2 National Collection of Chinese Herbal Medicine: Lily of the Valley 2. 1 Pinyin name Lí n π lá n
2.2 Lily of the Valley is also known as Caoyuling, Deer Spirit, Perfume Flower, Deer Bell Grass, and should be evenly distributed and fragrant.
2.3 It comes from keiskei Miq of Lily of the Valley. Liliaceae, and used as a complete herb. After the fruits are ripe in summer, the whole grass is harvested, the soil is removed and dried.
2.4 Sexual taste is bitter and warm. Toxic.
2.5 Function indications are cardiotonic and diuretic. Used for left heart failure caused by congestive heart failure, atrial fibrillation, hypertension and nephritis.
2.6 Usage and dosage of Lily of the Valley: 0.3g whole grass each time, 1.0g daily, and washed with clear water.
2.7 Remarks (1) Excessive use of this product may lead to atrioventricular and indoor conduction block, and the patient has no conscious discomfort and is not easy to find. Therefore, when using this product, we should pay special attention to the change of heart rhythm, and it is routine to observe the heart rhythm and pulse before each medication. Others are the same as general cardiotonic drugs.
(2) The side effects of this product are less than digitalis. Only a few patients have nausea and vomiting, or dizziness and palpitations. Pay attention to observation at this time.
2.8 Excerpted from the National Compilation of Chinese Herbal Medicine
3 "Chinese Materia Medica": Lily of the Valley 3. 1 Originated from "History of Northeast Herbal Medicine"
3.2 Pinyin Name Lí n ɡ Lan
3.3 English name Lilyofthevalley Herb
3.4 Lily of the Valley alias perfume flower, quinoa flower, deer bell grass, lily of the valley, small quinoa, grass inch incense.
3.5 Source: the whole grass or root of Liliaceae lily.
Latin plant and animal mineral name: lily of the valley. ]
Harvest and storage: digging in July, removing soil and drying in the sun.
3.6 The original form of Lily of the Valley, a perennial herb, is as high as 30cm. Rhizomes are slender and creeping. 2 leaves; The petiole is about 65,438+0.6 cm long, surrounded by each other into a sheath, and there are several sheath-like membranous scales at the base. The leaf blade is oval, with a length of 13 15cm and a width of 77.5cm, with a sharp apex and a slightly narrow base. Scape height 1530cm, slightly curved outward; Racemes are biased to one side; Bracts lanceolate, membranous, shorter than pedicels; The flowers are ivory, bell-shaped, drooping, about 7mm long and1cm wide; Perianth terminal 6-lobed, lobes ovate-triangular; Stamens 6; Style is shorter than perianth. Berries are spherical and red when they are ripe. Seeds elliptic, flat, 46. Flowering in May and fruiting in June.
3.7 Habitat distribution Ecological environment: Born in wet places or ditches at an altitude of 8502500m.
Distribution of resources: Northeast China, North China, Shaanxi, Gansu, Ningxia, Shandong, Jiangsu, Zhejiang, Henan, Hunan and other places.
3.8 Biological characteristics of cultivation, such as semi-shading, cool and humid environment, cold tolerance and fertilizer preference. The requirements for soil are not strict, so loam with deep soil layer, rich humus and loose fertility should be selected for planting. Avoid high temperature. Cultivation techniques use roots and seeds to propagate. Rhizome propagation: in autumn, the rhizomes before spring germination are removed, and the rhizomes are separated by bud eyes, and pits are dug with a row spacing of 25cm×5cm and a pit depth of about 5cm. Each pit is planted with 23 plants, covered with soil, compacted and watered, and connected after 23 years. Seed propagation: when the fruit turns red, harvest it, put it in water to rub off the pulp, wash and dry the seeds, and store them for later use. Sowing can be done in spring and autumn. Autumn sowing is in late June 65438+1October 65438+1early October, and spring sowing is in late March and early April. Sow seeds in furrows, with the row spacing of 10 15cm and the depth of 23cm, evenly spread the seeds in furrows, cover with soil, slightly press, and water at the temperature of 65438. Manage shallow soil in the field, pull weeds frequently, topdressing 23 times a year, applying cake fertilizer, calcium superphosphate and appropriate amount of plant ash, and watering frequently to keep the soil moist.
3.9 Trait identification: total grass length 1030cm. Rhizomes are slender and creeping, with many fleshy fibrous roots. There are usually two leaves. The complete leaf blade is elliptic or elliptic-lanceolate, 720 cm long and 38 cm wide, entire, with sharp apex and wedge-shaped base, and the veins are parallel and arc-shaped. The petiole is 820 cm long and slightly sheath-shaped. Racemes, leaning to one side, with white flowers, about 10, drooping and fragrant.
3. 10 The chemical constituents of the whole plant contain cardanol, cucurbitacin, glucose cucurbitacin, glucose cucurbitacin, glucosinolate, cucurbitacin. Monosaccharide glycosides include isorhamnetin 3 galactoside, quercetin 3 galactoside and kaempferol 3 galactoside; Disaccharides include isorhamnetin 3 galactose rhamnoside, quercetin 3 galactose rhamnoside and kaempferol 3 galactose rhamnoside; There are three kinds of glycosides: isorhamnetin 3 galactoside, quercetin 3 galactoside and kaempferol 3 galactoside. It also contains 6 kinds of periplocin, 6 kinds of Biping Polydeoxyguloside and 6 kinds of Biping Polydeoxyguloside. Indirubin 3O6' deoxy βD guloside, indirubin 3o6' deoxy β d alloside, indirubin 3o6' deoxy β d guloside, sarmentogenin 3 o6' deoxy β d guloside, sarmentogenin 3o6' deoxy β d guloside, sarmentogenin 3o6' rhamnoside, Sarmentosigenin 3O6' deoxyβ D leaves contain periplocin, 3β, 5, 14β trihydroxy 5β20(22) carnenolide 3αL rhamnoside (3β, 5, 14β trihydroxy 5β car20(22) enolized 3αL rhamnoside) and periplocin. 6- Deoxyβ-D-guloside, 6- Deoxyβ-D-guloside, 6- Deoxyβ-D-guloside, 6- Deoxyβ-D-guloside, 6- Deoxyβ-D-guloside, 3- Deoxyβ-rhamnoside. 9 hydrogenated strophanin βD6 deoxyguloside (Canesceol, Carmentogenin β dgulomethylide) 19 hydroxy salmone 3αL rhamnoside (19 hydroxy sarmentogenin 3αL rhamnoside), Samentogenin 3O6' deoxy βD aloside αL rhamnoside (sarmentogenin 3O6' deoxy β d rhamnoside) and salmentogenin 3o6' deoxy β d guloside (sarmentogenin 3o6' deoxy β d guloside). The flower contains periplocin, 3β, 5, 14β trihydroxy 5β20(22) erythrolactone 3αL rhamnoside, periplocin 6 deoxyβ d rhamnoside, cucurbitacin, 3', 4', 5,7 tetrahydroxyflavone 6 rhamnoside (biorobin). Isoquercetin, kaempferol 3βD galactopyranoside (2← 1)OαL pyranoside [kaempferol 3βD galactopyranoside (2← 1)Oα 1 pyranoside], Quercetin 3βD galactopyranosyl (2← 1)OαL pyranoside [Quercetin 3β d galactopyranosyl (2← 1)o rhizome contains hypericin 3αL pyranoside (1→5)OβD furanosyl [hypericin 3α lrhamnopyranosyl Roots and rhizomes contain glucosinolates, cucurbitacins, furastanol saponins and spirostanol saponins. The seeds contain cucurbitacin and cucurbitacin.
3. 1 1 pharmacological action 1. Cardiotonic effect: the extract of leaves, stems or whole grass of Lily of the Valley and the alcohol extract of whole grass all have digitalis-like effect, which can enhance myocardial contractility for cold-blooded and warm-blooded animals, and has a more significant effect on heart failure: it can slow down heart rate, inhibit conduction and show the characteristics of cardiac glycoside. Its infusion is easy to hydrolyze, which affects the stability of preservation and titer, and the oral curative effect is not good. When the whole herb is used as medicine, the active ingredient cardiotonic has a significant change due to different harvest seasons and treatment methods. The content of cardiac hormone in roots is the highest in the fruit formation stage, and it is also more in the current leaf stage and leaf exhibition stage. The contents of leaves, petioles, flowers and flowers are the highest in bud formation and early flowering (the fruit formation period is higher than the root); The seed content was the highest in yellow fruit stage and red fruit stage. The contents of fruits and seeds are similar. In earlier years, it was reported that the root was the most effective, which was 2325 times that of foxglove leaves, 10 15 times that of petioles and 78 times that of leaves. It is also reported that the potency of cardiotonic agent (pigeon method) is the highest in petiole, which is equivalent to 30.98 digitalis international units per gram, with roots 19.95, leaves 1 1.09 and flowers of 20.29. The difference in the above reports may be related to the collection time and dryness. The biological potency (pigeon method) of leaves and stems of lily of the valley collected in Yuquan, Northeast China in mid-May is about three times that of digitalis. After 1 year, its titer was about twice that of digitalis by guinea pig method. The curative effect of whole herb preparation (guinea pig method) is stronger than digitalis 1.9 times.
The cardiotonic effect of lily of the valley toxin is similar to that of echinacoside, and it is the strongest among all known plant cardiac glycosides. The domestic lily of the valley toxin injection (containing 0. 1mg per ml) is five times stronger than digitalis, and the adult saturation is between 0.20.3mg. It takes effect 2025 minutes after intravenous injection (diluted with glucose solution and injected slowly). The average curative effect can last for 8 15 hours, and the saturated dose is given in 23 times. When the total dose reaches 0.4mg, the effect is remarkable. The maintenance amount was 0.050. 1 mg. It can be used as a domestic substitute for echinacoside, but some people think that it can not be completely replaced for some serious cases. In the experiment of isolated frog heart, the combination of hawthorn extract and lily of the valley toxin enhanced the cardiotonic effect and weakened the toxicity. The combination of aminophylline and aminophylline is more sensitive to animals with left ventricular dysfunction. Injection of cucurbitacin in rats can significantly reduce the content of norepinephrine in the heart. After reserpine injection, the sensitivity of frogs to lily of the valley toxin decreased by 24 times. Lily of the valley toxin can improve the circulatory disorder (increased glycogen biosynthesis) of experimental acute coronary insufficiency in rabbits; Lily of the valley granule also seems to have curative effect on experimental myocarditis. Cucurbitacin glycoside has high titer. The titer of deglucoside is also very high. The titer of cucurbitacin glycoside (which is produced after hydrolysis) is about 2 times lower than that of cucurbitacin. The function of Sophora alopecuroides is similar to that of Digui Talin. Lily of the valley saponin can cause nausea, vomiting and diarrhea, and has no cardiotonic effect. The total glycoside obtained by removing impurities and saponins from lily of the valley is called lily of the valley (sometimes called lily of the valley toxin solution), and each milliliter is equivalent to 1g lily of the valley, with stable titer, which can be used for oral administration and intravenous injection. The total glycoside preparation of lily of the valley leaves is called Kelikang, which can be injected, and its effect is similar to echinacoside, but its effect is weak and its toxicity is less.
2. Absorption, excretion and accumulation: Lily of the Valley oral preparation is generally poor in stability and absorption, and it is easy to be destroyed in the intestine, so its efficacy is obviously reduced, and its effect is not as good as digitalis. Northeast Yuquan Lily of the Valley Tincture was given to the duodenum of guinea pigs, and only about 50% was absorbed in 6 hours. The curative effect of cucurbitacin was also significantly reduced after duodenal administration. Intravenous injection has the highest activity, while intestinal administration has the lowest activity. There are also differences among different animals, for example, the oral absorption rate of rats and cats can reach 90%, while that of guinea pigs is only 14%. It is destroyed quickly in the body, excreted quickly, and accumulated less than digitalis. Most of cucurbitacin has been excreted after 3 days of administration, and it can be completely excreted after 6 days. The accumulation of lily of the valley toxin is very low, and half the dose can be discharged in 1 day, and it will be discharged in 5 days. Some people report that it completely disappears from the body within 48 hours. It can destroy 34% in the liver in 24 hours, and the elimination rate is 0.00 190.0022mg/kg/ hour, which is 2. 1 times faster than digitalis. The cucurbitacin can be metabolized into cucurbitacin during perfusion of isolated rat small intestine. The accumulation of desglucose wallflower glycoside is also very low, and it and cucurbitacin glycoside are not destroyed in the liver, and are excreted at the same time as bile.
3. Diuretic effect: Lily of the valley has obvious diuretic effect. The diuretic effect on patients with heart failure is better than that of digitalis and echinacoside. For edema that cannot be subsided by the latter two drugs, Lily of the Valley preparation can often get satisfactory results. In the acute experiment of rabbits, the leaves of lily of the valley have diuretic effect after water load, and the diuretic effect of roots is more obvious than that of leaves. Lily of the valley toxin can increase the urine output of rats by 300%, which is stronger than other cardiac glycosides. It can also improve the excretion of electrolytes (mainly sodium ions), mainly because it inhibits the reabsorption of renal tubules, especially the sodium ion transport process of distal renal tubules.
4. Sedative effect: Lily of the Valley can make patients quiet, improve sleep and reduce anxiety in clinic. The whole herb extract and tincture can enhance the superficial anesthetic effect of barbital sodium on mice. Lilioside solution can reduce the excitation process of cerebral cortex and enhance its inhibition process. Sedative effect is mainly caused by its aglycone (echinacoside). The aglycone below toxic dose can prolong the latency of conditioned reflex, reduce the bioelectric potential activity of cerebral cortex and brain stem, significantly prolong and strengthen the hypnotic effect of isobarbital, and weaken the intensity of experimental electroconvulsions in rabbits and rats. Lily of the valley toxin, deglucoside and its aglycone can inhibit spontaneous activity in rats, but cucurbitacin has no sedative effect.
5. Effect on metabolism: Lilium brownii toxin can increase glycogen content in myocardium of normal or myocarditis rats and cats, but its effect is weaker than toxic echinacoside. If toxic dose is used for a long time, the content of glycogen in myocardium can be reduced. Lily of the valley toxin can enhance the assimilation process of myocardial hypoxia. The total glycosides of lily of the valley leaves can enhance the metabolism of cardiac phosphatides, which is beneficial to the energy supply of myocardium. Lily of the valley toxin can also improve pulmonary circulation, increase oxygenated hemoglobin in arterial blood of anesthetized dogs, and increase oxygen uptake in brain tissue and oxygen tension in skeletal muscle.
6. Other effects: toxic dose of Kolglikang can contract coronary vessels. Deglycidylcholate has vasoconstrictive effect on isolated coronary vessels and perfusion of rabbit ears and kidneys. The Japanese Lily of the Valley extract can contract the intestine in vitro, calcium can cooperate, and magnesium can antagonize this effect. Lily of the valley can also cause diarrhea in clinical application. Kaolikang can prolong the coagulation time and prothrombin time of rabbits (lily and lily have no such effect), and it can reduce the concentration of factor V and the activity of platelet activating enzyme in rabbit plasma when combined with lily liquid, but the effect is opposite when combined with inulin. The lily of the valley produced in the Soviet Union contains lily of the valley, which is beneficial to gallbladder and anti-inflammatory, and can alleviate the pathological process of carbon tetrachloride hepatitis in rabbits and shorten the recovery period.
3. 12 toxic Lily of the Valley preparation has less side effects and toxicity than digitalis, and a few patients may have digestive tract symptoms such as anorexia, salivation, nausea and vomiting. Some have dizziness, headache and palpitation. Subcutaneous injection of cucurbitacin injection will cause local pain because it contains some impurities. Unfortunately, it can be treated according to the principle of cardiac glycoside poisoning. The safe range of its treatment is greater than that of spinosad. The lethal dose of Lily of the Valley tincture to mice was1.61.1.238 mg/g.
3. 13 tastes sweet and bitter; Sexual temperature; Poisonous
3. 14 has the function of warming yang and promoting diuresis; Promoting blood circulation and expelling wind. Major congestive heart failure; Rheumatic heart disease; Paroxysmal tachycardia; oedema
3. 15 oral administration and dosage: decoction, 36g；; Or at the end of grinding, 0.30.6g each time; Or made into tincture and injection. See "Modern Clinical Research" for usage and dosage. External use: appropriate amount, washed with water; Or burn ash, grind powder, and apply it.
3. 16 Note that this product is toxic and cannot be used excessively.
3. 17 annex ① erysipelas: lily of the valley. Decoct and wash. ② Treatment of Purpura: Take an appropriate amount of Lily of the Valley, burn it and grind it into powder, and mix it with vegetable oil. ③ Treatment of traumatic injury: San Qian of Lily of the Valley, red 372 yuan, red 372 pills, five points, four watts and five yuan. Decocting in water, with yellow wine as the guide. ④ Treating metrorrhagia and metrorrhagia: Lily of the Valley, Leonurus San Qian. Red and white cockscomb flowers and red hair are two yuan each, safflower is one yuan and five cents, and lycopodium is one yuan. Decocting in water, with yellow wine as the guide. (The selected prescriptions are all Shaanxi Chinese herbal medicines).
3. 18 Various arguments 1. Handbook of commonly used Chinese herbal medicines in Northeast China: warming yang and promoting diuresis. Treatment of heart disease caused by rapid heartbeat, heart failure and edema.
2. "Shaanxi Chinese Herbal Medicine": strengthening the heart and diuresis, promoting blood circulation and expelling wind, nourishing yin and regulating qi. Treat rheumatic heart disease, Keshan disease, paroxysmal tachycardia, heart failure, erysipelas, purpura, traumatic injury, strain, metrorrhagia and leucorrhea.
3. Clinical application of19 lily of the valley in treating congestive heart failure: oral 10% tincture, each time 1ml, 4 times a day; After continuous administration for 3 days, it was changed to maintenance dose, daily dose 1ml. Or lily of the valley toxin injection, daily 0.050. 1mg (each ampoule contains lily of the valley toxin 0. 1mg), diluted with 20 ml of 2025 distilled glucose solution, and slowly injected intravenously. Tincture treatment of rheumatic heart disease and heart failure 10 cases. Symptoms and signs such as shortness of breath, cyanosis, lung rales, jugular vein swelling, hepatomegaly and edema were obviously improved in 7 cases within 37 days. Among them, 4 cases were complicated with atrial fibrillation, and the heart rate dropped to normal after 23 days of medication. Two cases of renal heart failure were treated. After 4 days, the edema subsided and the liver retreated to the costal margin. Treat heart failure 1 case caused by tuberculosis Keshan disease and hypertensive heart disease respectively, and all of them are effective after taking the medicine; In the treatment of 6 cases of pulmonary heart disease, 2 cases were markedly effective, 2 cases were improved, and 2 cases had toxic reaction after taking the medicine for 3 days. 1 case had a heart rate of 36 beats/min (considered as ⅲ atrioventricular block), and another 1 case had a biphasic heart rhythm, all of which had severe pulsating headache, dizziness and heart discomfort, but no symptoms such as nausea, vomiting and yellowing. The total curative effect 13 cases, 5 cases improved and 2 cases poor. 10 cases were treated with lily of the valley toxin injection, and the symptoms and signs of 4 cases were obviously improved within 2 hours after administration. Symptoms and signs improved 2 hours after drug injection, or disappeared or improved obviously after a few days, which was ineffective 1 case. General drug injection 10 minutes later, the curative effect can appear, reaching the peak in 2 hours, and the effect is not obvious after 24 hours. There are no side effects during the general treatment, but there are mild nausea, atrioventricular block, occasional premature beats, temporary biphasic rhythm and other phenomena. We should pay close attention to the changes of heart rhythm and heart rate to prevent accidents.
3.20 Excerpt from Chinese Materia Medica
A Chinese patent medicine, Xiaoshi IV, uses the traditional Chinese medicine Lily of the Valley.