospital of the medical college, Shihezi university were selected and randomly divided into Zhigancao Decoction group (n=20) and Zhenwu Decoction group (n =20) .The both of two groups were given conventional treatment, then were treated with respective drug according to different groups with two courses, one course of two weeks.The hemodynamic, MMP-9, TIMP-1 and myocardial enzyme spectrum indexes of two groups were compared post-treatment.Results After treatment, the indexes of hemodynamics in two groups were improved, hemodynamic indexes of Zhigancao Decoction recovered better than those of Zhenwu Decoction (P<0.05) .The serum MMP-9, MMP-9/TIMP-1 of Zhigancao Decoction group were lower and TIMP-1 was higher than those of Zhenwu Decoction group (P<0.05).The myocardial enzyme indexes in both groups were lower post-treatment, and the above indexes in Zhigancao Decoction were lower than those in Zhenwu Decoction group (P<0.05) . Conclusion Zhigancao Decoction could obviously improve the symptoms of chronic heart failure in elderly patients, which has the guiding significant in the clinical treatment.
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[Abstract ] Objective Modern pharmacological studies confirmed Zhigancao Decoction total extract, single active ingredients and their combinations could obviously inhibit arrhythmia.This study was to investigate the effects of Zhigancao Decoction medicated serum combined with myocardial tissue/silicon substrate microelectrode arrays (MEA) on rapid atrial pacing(RAP). Methods New Zealand white rabbits were randomly divided into normal control group, normal serum control group, Zhigancao Decoction medica-ted serum group and water decoction group, 8 in each group.After the establishment of an atrial fibrillation rabbit model, the field ac-tion potential duration ( fAPD) of the right atrial appendage ( RAA ) tissue was measured and the effections of Zhigancao Decoction medicated serum and water decoction on the fAPD of RAA were observed. Results The successful modeling of rapid atrial pacing induced atrial fibrillation in rabbits contributed to the significant shortening of fAPD 12 h after pacing compared to that before pacing ([174.30 ±1.36]ms vs[162.48 ±0.88]ms, P<0.05).After giving 10%~25% Zhigancao Decoction medicated serum and water decoction, the fAPDs of RAA tissue in rabbits with atrial fibrillation were prolonged, which represented positive dose-response relation-ship.The fAPDs of the rabbits given serum containing 10%, 15%, 20%and 25%Zhigancao Decoction were respectively (170.81 ± 0.61)ms, (171.00 ±0.46)ms, (179.08 ±0.67)ms, (179.76 ±2.26)ms, which were longer than those of water decoction group ([163.82 ±0.780]ms, [163.66 ±0.95]ms, [174.06 ±1.32]ms, [176.84 ±1.19]ms), and the difference was statistically sig-nificant (P<0.05). Conclusion The fAPD can be taken as one index of cardiac electrophysiological change, and 10%~25%Zh-igancao Decoction medicated serum can lead to fAPD extension in rabbit model of atrial fibrillation, which might be the electrophysio-logical mechanism of anti-atrial fibrillation.
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Objective: To establish an LC-MS/MS method for determination of glycyrrhetinic acid (GA) in plasma after ig administration of Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle (Zhigancao) Decoction in rats in vivo. Methods: Treating plasma with ethyl acetate protein precipitation and taking reseveratrol was used as the internal standard (IS), the residues were analyzed with LC-MS/MS system (Agilent ORBAX SB-C18 RP column, 50 mm x 2.1 mm, 1.8 μm) with the mobile phase consisted of acetonitrile-water (80 : 20, 0.2% formic acid), flow-rate of 0.2 mL/min, and column temperature of 30 °C. Agilent 6410 triple quad mass spectrometer system with an electrospray ionization (ESI) source and negative ion mode was used as the detector in this study. Multi-reaction monitoring (MRM) was used to detect GA by using ion combinations of m/z 469.4→425.4 for GA and 227.1→143.0 for IS. Results: The calibration curve showed good linear regression (R2 = 0.997 1) within measurement ranges (33.4-8 560.0 ng/mL). Both the intra- and inter-day precision and variation RSD were less than 10%. The average recovery rates at low, medium, and high concentrations of GA were 75.3%, 78.2%, and 78.5%, respectively. Under these conditions, the pharmacokinetic parameters of GA in plasma of rats after ig administration of Zhigancao Decoction were t max (8.00 ± 1.13) h, Cmax (811.02 ± 300.25) ng/mL, and AUC0.24 (11 439.21 ± 3 367.36) ng/mL·h. Conclusion: The method provides a sensitive, accurate, precise, and reliable analytical procedure for detecting GA in rat plasma and studying its pharmacokinetics.
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Object To study the influence of main active principles of ZHIGANCAO DECOCTIDN (ZD), glycyrrhizic acid (GA), ginseng total saponin (GTS) and Ophiopogon total saponin (OTS) on electrophysiology of isolated rat myocardium Methods The influence of GA, GTS and OTS on the automaticity, excitability and functional refractory period of isolated rat atrium and papillary muscle were studied in comparison with ZD made free of the above said active ingredients Results The combine use of GA, GTS and OTS significantly decreased the automaticity, inhibited excitaibility and prolonged the functional refractory period of isolated rat atrium; decreased the automaticity and arrhythmia of papillary muscle induced by epinephrine, while ZD made free of GS, GTS and OTS showed much less effect than the intact decoction Conclusion GA, GTS and OTS proved to be the main effective ingredients responsible for the antiarrhythmic activity of ZD