三七的活性成分抗心律失常作用机制的研究进展  

Research progress on antiarrhythmic mechanism of the active ingredient of Panax Notoginseng

作　　者：成万华 杨晓雪 李付强 CHENG Wanhua;YANG Xiaoxue;LI Fuqiang(Zhangjiakou First Hospital,Department of Cardiology,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院心内科,075000

出　　处：《环球中医药》2023年第4期796-801,共6页Global Traditional Chinese Medicine

摘　　要：心律失常可由多种器质性血管病变、酸碱和电解质失衡、药物、中毒、植物神经紊乱等因素引起,其发病机制复杂,临床治疗难度较大。中医天然活性物质成为抗心律失常相关药物研发的热点。三七是典型的人参属药物,目前对三七活性成分的实验研究主要集中于三七总皂苷(三七皂苷Rb、Rg、R1、R2和人参皂苷Rg1、Re)、三七叶皂苷中。三七叶总苷、人参三醇苷、三亚油酸、三七总皂苷Rb可有效阻止Ca^(2+)内流,降低心脏平滑肌收缩张力;人参皂苷Rb、三七总皂苷能抑制L钙电流通道活性,阻止Ca^(2+)内流,延长动作电位的持续时间;三七皂苷Rg1、Rb1、R1有助于减轻氧化应激反应,降低缺血/再灌注损伤引起的心律失常;人参皂苷Rg1及三七总皂苷能抑制多种炎症因子的分泌,减轻心肌缺血再灌注损伤;三七总皂苷延缓心肌纤维化进程,抑制心肌重构;三七二醇苷、三七叶皂苷能调节心脏自主神经功能,发挥负性传导作用;三七总皂苷、三七茎叶总苷恩能够直接促使血管扩张,显著改善心肌血液灌注;三七总皂苷可有效减轻心肌缺氧/复氧损伤,延长心肌动作电位。本文旨在探讨三七的活性成分抗心律失常作用机制,为临床提供理论依据。Arrhythmia can be caused by a variety of organic vascular diseases,acid-base and electrolyte imbalance,drugs,poisoning,phytonervous disorders and other factors,its pathogenesis is complex.The clinical treatment is difficult.The traditional of Chinese medicine natural active substances have become a hot spot in the research and development of anti-arrhythmic drugs.Panax notoginseng is a typical ginseng drug.The current studies on the active components of panax notoginseng mainly focus on the total saponins of panax notoginseng(panax notoginseng Rb,Rg,R1,R2 and ginsenoside Rg1,Re)and notoginseng saponins.The total saponin of notoginseng leaf,ginsenol side,sanyoleic acid and total saponin Rb of notoginseng can effectively prevent Ca^(2+)influx and reduce the contractile tension of cardiac smooth muscle.Ginsenoside Rb and panax notoginseng saponins can inhibit the activity of L calcium current channel,prevent Ca^(2+)influx and prolong the duration of action potential.Panax notoginseng saponins Rg1,Rb1,R1 can reduce oxidative stress response and reduce arrhythmia caused by ischemia/reperfusion injury.Ginsenoside Rg1 and total panax notoginseng saponins can inhibit the secretion of various inflammatory factors and alleviate myocardial ischemia-reperfusion injury.Panax notoginseng total saponins delayed myocardial fibrosis and inhibited myocardial remodeling.Notoginseng and notoginseng saponins can regulate autonomic nervous function and play a negative conduction role.Notoginseng total saponins and notoginseng stem and leaf total saponins can directly promote vascular dilation and significantly improve myocardial blood perfusion.Panax notoginseng saponins can effectively alleviate myocardial hypoxia/reoxygenation injury and prolong myocardial action potential.The purpose of this study was to explore the antiarrhythmic mechanism of panax notoginseng(Panax notoginseng)and provide theoretical basis for clinical study.

关 键 词：心律失常 三七 活性成分 作用机制 三七总皂苷 人参皂苷 

分 类 号：R285.5[医药卫生—中药学]