CN1723974A - Application of medicine contg. ligusticum wallichii for preparing medicine of anti-aspirn-resistance - Google Patents
Application of medicine contg. ligusticum wallichii for preparing medicine of anti-aspirn-resistance Download PDFInfo
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Abstract
A Chinese medicine for treating the aspirin-resistant cardiovascular disease is prepared from notoginseng, safflower and Chuanxiong rhizome.
Description
Technical field
The present invention relates to field of medicaments, specifically, the present invention relates to the application of a kind of medicine in preparation treatment resistant medication of aspirin.
Background technology
Aspirin (Aspirin) claim aspirin or aspirin again, is applied to clinical existing more than 80 year history, is a kind of ancient analgesic, analgesic.Along with the going deep into of prostaglandin research, aspirin there has been new understanding again in recent years: analgesic except being used for traditionally clinically, analgesia, the antiinflammatory, also be used for antiplatelet aggregation etc.Clinical trial shows that aspirin is the effective antiplatelet drug of cardiovascular and cerebrovascular disease high-risk patient primary prevention, and is also effective to the secondary prevention of myocardial infarction and ischemic vascular events.
But use the aspirin of therapeutic dose at present clinically, still there is part cardiovascular and cerebrovascular disease patient that coronary artery thrombus and apoplexy have taken place, strengthen therapeutic dose, not only fail to reach treatment and prevention purpose, and untoward reaction increases, this phenomenon be called " aspirin resistance " (Aspirin Resistance, AR).
Through long term follow-up, reason is as follows: first platelet is by other pathway activation, can not be blocked [Valles J by aspirin, Santos MT, Aznar J, et al.Erythrocyte Promotion of platelet reactivity decreases the effectivenessof aspirin as an antithrombotic therapeutic modality:the effect of low-dose aspirin is less thanoptimal in patients with vascular disease due to prothrombotic effects of erythrocytes on plateletreactivity.Circulation, 1998; 97:350-355]; The dosage that second some needs of patients is bigger than routine dose just can obtain best thromboembolism preventing effect, there is not evidence to show relevant [the Patrono C.Prevention ofmyocardial infarction and stroke by aspirin:different mechanisms of aspirin thromboembolism preventing effect with dosage? Different dosage? Thromb.Res., 1998; 92:S7-S12]; Although using the routine dose aspirin, the 3rd some patient also can generate TXA
2[Tayllor DW, Low-dose and high-dose acetylsalicylic acid for patients undergoing carotid endarterectomy:arandomized controlled trail; ASA and Carotid Endarterectomy (ACE) Trial Collaborators.Lancet, 1999; 353:2179-2184].
Studies show that the generation of AR is relevant with following mechanism.
Erythrocyte improves platelet response
Platelet-erythrocyte interacts influence platelet response, synthesizes and platelet is raised and caused aspirin resistance by platelet release reaction, eicosanoids.Erythrocyte causes TXA
2Synthetic increasing, 5-HT, β-TG and ADP discharge, generation [the Valles J that shows erythrocyte adjusting platelet eicosanoids, et al.Erythrocyte metabolically enhancescollagen-induced platelet responsiveness via increased thromboxane production, adenosinediphosphate release, and recruitment.Blood, 1991; 78:154-162].
Arachidonic acid (PGF
2
) metabolism
Arachidonic acid produces a series of bioactive PGF that have through lipid peroxidation
2See complex.F
2-isoprostanes is the important new predictor of angiopathy.Unstable angina, stable angina pectoris, ariant angina patient and healthy people take aspirin 100mg/d and measure 8-iso-PGF
2(mark of matter fat peroxidation) and 11 dehydrogenations-TXA
2(TXA
2Studies show that biosynthetic mark), unstable angina patient 8-iso-PGF
2Urinary excretion is apparently higher than stablizing patient with angina pectoris and matched group; TXA
2Excretion apparently higher than stable patient with angina pectoris.Unstable angina patient's oxidant stress increases, 8-iso-PGF
2Increase, platelet is to the increased response of other agonist.
Smoking stimulates
Smoking is the cardiovascular disease principal risk factor.Data shows that aspirin can the anticoagulant rate reduce platelet aggregation [the Davis JW that causes, et al.Cigarette smoking-induced enhancement of platelet function:lack ifprevention by aspirin in men with coronary artery disease.J Lab Clin Med, 1982; 126:637-639].Platelet aggregation rate reduces after the smoking.Take aspirin before non-smoker and the smoking addiction person smoking and can prevent that platelet aggregation rate from descending.
The catecholamine levels platelet increasing is assembled to be increased
External platelet shows adrenergic sensitivity and has contact [Larsson PT et al between platelet activation that catecholamine causes and the acute coronary syndrome, Norepinephrine-induced human platelet activation in vivo is only partlycounteracted by aspirin.Circulation, 1994; 89:1951-1957].40 patients of acute myocardial infarction are divided into warfarin group and aspirin group at random.Get blood before and after the bicycle ergometor exercise, relatively two groups baseline characteristic, movement time and maximum heart rate.The warfarin group obviously reduces than aspirin group platelet aggregation rate when baseline, illustrates that aspirin has the effect of antiplatelet aggregation.Two groups platelet aggregation rate all reduces during motion, shows that the platelet aggregation ability increases.Its reason may be that the noradrenaline levels increase causes platelet activation.
Platelet increases the sensitivity of collagen
Collagen is the agonist of physiological important platelet aggregation.Two experimental study aspirin reply and collagen between relation.Before aspirin 324mg/kg is taken in a test (n=8 healthy male), measure the bleeding time after taking medicine 2 hours, distinguish aspirin respondent and nonresponder.87 of philtrums have participated in second test, give collagen 0.15-4 μ g/ml and determine aspirin respondent and the nonresponder's platelet sensitivity to collagen.Among 8 patients of first test, 5 aspirin respondents, 3 nonresponders.Aspirin respondent and the nonresponder preceding bleeding time indifference [(408 ± 121) and (330 ± 30) second, P>0.05] of taking medicine has significant difference [(720 ± 225) and (330 ± 52) second] after taking medicine.Among 7 patients of second test, 4 aspirin respondents, 3 nonresponders.Aspirin respondent and the nonresponder preceding bleeding time indifference [(405 ± 52) and (357 ± 31) second of taking medicine, P>0.05], significant difference [(623 ± 189) and (345 ± 54) second] [Kawasaki T is arranged after taking medicine, el at.Incresed platelet sensitivity to cllagen in individuals resistant to low aspirin.Stroke, 2000; 31:591-595].
Cycloxygenase-2 (COX-2) (p900)
Cox is the synthetic rate-limiting enzyme of prostaglandin.Cox-1 expresses in most cells and tissue.In the great majority tissue, can not detect under the mRNA of Cox-2 and the protein normal condition.[Weber AA, et al.Cyclooxygenase-2 in human platelet as possible factor in aspirin resistance.Lancet, 1993 such as nearest Webr; 353:900] report that protein and the mRNA of Cox-2 express in healthy people's circulation platelet, this may be a reason of aspirin resistance.
Drug interaction
The interaction of aspirin and other nonsteroidal anti inflammatory medicines (NSAIDS) can weaken aspirin to hematoblastic effect.Aspirin needs at first to combine lysine-the 120th, the coefficient site of all NSAIDS with lysine-120 to the acetylation of serine residue.NSAIDS is stronger to the affinity of lysine-120, thereby has stoped the inhibitory action of aspirin to platelet Cox-1.
More than set forth possible mechanisms of aspirin resistance.Clear and definite platelet activation mechanism and reversible risk factor help to reduce the generation of aspirin resistance, improve patient's prognosis.
Aspirin resistance can not effectively stop thromboxane A after being meant and taking aspirin
2Synthetic, promptly aspirin has lost the protective effect to cardio-cerebrovascular, this phenomenon is referred to as aspirin resistance.Concerning Most patients, aspirin can make cardiovascular danger reduce by 25%, but the patient of aspirin resistance uses the aspirin for treatment cardiovascular disease, can not prevent the generation of cardiovascular event, can increase the incidence rate of heart infarction and apoplexy on the contrary, these find the use of restriction aspirin.Therefore, these cardiovascular disease are referred to as aspirin repellency cardiovascular disease in the middle of the present invention, particularly refer to coronary heart disease, the angina pectoris of using aspirin for treatment invalid.The present invention will be referred to as the medicine of anti-aspirin resistance to the medicine that aspirin repellency cardiovascular disease has a therapeutical effect, and this therapeutical effect is referred to as anti-aspirin resistance effect.
At present, the report for the treatment aspirin resistance also is not a lot.YusufS etc. [Effects ofpretreatment withclopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneouscoronary intervention:the PCI-CURE study.Lancet, 2001] have reported to add on the basis of aspirin for treatment and have adjoined Gray with chlorine and can reduce the incidence rate that Acute Coronary Syndrome Patients comprises the early stage and secular serious cardiovascular incident of patient of percutaneous coronary intervention (pci).
The Chinese medicine blood-regulating drug, particularly the blood-activating stasis-removing kind medicine is the medicine that ancient Chinese medicine doctor is used always, this class medicine has the effect of promoting blood flow to regulate menstruation, removing blood stasis Xiao Disorder, blood-activating analgetic, detumescence and promoting granulation, modern pharmacology confirms, blood-regulating drug has the expansion coronary artery, increases coronary flow, reduce myocardial oxygen consumption, reduce peripheral vascular resistance, anticoagulant, microcirculation improvement, suppress thrombosis, fortifying fibre protein dissolution activity, anticoagulation system, microcirculation improvement, effects such as smooth muscle spasm are alleviated in blood pressure lowering.The clinical effect of Rhizoma Chuanxiong in the blood-regulating drug, Radix Salviae Miltiorrhizae, Herba Leonuri, Semen Persicae, Flos Carthami, Hirudo etc. is constantly expanded, and particularly the research of Radix Salviae Miltiorrhizae is particularly outstanding.
Find that through secular clinical research the traditional Chinese medical science thinks that the etiology and pathology of coronary heart disease is many because " imbalance of YIN and YANG, mechanism of qi be contrary to cause disorderly that the painstaking effort stasis of blood stagnates, blockage of the cardiac vessels, stagnation of QI and blood may bring about pain ".According to mentioned above principle, the someone has chosen Radix Notoginseng, Flos Carthami, Rhizoma Chuanxiong and has made preparation, and said preparation has invigorates blood circulation, blood stasis dispelling, and the effect of pain relieving is used for stagnation of blood stasis, obstruction of qi in the chest and cardialgia, traumatic injury, swelling and pain due to blood stasis; Coronary heart disease, angina pectoris, arrhythmia, soft tissue contusion.At present the research of said preparation is mainly concentrated in the research of the angina pectoris that the coronary disease disease causes, the effect of relevant said preparation treatment aspirin resistance does not appear in the newspapers as yet.In order to alleviate the phenomenon that can produce aspirin resistance when cardio-cerebral vascular disease patient uses aspirin Drug therapy cardiovascular and cerebrovascular disease, some researchers are being sought the medicine that can substitute or alleviate the aspirin resistance phenomenon at present, the present invention tests at present more present medicines just on this basis, in the hope of finding its new medicine use, easily produce the aspirin resistance phenomenon to solve present aspirin medication.
Summary of the invention
The object of the present invention is to provide the application of a kind of pharmaceutical composition in the medicine of the anti-aspirin resistance of preparation.
Described Chinese medicine composition is by comprising that following crude drug makes: Radix Notoginseng 50~200g, Flos Carthami 50~200g, Rhizoma Chuanxiong 100~400g; Preferred each amounts of components is Radix Notoginseng 85~150g, Flos Carthami 85~150g, Rhizoma Chuanxiong 150~250g; Each best amounts of components is Radix Notoginseng 100g, Flos Carthami 100g, Rhizoma Chuanxiong 200g.
The preparation of the effective ingredient of described Chinese medicine composition can be adopted following method: water extraction, decoction and alcohol sedimentation technique, extraction, infusion process, percolation, reflux extraction, continuous backflow extraction method, macroreticular resin absorbing method preparation.For example, these crude drug pulverize mix homogeneously can be made powder takes after mixing it with water; Also can be with these medicines decocting together, the condensed water decocting liquid is made oral liquid then; But, preferably adopt following technology to extract, but this can not limit protection scope of the present invention to raw material in order to make each crude drug of this medicine bring into play drug effect better.
Get Radix Notoginseng 100g, Flos Carthami 100g, Rhizoma Chuanxiong 200g is standby;
More than three the flavor, Radix Notoginseng powder is broken into fine powder, sieves; Rhizoma Chuanxiong decocts with water 2 hours, filters, and filtrate is deposited in addition, and medicinal residues and Flos Carthami decoct with water secondary, each 1 hour, merge three times decocting liquid, filter, filtrate was left standstill 24 hours, get supernatant, filter, filtrate concentrates, be dried to dry extract, be ground into fine powder, add the Radix Notoginseng fine powder, mixing is made granule, drying, be pressed into 1000, sugar coating, promptly.
Described Chinese medicine composition can be made tablet, sugar coated tablet, film coated tablet, enteric coated tablet, capsule, hard capsule, soft capsule, oral liquid, suck agent, granule, electuary, pill, powder, unguentum, sublimed preparation, suspensoid, solution, ointment, plaster, spray, drop pill.
More than form when producing and to increase or to reduce according to corresponding ratio, as large-scale production can be unit with kilogram or with the ton, small-scale production can be unit with the gram also, and weight can increase or reduce, but the crude drug material weight proportion constant rate between each composition.
In order to understand essence of the present invention better,, its new purposes in pharmaceutical field is described below by the result of the test of this pharmaceutical composition of clinical observation at anti-" aspirin resistance ".
The present invention adopts the research method to aspirin resistance commonly used at present, by measuring platelet aggregation rate, judge whether the patient has the effect that reduces aspirin resistance after taking medicine of the present invention, the present invention passes through clinical research observation, proved the application of medicine of the present invention in the medicine of the anti-aspirin resistance of preparation, medicine of the present invention has the effect of anti-aspirin resistance, in order to understand the present invention better, clinical test results with medicine of the present invention illustrates its new purposes in pharmaceutical field below, be convenient narration, below medicine of the present invention be called SHUXIONG PIAN.The preparation of embodiment 1 method is adopted in the experimental example medication.
The experimental example SHUXIONG PIAN reduces aspirin resistance effect experiment
We detect examination to 20 Yu Jia cadre's sanitarium retired cadres and family members are carried out aspirin, filter out 88 of aspirin resistance patients (58 of men, 30 of woman, 71.5 ± 11.3 years old age) altogether, find that the aspirin resistance incidence rate is about 15.6%.The aspirin resistance patient is divided into (55 of combination group; Unite and use aspirin and SHUXIONG PIAN), single with SHUXIONG PIAN group (33, the aspirin of stopping using, single SHUXIONG PIAN of using), measure the platelet maximum agglutination rate once more after treating for 2 weeks.
Method:
One. inclusion criteria
1. take low-dosage aspirin continuously and surpass 2 all persons
2. use U.S. CHRON-LOG AGGREGOMETER 540VS and detect the platelet maximum agglutination rate of its arachidonic acid-induction greater than 30%
Meeting above-mentioned two persons simultaneously can be selected in
Two. exclusion standard:
1. disease in the blood system hemorrhage especially;
2. cancer
3. chronic obstructive pulmonary disease
The person promptly is excluded to meet the one
Three. grouping:
Combination group: select 55 aspirin resistance patients at random, continue to use aspirin, add simultaneously with 2 all SHUXIONG PIAN, one time 5,3 times on the one.
Single use SHUXIONG PIAN: select 33 aspirin resistance patients at random, inactive aspirin is used SHUXIONG PIAN instead, and is oral, one time 5,3 times on the one, 2 weeks.
Four. curative effect determinate standard
Produce effects: the platelet maximum agglutination rate is less than 30% (effect is equal to normal aspirin effect)
Effectively: the platelet maximum agglutination rate is greater than 30%, but is lower than for 80% (the platelet activation value normally suppresses effect but be lower than aspirin in normal range)
Invalid: the maximum agglutination rate excursion is ± 10% before and after the treatment
Raise: the maximum agglutination rate excursion is ± 10% before and after the treatment
Effective percentage=(produce effects number+effective number)/total number of persons
The result
One, aspirin resistance aspirin and SHUXIONG PIAN are united use
1. treatment effective percentage
Therapeutic effect | Number | Ratio % |
The produce effects enabledisable raises | 20 23 7 5 | 36 42 13 9 |
The total effective rate that aspirin and SHUXIONG PIAN are united use reaches 78% (43/55)
2. compare before and after the platelet maximum agglutination rate:
Before the treatment (71.0 ± 27.8), treatment 2 week backs (27.1 ± 20.4) are through paired t-test: p<0.01; The average range of decrease of platelet aggregation rate is 50.3%.
Annotate: value before reduction amplitude=(being worth after value-medication before the medication)/medication
Two. aspirin resistance stops aspirin, singly uses SHUXIONG PIAN
1. treatment effective percentage
Therapeutic effect | Number | Ratio % |
The produce effects enabledisable raises | 7 9 9 8 | 21 27 27 24 |
Stop aspirin, single SHUXIONG PIAN of using, the total effective rate that aspirin resistance is treated reaches 48% (16/33)
2. compare before and after the platelet maximum agglutination rate:
Before the treatment (80.6 ± 30.7), treatment 2 week backs (61.9 ± 28.9) are through paired t-test: p<0.05; The average range of decrease of platelet aggregation rate is 21.01%.
Annotate: value before reduction amplitude=(being worth after value-medication before the medication)/medication
Conclusion: to the aspirin resistance person, use the treatment of aspirin and SHUXIONG PIAN can obviously lower platelet aggregation rate simultaneously, effective percentage is 78%, and the average range of decrease is 50.3%; List is treated aspirin resistance with SHUXIONG PIAN, and its effective percentage is 48%, and the average range of decrease is 20.01%.Presentation of results is to the invalid cardiovascular patient of independent use aspirin for treatment, SHUXIONG PIAN and aspirin share has the effect of good curing aspirin resistance, use SHUXIONG PIAN treatment aspirin resistance that effect is preferably also arranged separately, but the effect not as good as with the aspirin combination group, whether SHUXIONG PIAN reduces aspirin resistance by other mechanism of action, the further research of still needing.
Medicine of the present invention is to be prepared from by following examples, and following specific embodiment is an explanation of the invention, can not limit the present invention.
The specific embodiment
Below in conjunction with embodiment the present invention is done step explanation, following each embodiment only is used to the present invention is described and is not limitation of the present invention.
Embodiment 1
Get Radix Notoginseng 100g, Flos Carthami 100g, Rhizoma Chuanxiong 200g is standby;
More than three the flavor, Radix Notoginseng powder is broken into fine powder, sieves; Rhizoma Chuanxiong decocts with water 2 hours, filters, and filtrate is deposited in addition, and medicinal residues and Flos Carthami decoct with water secondary, each 1 hour, merge three times decocting liquid, filter, filtrate was left standstill 24 hours, get supernatant, filter, filtrate concentrates, be dried to dry extract, be ground into fine powder, add the Radix Notoginseng fine powder, mixing is made granule, drying, be pressed into 1000, sugar coating, promptly.
Embodiment 2
Get Radix Notoginseng 200g, Flos Carthami 200g, Rhizoma Chuanxiong 400g is standby;
More than three the flavor, Radix Notoginseng powder is broken into fine powder, sieves; Rhizoma Chuanxiong decocts with water 3 hours, filters, and filtrate is deposited in addition, and medicinal residues and Flos Carthami decoct with water secondary, each 2 hours, merge three times decocting liquid, filter, filtrate was left standstill 18 hours, got supernatant, filtered, filtrate concentrates, and is dried to dry extract, is ground into fine powder, add the Radix Notoginseng fine powder, mixing is made granule, drying is pressed into 2000, promptly.
Embodiment 3
Get Radix Notoginseng 50g, Flos Carthami 50g, Rhizoma Chuanxiong 100g is standby;
More than three the flavor, Radix Notoginseng powder is broken into fine powder, sieves; Rhizoma Chuanxiong decocts with water 3 hours, filters, and filtrate is deposited in addition, medicinal residues and Flos Carthami decoct with water secondary, each 1.5 hours, merge three times decocting liquid, filter, filtrate was left standstill 36 hours, got supernatant, filter, filtrate concentrates, and is dried to dry extract, be ground into fine powder, add the Radix Notoginseng fine powder, mixing, make granule, incapsulate, promptly.
Embodiment 4
Get Radix Notoginseng 150g, Flos Carthami 85g, Rhizoma Chuanxiong 250g is standby;
More than three the flavor, Radix Notoginseng powder is broken into fine powder, sieves; Rhizoma Chuanxiong decocts with water 4 hours, filters, and filtrate is deposited in addition, and medicinal residues and Flos Carthami decoct with water secondary, each 2 hours, merge three times decocting liquid, filter, filtrate was left standstill 36 hours, got supernatant, filtered, and filtrate concentrates, and is dried to dry extract, be ground into fine powder, add the Radix Notoginseng fine powder, mixing is made granule,, promptly.
Embodiment 5
Get Radix Notoginseng 85g, Flos Carthami 150g, Rhizoma Chuanxiong 150g is standby;
More than three the flavor, Radix Notoginseng powder is broken into fine powder, sieves; Rhizoma Chuanxiong decocts with water 2 hours, filters, and filtrate is deposited in addition, and medicinal residues and Flos Carthami decoct with water secondary, each 1 hour, merge three times decocting liquid, filter, filtrate was left standstill 24 hours, got supernatant, filtered, filtrate concentrates, and is dried to dry extract, is ground into fine powder, add the Radix Notoginseng fine powder, mixing is made granule, add proper honey, be prepared into pill by the conventional preparation method of pill, promptly.
Embodiment 6
Get Radix Notoginseng 100g, Flos Carthami 110g, Rhizoma Chuanxiong 240g is standby;
More than three the flavor, Radix Notoginseng powder is broken into fine powder, sieves; Rhizoma Chuanxiong decocts with water 2.5 hours, filters, and filtrate is deposited in addition, and medicinal residues and Flos Carthami decoct with water secondary, each 1.5 hours, merge three times decocting liquid, filter, filtrate was left standstill 12 hours, get supernatant, filter, filtrate concentrates, be dried to dry extract, be ground into fine powder, add the Radix Notoginseng fine powder, mixing is made granule, drying, be pressed into 1000, sugar coating, promptly.
Claims (7)
1, the application of a kind of pharmaceutical composition in the low anti-medicine of the anti-aspirin of preparation, wherein this drug composition is by comprising that following crude drug makes: Radix Notoginseng 50~200g, Flos Carthami 50~200g, Rhizoma Chuanxiong 100~400g.
2, application as claimed in claim 1, wherein this drug composition is by comprising that following crude drug makes: Radix Notoginseng 85~150g, Flos Carthami 85~150g, Rhizoma Chuanxiong 150~250g.
3, application as claimed in claim 1, wherein this drug composition is by comprising that following crude drug makes: Radix Notoginseng 100g, Flos Carthami 100g, Rhizoma Chuanxiong 200g.
4,, it is characterized in that described compositions is tablet, sugar coated tablet, film coated tablet, enteric coated tablet, capsule, hard capsule, soft capsule, oral liquid, sucks agent, granule, electuary, pill, powder, unguentum, sublimed preparation, suspensoid, solution, ointment, plaster, spray, drop pill as any one described application in the claim 1~3.
5,, it is characterized in that the application of this pharmaceutical composition in the medicine of preparation treatment aspirin repellency cardiovascular and cerebrovascular disease as any one described application in the claim 1~3.
6, application as claimed in claim 5 is characterized in that said aspirin repellency cardiovascular and cerebrovascular disease is meant the invalid cardiovascular and cerebrovascular disease of use aspirin for treatment.
7, application as claimed in claim 6 is characterized in that said aspirin repellency cardiovascular and cerebrovascular disease is meant invalid coronary heart disease, the angina pectoris of use aspirin for treatment.
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CN106214719A (en) * | 2016-08-31 | 2016-12-14 | 江西桔王药业有限公司 | A kind of preparation method of new relieving disorders of the chest granule |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN106214719A (en) * | 2016-08-31 | 2016-12-14 | 江西桔王药业有限公司 | A kind of preparation method of new relieving disorders of the chest granule |
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