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Realgar- and cinnabar-containing AnGongNiuHuang Pill (AGNHP) is widely used for treating encephalopathy syndrome. However, it raises great safety concerns due to the adverse effects reported by arsenic or mercury poisoning. Although AGNHP has been generally recognized, little is known about the metabolism of arsenic and mercury and their resulting potential health risk in vivo. Thus, comparative pharmacokinetics and urinary excretion of arsenic and mercury were conducted in rats after oral administration of realgar, cinnabar and AGNHP, respectively. The contents of arsenic and mercury in rat blood and urine were determined by hydride-generation atomic fluorescence spectrometry (HG-AFS) after wet digestion. AGNHP significantly reduced the absorption of arsenic in blood and promoted urinary arsenic excretion. Whereas, it increased the blood mercury absorption and reduced urinary mercury excretion. No significant toxicity was observed in the clinical dose range of AGNHP. However, excessive exposure to arsenic and mercury may still pose risks especially by long-term or excessive medication. The results are helpful for the rational clinical applications of realgar- and cinnabar-containing TCMs.
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OBJECTIVE To investigate the effect and mechanism of AngongNiuhuang Pill(AGNH) on neurological function and intestinal mucosal barrier in intracerebral hemorrhage (ICH). METHODS Male CD-1 mice were randomly divided into sham, ICH, AGNH 0.1 g·kg-1, AGNH 0.2 g·kg-1, and AGNH 0.4 g·kg-1groups. The ICH mice models were prepared by intrastriatal injection with collage-nase using a stereotaxic frame.Garcia test was used to evaluate the neurological function of mice.The brain water content was measured with dry/wet weight method.The permeability of intestinal mucosa was detected by FITC-D method. H&E staining was used to observe the pathological changes of intestine. The content of endotoxin in blood and the expressions of ZO-1,occludin in intestinewere also investigated.RESULTS After AGNH administration,the neurological score of mice was increased,and the brain water content was decreased(P<0.01).AGNH attenuated the ICH-induced increase of perme-ability of intestinal mucosa(P<0.01).Treatment with AGNHnot only alleviated the pathological changes of the intestine but alsoreduced the endotoxin content in blood (P<0.01).The expressions of ZO-1, occludinin AGNH groups were significantly increased compared with that of ICH group (P<0.05). CONCLUSION AGNH improves the neurological dysfunction in ICH mice and the mechanism of action is implicated in protecting the intestinal mucosa.
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Objective To observe the clinical effects and safety of Angongniuhuang Pill (a traditional Chinese medical preparation)adjuvant to haloperidol for the treatment of Intensive Care Unit (ICU)patients in postoperative delirium.Methods A prospective study of 243 postoperative patients with delirium adimitted in Intensive Care Unit of Xinjiang Medical University First Affiliated Hospital (January 2013-December 2014),by using confusion assessment method of Intensive Care Unit (CAMICU).All of 243 patients with delirium were randomly divided into two groups by computer randomization software (SAS 9.1):group A in which patients were treated with Angongniuhuang Pill adjuvant to haloperidol and group Fin which patiets were treated with haloperidol alone.The end of two intervention methods was determined by two consecutive CAMICU showing negative or the treatment were ended up at seven days treatment.The data of general information,and the results of treatment were recorded and analized by statistical software SPSS 19.0.The measurement data was expressed as mean ±standard deviation;the comparision between two groups was tested by t test;and repeated measurement was analised by variance.Count data was described as number and constitution ratio;and intergroup comparision was tested by Chi-square test. Results There was no significant difference in general information between two groups.The delirium duration and ICU treatment time in group A were shorter than those in group F [(3.0 ±0.9)d vs.(3.8 ±1.0) d,P =0.010; (6.2 ± 1.4) d vs.(6.7 ± 1.5) d,P = 0.008].When delirium was diagnosed (T0),all patients had EEG abnormalities.As treatment went on,EEG abnormal rate gradually declined.At day one (T1),there was no statistically significant difference in EEG findings between group A and group F (95.7% vs.97.5%,P = 0.045 ).At day two (T2 )and day three (T3 ),there was statistically significant difference in EEG findings between group A and group F (65.5% vs.77.7%,P =0.038;42.2% vs.56.2%,P = 0.032).The levels of S100βprotein,interleukin-6 (IL-6),tumor necrosis factor α(TNF-α)in two groups at T0 were all elevated without noticeable difference.These markers were all deceased at T1,T2,T3,but the speed of descend in group A was relatively faster than that in group F.The differences were statistically significant (S100β:time effect P <0.01,inter-group effectp =0.002,interaction effectp =0.686;IL-6:time effect P <0.01,inter-group effectp =0.034,interaction effectp =0.01;TNF-α:time effect P <0.01,inter-group effectp =0.003,interaction effectp =0.516). The discharge rate in group A after improvement of general condition was higher than that in group F (89.7% vs.79.3%,P =0.029).The incidence of postoperative complications and mortality 28 days after operation in group A were lower than those in group F (45.7% vs.58.7%P =0.045;12.9% vs. 24.0%,P =0.028).Conclusion During the treatment of delirium,Angongniuhuang pill adjuvant to haloperidol was a better method compared with using haloperidol alone in respect of effectiveness and safety perspectives.It may be a novel approach to the treatment for delirium by the combination of Chinese and Western medicine.
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[Objective] To explore the effects of angongniuhuang pill on the synthesis of apolipoprotein E in brains of rats after traumatic brain injury.[Methods] Using reverse transcription-polymerase chain reaction(RT-PCR) and enzyme linked immunosorbent assay(ELISA),the apolipoprotein E’s mRNA of contused brain tissue and the concentration of apolipoprotein E in CSF at different phases after traumatic brain injury were detected of rats fed with angongniuhuang pills.[Results]High expression of apolipoprotein E mRNA and high concentration of apolipoprotein E were found in rats fed with angongniuhuang pills compared with controls.[Conclusion]Angongniuhuang pills may increase the expression of apolipoprotein E mRNA in brains after traumatic brain injury,thus promote the synthesizing and secreting of apolipoprotein E.
