WO2012068962A1 - 复方丹参制剂在制备抗肺动脉高压药剂中的应用 - Google Patents

复方丹参制剂在制备抗肺动脉高压药剂中的应用 Download PDF

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WO2012068962A1
WO2012068962A1 PCT/CN2011/082145 CN2011082145W WO2012068962A1 WO 2012068962 A1 WO2012068962 A1 WO 2012068962A1 CN 2011082145 W CN2011082145 W CN 2011082145W WO 2012068962 A1 WO2012068962 A1 WO 2012068962A1
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pulmonary
use according
preparation
borneol
danshen
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PCT/CN2011/082145
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English (en)
French (fr)
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朱永宏
李欣欣
马晓慧
马洁
周王谊
莫红梅
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天津天士力制药股份有限公司
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Publication of WO2012068962A1 publication Critical patent/WO2012068962A1/zh

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/53Lamiaceae or Labiatae (Mint family), e.g. thyme, rosemary or lavender
    • A61K36/537Salvia (sage)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/045Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/25Araliaceae (Ginseng family), e.g. ivy, aralia, schefflera or tetrapanax
    • A61K36/258Panax (ginseng)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00Drugs for disorders of the respiratory system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/04Inotropic agents, i.e. stimulants of cardiac contraction; Drugs for heart failure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/12Antihypertensives

Definitions

  • the invention belongs to the field of medicine, and particularly relates to the application of the compound Danshen preparation in preparing an anti-pulmonary hypertension agent.
  • Pulmonary arterial hypertension is a disease characterized by vasospasm, intimal hyperplasia, and structural remodeling of the pulmonary arterioles.
  • the combination of vasoconstriction, vascular structural remodeling and in situ thrombosis causes a progressive increase in pulmonary vascular resistance, which ultimately leads to right heart failure and death. It is a progressive disease with a poor prognosis and is currently ineffective. Treatment plan.
  • Pulmonary hypertension is treated with traditional therapies: oral calcium channel blockers, anticoagulants, diuretics, and oxygen, with an average survival of ⁇ 3 years.
  • traditional therapies oral calcium channel blockers, anticoagulants, diuretics, and oxygen
  • endothelin receptor antagonists have become the first-line treatment for severe pulmonary hypertension.
  • the new drugs developed in recent years target three different pathological pathways of pulmonary hypertension. These three different pathological pathways and their representative drugs are: prostacyclin pathway (representative drug: epoprostenol), endothelin pathway (representative drug) : Bosentan), Nitric Oxide Pathway (representative drug: sildenafil).
  • epoprostenol has been the only choice for most patients with PAH, but the half-life of epoprostenol is short and requires continuous intravenous administration, increasing the risk of infection due to infusion. If the drug is suddenly discontinued, the patient's blood flow. The dynamics are again abnormal.
  • Salvia miltiorrhiza is bitter, slightly cold, and has the effects of promoting blood circulation, nourishing blood and soothing the nerves, cooling blood and removing blood stasis and detoxifying the muscles. It is a common medicine for promoting blood circulation and removing blood stasis.
  • Salvia miltiorrhiza contains mainly fat-soluble diterpenoids and water-soluble phenolic acids, and contains other components such as flavonoids, triterpenoids and alcohols.
  • tanshinone I tanshinone oxime
  • tanshinone IIR tanshinone V
  • tanshinone VI cryptotanshinone
  • isonishenone I istansinone II
  • isodanshinone IIB dihydrotanshinone I, etc.
  • Water-soluble phenolic acids are danshensu, protocatechuic aldehyde, protocatechuic acid, caffeic acid, derivatives of danshensu and caffeic acid, or depsipeptides (such as salvianolic acid) 8.
  • Tanshinone is one of the representative components of Salvia miltiorrhiza Bunge. Modern pharmacological studies have shown that Salvia miltiorrhiza has the effects of dilating coronary artery, anti-cardiac ischemia, anticoagulation, antithrombotic, sedative pain, and lowering blood fat and anti-atherosclerosis.
  • Sanqi belongs to the traditional Chinese medicine for stopping bleeding.
  • Traditional Chinese medicine believes that it has the function of dispersing silt and stopping bleeding, reducing swelling and setting pain, and both stops bleeding and promotes blood circulation.
  • Modern pharmacological studies have proven that Sanqi has both hemostasis and anticoagulant effects. Hemostasis includes shortening of bleeding and clotting time, increasing the number of platelets and causing stretching, aggregation, degranulation, etc., and reducing capillary permeability.
  • Panax notoginseng saponins Some of the ingredients in Panax notoginseng are shown to be anti-coagulant: Panax notoginseng saponins, Panax notoginseng diol saponins and triol saponins, all of which inhibit the aggregation of human and rabbit platelets.
  • Panax notoginseng saponins can promote the secretion of tissue-type plasminogen (t-N) by vascular endothelial cells and prevent the formation of blood clots.
  • tissue-N tissue-type plasminogen
  • Borneol is a processed crystal of the dipterocarpic plant.
  • the crystals obtained from the steam extraction of the leaves of the Asteraceae plant, the genus A. sinensis, are called eucalyptus.
  • the processed product synthesized by chemical methods such as camphor and turpentine is called a mechanism borneol.
  • the borneol is a bitter and fragrant, and the aroma is astringent. It can pass through the sputum, and it can be used for smoldering.
  • the dragon brain borneol mainly contains the right-handed borneol; the diarrhea mainly contains the left-handed dragon brain.
  • Modern pharmacological studies have shown that borneol has anti-myocardial ischemia effect, which can significantly increase coronary flow; in addition, borneol can increase the permeability of blood-brain barrier and enhance the cross-barrier ability of drugs.
  • Compound Danshen preparation is prepared from Danshen, Sanqi and Borneol three traditional Chinese medicines as raw materials, and is widely used in patients with coronary heart disease. After years of clinical observation and experimental research, the application range of compound Danshen preparation has been greatly expanded. It has been confirmed that compound Danshen preparation has increased coronary flow, dilated vascular smooth muscle, promotes collateral circulation, significantly improves myocardial ischemia and infarction, improves hypoxia tolerance, resists lipid peroxidation, scavenges free radicals, and protects vascular endothelial cells. , anti-arrhythmia, anti-platelet aggregation, anti-thrombosis, reduce blood viscosity, regulate blood lipids, enhance immunity and many other aspects.
  • One of the objects of the present invention is to provide a use of a compound Danshen preparation for the preparation of an anti-pulmonary hypertension agent.
  • the anti-pulmonary hypertension is a hypoxic or drug-induced pulmonary hypertension disease, and the drug is, for example, wild lily.
  • Another object of the present invention is to provide a use of a compound salvia miltiorrhiza preparation for the preparation of a medicament for treating pulmonary hypertension related diseases such as pulmonary heart disease, emphysema, congestive heart failure and the like.
  • the application is to reduce pulmonary artery pressure and reduce right ventricular pressure.
  • the application is to improve pulmonary vascular proliferation, which improves pulmonary vascular hyperplasia to reduce thickening of pulmonary arteriolar wall and smooth muscle layer, improve stenosis of pulmonary arterioles, and reduce pulmonary artery wall thickness and extravascular
  • the application is to improve the right ventricular hypertrophy index.
  • the application is to improve the relaxation of the pulmonary artery ring.
  • the application is to improve pathological changes of lung tissue caused by pulmonary hypertension.
  • the compound Danshen preparation of the invention is a pharmaceutical preparation prepared by using Danshen, Sanqi and Borneol three traditional Chinese medicines as raw materials.
  • the compound Danshen preparations which have been listed at present include Compound Danshen Tablets, Compound danshen Capsules and Compound Danshen Dropping Pills.
  • the compound Danshen preparation of the present invention is generally prepared from the following weight percentages of raw materials: Salvia miltiorrhiza Bge. 48.0%-97.0%, Panax notoginseng 1.0%-50.0%
  • the borneol is 0.1%-3.0%, preferably Danshen 63.0%-94.0%, Sanqi 4.0%-35.0%, borneol 0.5%-2.0%, more preferably Salvia 82.87%, Sanqi 16.21%, and borneol 0.92%.
  • the preparation is to first process the raw material medicine into a pharmaceutically active ingredient, and further prepare a pharmaceutical preparation.
  • the preparation method of the compound danshen preparation of the present invention belongs to the prior art and can be obtained from the existing patent publications or prepared according to the disclosed pharmaceutical standards.
  • the compound Danshen preparation of the present invention is preferably a compound Danshen dropping pill.
  • the compound Danshen preparation of the present invention is prepared from the following weight percentages of raw materials: Salvia miltiorrhiza Bge. 48.0%-97.0%, Panax notoginseng 1.0%-50.0 %, borneol 0.1%-3.0%, preferably Salvia miltiorrhiza 63.0%-94.0%, Panax notis 4.0%-35.0%, borneol 0.5%-2.0%, more preferably Salvia 82.87%, Panax notar 16.21%, borneol 0.92% prepared for drug activity
  • a pharmaceutically acceptable carrier may be added to the pharmaceutically active ingredient as needed, and the pharmaceutically acceptable carrier may comprise from 0.1 to 99.9% by weight of the total formulation.
  • the pharmaceutical composition of the present invention is present in unit dosage form, which means a unit of the preparation, such as each tablet of the tablet, each of the capsules, each bottle of the oral solution, each bag of the granules, and the injection of the granules. Every one.
  • the compound salvia miltiorrhiza preparation of the present invention may be in any pharmaceutically acceptable dosage form, and the dosage forms include: tablets, such as sugar-coated tablets, film-coated tablets, enteric coated tablets; capsules, such as hard capsules, soft capsules; Oral liquid; oral preparation; granules; granules; pills; powders; powders; ointments, such as ointments, plasters; remedies; suspensions; powders; solutions, for example, injections; suppositories, creams, sprays, drops ; pills and patches.
  • tablets such as sugar-coated tablets, film-coated tablets, enteric coated tablets
  • capsules such as hard capsules, soft capsules
  • Oral liquid oral preparation
  • Suitable fillers include cellulose, mannitol, lactose and other similar fillers.
  • Suitable disintegrants include starch, polyvinylpyrrolidone and starch derivatives such as sodium starch glycolate.
  • Suitable lubricants include, for example, magnesium stearate.
  • Suitable pharmaceutically acceptable wetting agents include sodium lauryl sulfate.
  • Solid oral compositions can be prepared by conventional methods such as mixing, filling, tableting, and the like. Repeated mixing allows the pharmaceutically active ingredient to be distributed throughout the composition using a large amount of filler.
  • the oral liquid preparation may be in the form of, for example, an aqueous or oily suspension, a solution, an emulsion, a syrup or an elixir, or may be a dry product which may be formulated with water or other suitable carrier before use.
  • Such liquid preparations may contain conventional additives such as suspending agents such as sorbitol, syrup, methylcellulose, gelatin, hydroxyethylcellulose, carboxymethylcellulose, aluminum stearate gel or hydrogenated edible fat; Emulsifiers such as lecithin, sorbitan monooleate or gum arabic; nonaqueous vehicles (which may include edible oils), such as almond oil, tiller coconut oil, oily esters of esters such as glycerol, propylene glycol or ethanol; A preservative such as p-hydroxybenzyl or propylparaben or sorbic acid, and if desired, may contain conventional flavoring or coloring agents.
  • suspending agents such as sorbitol, syrup, methylcellulose, gelatin, hydroxyethylcellulose, carboxymethylcellulose, aluminum stearate gel or hydrogenated edible fat
  • Emulsifiers such as lecithin, sorbitan monooleate or gum arabic
  • nonaqueous vehicles which may include edible oils
  • the liquid unit dosage form prepared contains the pharmaceutically active ingredient of the present invention and a sterile carrier.
  • the pharmaceutically active ingredient may be suspended or dissolved depending on the kind of the carrier and the concentration of the pharmaceutically active ingredient.
  • the solution is usually prepared by dissolving the pharmaceutically active ingredient in the carrier. In the body, it is filtered and sterilized before being placed in a suitable vial or ampoule, and then sealed. Excipients (e.g., local anesthetics, preservatives, and buffers) can also be dissolved in the carrier. To increase its stability, the composition can be frozen after filling the vial and the water removed under vacuum.
  • the compound salvia miltiorrhiza preparation of the present invention may optionally be added to a suitable pharmaceutically acceptable carrier when prepared as a medicament
  • the pharmaceutically acceptable carrier includes, but is not limited to, the following: a sugar alcohol such as mannitol , sorbitol, xylitol; amino acids, such as cysteine hydrochloride, methionine, glycine; vitamin C; disodium EDTA, calcium EDTA; inorganic salts, such as monovalent alkali metal carbonates, acetates, phosphoric acids Salt or its aqueous solution; sodium chloride, potassium chloride; sodium metabisulfite, sodium hydrogen sulfite, sodium thiosulfate; calcium carbonate, calcium hydrogencarbonate; stearate, such as calcium stearate, magnesium stearate; Acids such as hydrochloric acid, acetic acid, sulfuric acid, phosphoric acid; organic or organic acid salts such as thioglycolic acid, sodium
  • the compound danshen preparation of the present invention determines the dosage according to the condition of the patient at the time of use.
  • the compound Danshen dropping pills according to the present invention are prepared from Danshen, Sanqi and borneol.
  • the compound Danshen dropping pills according to the present invention are compared with the total weight of three kinds of Chinese herbal medicines such as Danshen, Sanqi and Borneol.
  • the following weight percentages of raw materials are made:
  • the compound Danshen dropping pills according to the present invention are made of the following weight percent raw material medicines relative to the total weight of three Chinese herbal medicines: salvia miltiorrhiza, notoginseng and borneol:
  • the compound Danshen dropping pills according to the present invention are made of the following weight percentages of raw materials relative to the total weight of three Chinese herbal medicines: salvia miltiorrhiza, notoginseng and borneol:
  • the preparation of the traditional Chinese medicine composition of the present invention can be carried out by a method of the prior art, for example, Chinese Patent Application No. 01136155.7, No. 01820875.4, No. 03144300.1, No. 200310107279.5, No. 200410018758.4, No. 200410019827.3 and No. 02100884.1, the entire contents of which are hereby incorporated by reference.
  • the pulverized Salvia miltiorrhiza Bge., Radix Notoginseng, boiled water, boiled, filtered, and the filtrate is combined, and the filtrate is appropriately concentrated; ethanol is added to the concentrate for alcohol precipitation, and the supernatant is allowed to recover ethanol, and concentrated.
  • the extract is mixed; the obtained extract is uniformly mixed with the borneol and the auxiliary material, and then the dropping pills are prepared.
  • the compound danshen dropping pills can be prepared according to the following steps:
  • the pulverized Danshen and Sanqi medicinal materials are weighed according to the above ratio, and extracted with hot water for 2-4 times, each time adding water is 4-8 times of the amount of the medicinal materials (
  • additional amount of water is a multiple of the amount of the medicinal material means that the volume of the added water (L) is equivalent to the weight of the medicinal material (kg), and the boiled liquid is obtained; the boiled liquid is filtered and combined.
  • the filtrate was concentrated, and the filtrate was concentrated; 95% (v/v) ethanol was added to the concentrated filtrate, and allowed to stand for 4-24 hours, precipitated, and the supernatant was filtered, and the filtrate was recovered to ethanol, and concentrated to an extract; the obtained extract and the above After the proportion of borneol and the auxiliary material are evenly mixed, the pellet preparation is prepared.
  • the temperature of the hot water reflux extraction is 60-100 ° C; the filtrate is concentrated until the ratio of the liquid volume (L) to the weight of the medicine (kg) is 1:0.7-1.3; when the ethanol is used for precipitation, the concentrated filtrate The final ethanol content is 50-80% (v/v); the relative density of the extract is 1.15-1.45.
  • the matrix adjuvant used in the compound Danshen dropping pill of the present invention may be polyethylene glycol-6000 having a freezing point of 53-58 ° C, and the ratio of the weights of the three raw materials to the auxiliary materials is 1:0.31-0.49; After the paste is evenly mixed with the borneol and the auxiliary material, the chemical is heated, transferred into a drip tank of the dropping machine, and the drug is dropped into the low-temperature liquid paraffin to remove the liquid paraffin, and the pill can be selected.
  • the temperature of the chemical is 60-100 ° C; the temperature of the liquid paraffin is 0-10 ° C (optimally 5-10 ° C).
  • the matrix adjuvant may also be a natural granule matrix adjuvant of plant origin, for example, may be selected from pharmaceutically acceptable One or more of the following: D-ribose, fructose, xylose, trehalose, raffinose, maltose, agarose, sucrose ester, D-ribose- ⁇ -lactone, erythritol, Sorbitol, xylitol, arabinol, isomalt, lactitol, malic acid, glyceryl stearate, shellac, phenylethylene glycol, polyoxyethylene alkyl ether, and a crystalline water-containing compound of the above compounds;
  • the matrix adjuvant may further comprise a plasticizing matrix adjuvant.
  • the plasticizing matrix adjuvant may be selected from one or more of the group consisting of pregelatinized starch, carboxymethyl starch, gum arabic, dextran, and laparo Gum, carrageenan, gum, red algae, tragacanth, carrageenan, tamarind, pectin, xanthan gum, alginic acid and its salts, agar, lactose, glyceryl monostearate, Polyoxyethylene monostearate, croscarmellose sodium, and silica.
  • the compound Danshen dropping pill may be a vegetarian pill or a coated pill.
  • the specific preparation method of the compound pellet of the compound danshen dropping pill can be, for example:
  • the specific preparation method of the coated pellet of the compound danshen dropping pill can be, for example:
  • the solution prepared by dissolving the water-soluble gastric coating material is fully stirred, and then transferred to the coating equipment at an average inlet air temperature of 85 ° C, the average film bed
  • the coating was carried out under the conditions of a temperature of 35-38 ° C, an atomization pressure of 2 bar, an average rotation speed of 15-23 rpm, and an average material flow rate of 3-4 g/min.
  • Pulmonary hypertension is a clinically difficult disease to treat, except for a few primary, most of which are secondary.
  • Hypoxia and wild lily alkaloids have been widely used in the establishment of pulmonary hypertension models at home and abroad. Pulmonary vascular activity changes and pulmonary vascular structural remodeling due to hypoxia are the basis for the occurrence, development and maintenance of hypoxic pulmonary hypertension.
  • the expression of the animal pathological model induced by monocrotaline (MCT) is similar to that of human primary pulmonary hypertension, which is accompanied by inflammation of the lung tissue and damage of pulmonary vascular endothelial cells.
  • the hypoxic model and the wild lily model can also have a certain effect on the systemic circulation.
  • the invention utilizes two pulmonary hypertension models to evaluate the anti-pulmonary hypertension effect of the compound danshen preparation.
  • the drug used in the experiment of the present invention is a compound Danshen dripping pill produced by Tianjin Tianshili Pharmaceutical Co., Ltd., which can be purchased from the market.
  • the hypoxic model uses a specially made low pressure oxygen chamber.
  • the course of pulmonary hypertension caused by hypobaric oxygen chamber includes pulmonary vasoconstriction, pulmonary artery smooth muscle cells (PASMCs) hypertrophy and hyperplasia, and pulmonary vascular structural reconstruction.
  • PASMCs pulmonary artery smooth muscle cells
  • pulmonary vascular structural reconstruction In addition to routine treatments to improve hypoxia and carbon dioxide retention, drug treatments include L-arginine, calcium antagonists, and angiotensin-converting enzyme inhibitors (ACEI), which have a therapeutic effect but at the same time reduce Systemic circulation pressure. Changes in pulmonary arterial pressure, right ventricular hypertrophy index, and lung histomorphology were measured.
  • the model of pulmonary hypertension caused by MCT injection into experimental animals has been adopted by many researchers at home and abroad, and is an important tool for studying anti-pulmonary hypertension drugs. Changes in pulmonary hypertension, right ventricular hypertrophy index, and lung histomorphology were measured.
  • the compound Danshen preparation can significantly reduce the mean pulmonary artery pressure of the two model animals, significantly improve the pulmonary vascular structural reconstruction and proliferation caused by pulmonary hypertension, and improve the relaxation of the pulmonary artery ring of the model animal, so it has a certain anti-pulmonary hypertension effect.
  • the compound Danshen preparation is convenient to take and carry, and has high safety and can be taken for a long time. Therefore, compound Danshen preparation can be used to prevent and treat pulmonary hypertension and related diseases.
  • Experimental Example 1 Effect of pre-administration of compound Danshen dripping pills on pulmonary artery spasm induced by monocrotaline in rats.
  • mice 50 SD rats were randomly divided into 5 groups, 10 in each group.
  • the model group and each drug-administered group were intraperitoneally injected with 2% MCT (formed with ethanol: normal saline volume ratio of 2:8) to replicate the rat pulmonary hypertension model at 60 mg/kg, and began to be administered on the second day after modeling.
  • Stomach administration Each group of animals was intragastrically administered once a day for one month. After the end of the administration, pulmonary artery pressure was measured in 6-8 rats per group. After the pulmonary artery pressure was measured, the heart, liver, and lungs were taken out and weighed. Weigh the right ventricle and scale it. The right lung was taken for pathological examination. Remaining The rats in the same way were all taken for blood collection, harvested and sacrificed. The results are as follows:
  • mean right common carotid artery pressure (mCAP) and right ventricular systolic blood pressure peak (RVPSP) were determined.
  • mCAP common carotid artery pressure
  • RVSP right ventricular systolic blood pressure peak
  • the heart, liver, and lungs were taken out and weighed.
  • the heart is weighed, after cutting the left and right atrium, the auricle, the end of the blood vessel and the surrounding tissue, the right ventricular wall tissue (RV) is cut along the exit of the pulmonary artery, and the rest is the left ventricle and interventricular septal tissue (LV+S), which are weighed separately.
  • Proportional conversion was performed to obtain a right ventricular hypertrophy index (RVHI) as an indicator of right ventricular hypertrophy to reflect the extent of pulmonary hypertension.
  • RVHI right ventricular hypertrophy index
  • the right lung was taken for pathological examination, and the ratio of the wall thickness of the pulmonary arterioles to the outer diameter of the tube (WT%), the ratio of the area of the pulmonary arteriolar wall to the total area of the blood vessels (WA%) was calculated.
  • WT% wall thickness of the pulmonary arterioles to the outer diameter of the tube
  • WA% total area of the blood vessels
  • the RVPSP of the rats treated by intermittent hypobaric hypoxia was significantly higher than that of the control group (p ⁇ 0.05), indicating that the model was successful.
  • the RVPSP of the rats in the compound Danshen dripping pill group was significantly lower than that in the model group (p ⁇ 0.05), indicating that it had a significant alleviation effect on RVPSP elevation induced by hypoxia.
  • the right ventricular hypertrophy index of each group treated by intermittent hypobaric hypoxia was significantly higher than that of the right ventricular hypertrophy index of the control group (p ⁇ 0.05), suggesting that hypoxia caused significant thickening of the right ventricle in rats.
  • the right ventricular hypertrophy index of the compound Danshen dripping pill group was significantly lower than that of the model group (p ⁇ 0.05), but it could not completely reverse the right ventricular hypertrophy caused by hypoxia.
  • Table 3 Effects of compound Danshen dripping pills on hemodynamics and right ventricular hypertrophy in chronic hypoxic rats (mean ⁇ standard deviation)
  • the coarsely pulverized Danshen and Sanqi medicinal materials are taken into the extraction tank, and 5 times of the above-mentioned medicinal materials are added (that is, the volume (L) of the added water is 5 times the weight (kg) of the medicinal material), and decocted for 2 hours, filtered. 4 times the amount of water was added to the residue (that is, the volume (L) of the added water was 4 times the weight of the filter residue (kg)), and the second extraction was carried out, decocted for 1 hour, filtered, discarded, and the filtrate was combined.
  • the filtrate was concentrated under reduced pressure until the ratio of the volume of the liquid (L) to the weight of the medicinal material (kg) was 1:0.9-1.1, and 95% (v/v) of ethanol was slowly added to make the concentration of the alcohol in the liquid solution at 69-71% ( v/v), let stand for 12 hours.
  • the supernatant of the liquid after the alcohol precipitation was filtered, and the filtrate was recovered to ethanol, and concentrated to an extract having a relative density of 1.32-1.40.

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Description

复方丹参制剂在制备抗肺动脉髙压药剂中的应用
技术领域
本发明属于医药领域, 具体涉及复方丹参制剂在制备抗肺动脉高压药剂中的应用。
背景技术
肺动脉高压 (pulmonary arterial hypertension, PAH)是以肺小动脉的血管痉挛、 内膜增生和结构重 建为主要特征的一种疾病。血管收缩、血管结构重建及原位血栓形成这三种因素的综合作用使肺血管阻 力进行性升高, 最终引起右心功能衰竭和死亡, 是一种进展性疾病, 预后较差, 目前缺乏有效的治疗方 案。
肺动脉高压的治疗主要采用传统疗法: 包括口服钙通道阻滞剂、 抗凝剂、 利尿剂和吸氧, 平均生存 期<3 年。 近年来, 肺动脉高压的机制研究有了飞速发展, 也出现了很多不同作用机制的新药, 其中, 内皮素受体拮抗剂已成为治疗重度肺动脉高压的一线治疗药物。近年来开发的新药以肺动脉高压的三个 不同病理途径为靶点, 这三个不同的病理途径及其代表药物是: 前列环素途径(代表药物: 依前列醇)、 内皮素途径(代表药物: 波生坦)、 一氧化氮途径(代表药物: 西地那非)。 多年来, 依前列醇一直是绝 大多数 PAH患者的唯一选择, 但是依前列醇的半衰期短, 需要连续静脉给药, 增加了因输液带来的感 染风险, 如果突然停药, 患者的血流动力学状况再次异常。
中医认为肺动脉高压与中医的"喘证"、 "痰饮"、 "水气 "等临床特点相似, 近年来主要运用化痰、 祛 瘀、利水等法治疗。 主要包括: 活血祛瘀药(川芎、丹参、三七、 赤芍等)、化痰药(前胡)、补血药(当 归)、祛风湿药(粉防已)等。 目前,有较深入研究报道的有效单味药或其提取物仅 10余种,如川芎(川 芎嗪)、 丹参、 前胡等。
丹参味苦, 性微寒, 具有活血化瘀、 养血安神、 凉血排痈和排毒生肌的功效, 是中药活血化瘀的常 用药物。 丹参药材主含脂溶性的二萜类成分和水溶性的酚酸类成分, 尚含有黄酮类、三萜类、 醇等其 他成分。 二萜类成分中, 属醌、 酮型结构的有丹参酮 I、 丹参酮 ΠΑ、 丹参酮 IIR、 丹参酮 V、 丹参酮 VI、 隐丹参酮、 异丹参酮 I、 异丹参酮 II、 异丹参酮 IIB、 二氢丹参酮 I等。 水溶性的酚酸类成分有丹参 素、 原儿茶醛、 原儿茶酸、 咖啡酸、 丹参素与咖啡酸的衍生物或者是二聚物酯化而成的缩酚酸(如丹酚 酸八、丹酚酸 B、丹酚酸 C、丹酚酸 D、丹酚酸 E、丹酚酸 G、 紫草酸 B、迷迭香酸、 迷迭香酸甲酯等)。 丹参酮 ΠΑ是丹参二萜类活血化瘀的代表成分之一。 现代药理研究证明, 丹参具有扩张冠状动脉、 抗心 肌缺血、 抗凝、 抗血栓形成、 镇静止痛以及降血脂和抗动脉粥样硬化等作用。
三七属于止血类中药。 中医学认为其具有散淤止血、 消肿定痛的功能, 既止血又活血。 现代药理研 究证明, 三七既有止血作用又有抗凝血作用。止血作用包括缩短出血和凝血时间、增加血小板数量并使 其出现伸展伪足、 聚集、 脱颗粒等现象, 还能降低毛细血管通透性。 显示抗凝血作用的是三七中的部分 成分: 三七总皂甙、三七人参二醇型皂甙和三醇型皂甙, 它们均能抑制人和兔血小板的聚集。三七总皂 甙可促进血管内皮细胞分泌组织型纤溶酶原 (t-N), 阻止血栓的形成。
冰片为龙脑香科植物龙脑香树脂的加工结晶品。菊科艾纳香属植物大风艾的叶经水蒸汽蒸熘提取加 工而得的结晶称为艾片。由樟脑、松节油等用化学方法合成的加工制成品称为机制冰片。冰片辛散苦泄, 芳香走串, 能通诸窍, 散郁火, 有类似麝香的开窍醒神之功效。 龙脑冰片主要含右旋龙脑; 艾片主要含 左旋龙脑。 现代药理研究证明, 冰片具有抗心肌缺血的作用, 能使冠脉流量明显增加; 此外, 冰片还能 增加血脑屏障的通透性, 加强药物的跨屏障能力。
复方丹参制剂由丹参、三七、 冰片三味中药作为原料药材制备而成, 在冠心病患者中广泛应用。经 过多年的临床观察和实验研究, 复方丹参制剂的应用范围得到了很大的拓展。 目前已经证实, 复方丹参 制剂具有增加冠脉流量、舒张血管平滑肌、促进侧枝循环、明显改善心肌缺血和梗塞、提高缺氧耐受力、 抗脂质过氧化、 清除自由基、 保护血管内皮细胞、 抗心律失常、 抗血小板聚集、 抗血栓、 降低血液粘稠 度、 调节血脂、 增强免疫等多方面的作用。
近年来的临床证明,复方丹参制剂在治疗多种心血管和脑血管疾病中发挥着重大作用,而且已经扩 展到了肝、肾功能障碍等领域的治疗上。但是,有关复方丹参制剂治疗肺动脉高压疾病的作用未见报道。 发明内容
本发明的目的之一是提供复方丹参制剂在制备抗肺动脉高压药剂中的应用。
所述抗肺动脉高压是低氧或者药物引起的肺动脉高压疾病, 所述药物例如为野百合碱。
本发明的另一目的是提供复方丹参制剂在制备治疗肺动脉高压相关疾病例如肺心病、肺气肿、充血 性心衰等的药剂中的应用。
其中, 所述应用是降低肺动脉压力, 降低右心室压。
其中,所述应用是改善肺动脉血管增生,所述改善肺动脉血管增生为减轻肺小动脉管壁和平滑肌层 的增厚、 改善肺小动脉管腔的狭窄, 降低肺小动脉管壁厚度与管外径之比, 以及降低肺小动脉管壁面积 与血管总面积之比。
其中, 所述应用是改善右心室肥厚指数。
其中, 所述应用是改善肺动脉血管环的舒张。
其中, 所述应用是改善由肺动脉高压引起的肺组织病理变化。
本发明所述复方丹参制剂是由丹参、三七、冰片三味中药作为原料药材制备而成的药物制剂, 目前 已经上市的复方丹参制剂包括复方丹参片、 复方丹参胶囊、 复方丹参滴丸等。
相对于丹参、三七和冰片这三种中药材的总重量,本发明所述复方丹参制剂一般由以下重量百分比 的原料药材制备而成: 丹参 48.0%-97.0%、 三七 1.0%-50.0%、 冰片 0.1%-3.0%, 优选丹参 63.0%-94.0%、 三七 4.0%-35.0%、 冰片 0.5%-2.0%, 更优选丹参 82.87%、 三七 16.21%、 冰片 0.92%。 所述制备是先将原料药材经过加工, 制备成药物活性成分, 再进一步制备成药物制剂。
本发明所述复方丹参制剂的制备方法属于现有技术,可以从现有专利公开文件中获得,或根据公开 的药品标准制备。
本发明所述复方丹参制剂优选复方丹参滴丸。
相对于丹参、三七和冰片这三种中药材的总重量,本发明所述的复方丹参制剂是由以下重量百分比 的原料药材制备而成: 丹参 48.0%-97.0%、 三七 1.0%-50.0%、 冰片 0.1%-3.0%, 优选丹参 63.0%-94.0%、 三七 4.0%-35.0%、 冰片 0.5%-2.0%, 更优选丹参 82.87%、 三七 16.21%、 冰片 0.92%制备成药物活性成分, 根据需要, 在该药物活性成分中可以添加药学上可接受的载体, 所述药学 上可接受的载体在整个制剂中所占的重量百分比可以是 0.1-99.9%。 本发明的药物组合物以单位剂量形 式存在, 所述单位剂量形式是指制剂的单位, 如片剂的每片、 胶囊剂的每粒、 口服液的每瓶、 颗粒剂的 每袋、 注射剂的每支等。
本发明的复方丹参制剂可以是任何可药用的剂型, 这些剂型包括: 片剂, 例如糖衣片剂、 薄膜衣片 剂、 肠溶衣片剂; 胶囊剂, 例如硬胶囊剂、 软胶囊剂; 口服液; 口含剂; 颗粒剂; 冲剂; 丸剂; 散剂; 膏剂, 例如软膏剂、 硬膏剂; 丹剂; 混悬剂; 粉剂; 溶液剂, 例如注射剂; 栓剂、 霜剂; 喷雾剂; 滴剂; 滴丸剂以及贴剂。
适用的填充剂包括纤维素、 甘露糖醇、 乳糖和其它类似的填充剂。 适宜的崩解剂包括淀粉、 聚乙烯 吡咯烷酮和淀粉衍生物, 例如羟基乙酸淀粉钠。适宜的润滑剂包括例如硬脂酸镁。适宜的药物可接受的 湿润剂包括十二烷基硫酸钠。
可通过混合、填充、压片等常用的方法制备固体口服组合物。进行反复混合可使药物活性成分分布 在整个使用大量填充剂的组合物中。
口服液体制剂的形式例如可以是水性或油性悬浮液、溶液剂、 乳剂、 糖浆剂或酏剂, 或者可以是一 种在使用前可用水或其它适宜的载体复配的干燥产品。这种液体制剂可含有常规的添加剂,诸如悬浮剂, 例如山梨醇、糖浆、 甲基纤维素、 明胶、羟乙基纤维素、羧甲基纤维素、硬脂酸铝凝胶或氢化食用脂肪; 乳化剂, 例如卵磷脂、 脱水山梨醇一油酸酯或阿拉伯胶; 非水性载体 (它们可以包括食用油), 例如杏 仁油、 分熘椰子油、 诸如甘油的酯的油性酯、 丙二醇或乙醇; 防腐剂, 例如对羟基苯甲酯或对羟基苯甲 酸丙酯或山梨酸, 并且如果需要, 可含有常规的香味剂或着色剂。
对于注射剂,制备的液体单位剂型含有本发明的药物活性成分和无菌载体。根据载体的种类和药物 活性成分的浓度,可以将药物活性成分悬浮或者溶解。溶液的制备通常是通过将药物活性成分溶解在载 体中, 在将其装入适宜的小瓶或安瓿前过滤消毒,然后密封。辅料(例如局部麻醉剂、 防腐剂和缓冲剂) 也可以溶解在所述载体中。为了提高其稳定性, 可在装入小瓶以后将这种组合物冰冻, 并在真空下将水 除去。
本发明的复方丹参制剂在制备成药剂时,可选择性地加入适合的药学上可接受的载体,所述药学上 可接受的载体包括但不限于以下物质, 选自: 糖醇, 例如甘露醇、 山梨醇、 木糖醇; 氨基酸, 例如盐酸 半胱氨酸、 蛋氨酸、 甘氨酸; 维生素 C; EDTA二钠、 EDTA钙钠; 无机盐, 例如一价碱金属的碳酸盐、 醋酸盐、 磷酸盐或其水溶液; 氯化钠、 氯化钾; 焦亚硫酸钠、 亚硫酸氢钠、 硫代硫酸钠; 碳酸钙、 碳酸 氢钙; 硬脂酸盐, 例如硬脂酸钙、 硬脂酸镁; 无机酸, 例如盐酸、 醋酸、 硫酸、 磷酸; 有机酸或有机酸 盐, 例如巯基乙酸、 乳酸钠; 寡糖、 多糖、 纤维素及其衍生物, 例如麦芽糖、 葡萄糖、 果糖、 右旋糖苷、 蔗糖、 乳糖、 环糊精 (例如 β-环糊精)、 淀粉; 硅衍生物; 藻酸盐; 明胶; 聚乙烯吡咯烷酮; 甘油; 吐 温 80; 琼脂; 表面活性剂; 聚乙二醇; 磷脂类材料; 高岭土; 滑石粉等。
本发明的复方丹参制剂在使用时根据病人的情况确定用法用量。
本发明所涉及的复方丹参滴丸由丹参、 三七和冰片制备而成, 优选地, 相对于丹参、 三七和冰片这 三种中药材的总重量, 本发明所涉及的复方丹参滴丸由下述重量百分含量的原料药材制成:
丹参 48.0%-97.0%
三七 1.0%-50.0%
水片 0.1%-3.0%。
更优选地, 相对于丹参、三七和冰片这三种中药材的总重量, 本发明所涉及的复方丹参滴丸由以下 重量百分含量的原料药材制成:
丹参 63.0%-94.0%
三七 4.0%-35.0%
冰片 0.5%-2.0%。
最优选地, 相对于丹参、三七和冰片这三种中药材的总重量, 本发明所涉及的复方丹参滴丸由以下 重量百分含量的原料药材制成:
丹参 82.87%
三七 16.21%
冰片 0.92%。
本发明的中药组合物的制备可以采用现有技术的方法制备, 例如, 中国专利申请 01136155.7、 01820875.4、 03144300.1、 200310107279.5、 200410018758.4、 200410019827.3和 02100884.1, 以上专利 申请文本在此并入本文作为参考。
举例来说, 可以取经粉碎的丹参、 三七药材, 沸水煮提, 滤过, 合并滤液, 并将滤液适当浓缩; 在 浓缩液中加入乙醇进行醇沉, 静置, 上清液回收乙醇, 浓缩成浸膏; 将所得浸膏与冰片及辅料混和均匀 后, 制成滴丸。
具体地说, 复方丹参滴丸可以按照如下步骤制备: 按上述比例称取经粉碎的丹参、 三七药材, 用热 水回流提取 2-4次, 每次加水量为药材量的 4-8倍 (本申请文件中, 所述的 "加水量为药材量的倍数" 是指加入水的体积 (L) 相当于药材重量 (kg) 的倍数) , 得到煮提液; 将煮提液滤过, 合并滤液, 并 浓缩滤液; 在浓缩滤液中加入 95% (v/v) 乙醇, 静置 4-24小时, 沉淀, 上清液滤过, 滤液回收乙醇, 浓缩为浸膏; 将所得浸膏和上述比例冰片与辅料混和均匀后, 制成滴丸制剂。
其中, 所述热水回流提取的温度为 60-100°C ; 滤液浓缩至药液体积 (L) 与药材重量 (kg ) 比为 1:0.7-1.3; 使用乙醇进行沉淀时, 所述浓缩滤液中最终的乙醇含量为 50-80% (v/v) ; 所述浸膏的相对 密度为 1.15-1.45。
本发明的复方丹参滴丸所用的基质辅料可以是聚乙二醇 -6000, 其凝点 53-58°C,三种原料药材与辅 料的重量之比是 1 :0.31-0.49;将上述所得浸膏与冰片及辅料混和均匀后,加热化料,移入滴丸机的滴罐, 药液滴至低温液体石蜡中, 除去液体石蜡, 选丸即可。 所述化料温度为 60-100°C ; 液体石蜡的温度为 0-10°C (最佳为 5-10°C )。 所述基质辅料也可以是植物来源的天然滴丸基质辅料, 例如可以选自可药用 的下列物质中的一种或多种: D-核糖、 果糖、 木糖、 海藻糖、 棉子糖、 麦芽糖、 琼脂糖、 蔗糖酯、 D- 核糖酸 -γ-内酯、 赤藓糖醇、 山梨醇、 木糖醇、 阿拉伯醇、 异麦芽醇、 乳糖醇、 苹果酸、 硬脂酸甘油酯、 虫胶、苯基乙二醇、聚氧乙烯烷基醚以及上述化合物的含结晶水化合物; 所述基质辅料还可以包括增塑 性基质辅料,例如,所述增塑性基质辅料可以选自下列物质中的一种或多种:预胶化淀粉、羧甲基淀粉、 阿拉伯胶、 右旋糖酐、 田箐胶、 卡拉胶、 印度胶、 红藻胶、 西黄蓍胶、 角叉菜胶、 罗望子胶、 果胶、 黄 原胶、 海藻酸及其盐、 琼脂、 乳糖、 单硬脂酸甘油酯、 聚氧乙烯单硬脂酸酯、 交联羧甲基纤维素钠以及 二氧化硅。
所述复方丹参滴丸可以是素丸, 也可以是包衣丸。
其中, 所述复方丹参滴丸的素丸的具体制法例如可以为:
【成分】丹参、 三七、 冰片
【制法】取丹参三七浸膏, 加入浸膏重量的 2.5-3.5倍重量的聚乙二醇 -6000, 于 85-90°C化料, 化 料均匀后, 按处方量加入研细过筛后的冰片, 搅拌混匀, 转移至滴丸机, 于 80-85°C滴制, 即得。
所述复方丹参滴丸的包衣丸的具体制法例如可以为:
【成分】丹参、 三七、 冰片
【制法】取丹参三七浸膏, 加入浸膏重量的 2.5-3.5倍重量的聚乙二醇 -6000, 于 85-90°C化料, 化 料均匀后, 按处方量加入研细过筛后的冰片, 搅拌混匀, 转移至滴丸机, 于 80-85°C滴制, 得到小滴丸 的素丸。 按照包衣增重 6wt%的比例, 将水溶解胃溶型包衣材料制成的溶液充分搅拌均匀后, 将素丸转 移到包衣设备内, 在平均进风温度 85°C、 平均片床温度 35-38°C、 雾化压力 2bar、 平均转速 15-23rpm、 平均物料流速 3-4g/min的条件下进行包衣, 即得。
肺动脉高压是临床上较难治疗的一种疾病, 除了少数为原发性外, 绝大多数为继发性。缺氧以及野 百合碱 (MCT) 在国内外已经被广泛用于肺动脉高压模型的建立。 缺氧所致肺血管活性改变和肺血管 结构重建是缺氧性肺动脉高压发生、 发展和维持的基础。 而野百合碱 (MCT) 诱导动物病理模型的表 现与人类原发性肺动脉高压症相似, 即伴随肺组织炎症以及肺血管内皮细胞损伤。缺氧模型以及野百合 碱模型也可以对体循环造成一定的影响。
本发明利用两种肺动脉高压模型, 评价复方丹参制剂的抗肺动脉高压作用。
本发明在实验中使用的药物为天津天士力制药股份有限公司生产的复方丹参滴丸,该产品可以从市 场上购买得到。
缺氧模型采用的是专门制作的低压氧仓。低压氧仓所致的肺动脉高压病程包括肺部血管收缩、肺动 脉平滑肌细胞(PASMCs )肥大和增生以及肺血管结构重建等。 除了常规的改善缺氧和二氧化碳潴留的 治疗外, 药物治疗包括 L-精氨酸、 钙离子拮抗剂和血管紧张素转换酶抑制剂 (ACEI) 等, 这些治疗具 有一定的疗效, 但同时会降低体循环压力。 检测肺动脉压、 右心室肥厚指数、 肺组织形态学等的变化。
MCT注入实验动物体内造成的肺动脉高压模型已被国内外许多学者采用, 是研究抗肺动脉高压药 物常用的重要工具。 检测肺动脉高压、 右心室肥厚指数、 肺组织形态学等的变化。
结果表明,复方丹参制剂可以显著降低两种模型动物的平均肺动脉压,显著改善肺动脉高压引起的 肺血管结构重建和增生, 并且改善模型动物肺动脉血管环的舒张, 因此具有一定的抗肺动脉高压作用。 而且, 复方丹参制剂服用和携带都方便, 并且安全性高, 可以长期服用。所以复方丹参制剂可用于预防 及治疗肺动脉高压及其相关疾病。
具体实施方式
为了更好地理解本发明, 下面列举两个实验例, 说明其在制药领域中的新用途。 以下实验旨在说明 本发明而非对本发明的限制。
实验例 1 : 复方丹参滴丸预给药对野百合碱引起的大鼠肺动脉髙压的影响。
SD大鼠 50只, 随机分为 5组, 每组 10只。 模型组和各给药组一次性腹腔注射 2 %MCT (用乙醇: 生理盐水体积比为 2:8进行配制)按照 60mg/kg复制大鼠肺动脉高压模型, 于造模后的第二天开始灌胃 给药。各组动物灌胃给药, 每天 1次, 连续给药一个月。给药结束后, 每组取 6-8只大鼠测定肺动脉压。 测定肺动脉压后, 取出心、 肝、 肺, 称重。 称取右心室重量, 进行比例换算。 取右肺进行病理检验。 剩 余大鼠均采用同样的方法进行采血、 取材并处死。 结果见下:
和对照组比较, 模型组大鼠的平均肺动脉压明显升高, 提示病理模型成功。复方丹参滴丸高剂量组 和低剂量组、 西地那非组均有效降低了 MCT引起的肺动脉高压。 体循环压力没有显著区别。 表 1 给药后各组平均肺动脉压的影响 (平均值±标准差)
Figure imgf000006_0001
注: 和模型组比较: *: p<0.05 ; ** : p<0.01 ; p<0.001 o 病理切片的结果表明: 和对照组相比, 模型组动物肺动脉血管壁以及肺泡壁明显增厚, 肺组织结构 不清, 血管周围有大量炎性细胞浸润, 炎性细胞主要包括中性粒细胞、 单核巨噬细胞和淋巴细胞。 复方 丹参滴丸两个剂量组均剂量依赖性地降低肺动脉平滑肌细胞(PASMCs )增生,血管周围炎性细胞减少, 肺组织结构清楚。 见表 2。 表 2 给药后各组肺血管壁的变化
Figure imgf000006_0002
注: 和模型组比较: *: ρ<0.05。 实验结果表明, 复方丹参滴丸对野百合碱引起的大鼠肺动脉高压具有一定的治疗作用。 实验例 2: 复方丹参滴丸预给药对低压氧仓引起的大鼠肺动脉髙压的影响。
SD大鼠 40只, 随机分为 5组, 每组 8只。这 5组分别是对照组、模型组、复方丹参滴丸低剂量组、 复方丹参滴丸高剂量组、 西地那非组, 后四组采取间断性低压低氧法, 将大鼠放在低压低氧舱内, 关闭 舱门, 开启泵门, 当舱内的压力下降到 380mmHg左右, 氧浓度保持在 10.0士0.5% (v/v) 左右, 相当于 海拔高度 5000-5500m处空气中的氧气浓度。 调节进气阀, 使进出气体速度一致, 舱内压力保持稳定。 每天一次, 每次 6小时, 连续缺氧三周。 每天向动物灌胃给药一次, 持续三周。
给药结束后, 测定平均右颈总动脉压 (mCAP ) 和右心室收缩压峰值 (RVPSP)。 测定血压后, 取 出心、 肝、 肺, 称重。 心脏称重后, 剪去左右心房、 心耳、 血管末端以及周围组织后, 沿肺动脉出口剪 开右心室室壁组织 (RV), 其余为左心室和室间隔组织 (LV+S ), 分别称重, 进行比例换算, 得到右心 室肥厚指数(RVHI )作为衡量右心室肥厚的指标, 以此反映肺动脉高压的程度。 取右肺进行病理检验, 计算肺小动脉管壁厚度与管外径之比(WT%)、 肺小动脉管壁面积与血管总面积之比(WA%)。 结果见 下:
经过间断性低压低氧法处理的各组大鼠的 RVPSP显著高于对照组的 RVPSP (p<0.05 ),说明模型成 功。 复方丹参滴丸组的大鼠的 RVPSP与模型组大鼠的 RVPSP比较有显著的降低 (p<0.05), 说明它对 低氧所致的 RVPSP升高具有明显的减轻作用。 经过间断性低压低氧法处理的各组的右心室肥厚指数显 著高于对照组的右心室肥厚指数 (p<0.05 ), 提示低氧导致大鼠右心室明显增厚。 而复方丹参滴丸组的 右心室肥厚指数明显低于模型组的右心室肥厚指数(p<0.05 ), 但不能完全逆转低氧引起的右心室肥厚。 表 3 复方丹参滴丸对慢性低氧大鼠血流动力学和右心室肥厚的影响 (平均值±标准差)
Figure imgf000007_0001
注: 和模型组比较: p 病理切片的情况表明: 和对照组相比, 模型组的大鼠可见肺泡腔水肿, 点状及片状渗出、 出血, 肺 小动脉管壁和平滑肌层明显增厚, 管腔狭窄; WA%和 WT%显著高于对照组的 WA%和 WT%。 复方丹 参滴丸组的肺形态学变化和模型组比较起来明显减轻, WA%和 WT%显著低于模型组的 WA%和 WT% (p<0.05 见表 4: 表 4 复方丹参滴丸对慢性低氧大鼠肺小动脉形态的影响 (平均值±标准差)
Figure imgf000007_0002
注: 和模型组比较: p 实验结果表明, 复方丹参滴丸对低压氧仓引起的大鼠肺动脉高压具有一定的治疗作用- 实施例 1 滴丸
配方用量
丹参 45.0g 冰片 O. lg
辅料聚乙二醇 -6000
制成 1000粒滴丸 丹参、 三七的提取 取经粗粉碎的丹参、 三七药材至提取罐中, 加入上述药材 5倍量的水 (即, 加入水的体积 (L) 为 药材重量 (kg) 的 5倍), 煎煮 2小时, 滤过, 滤渣中加入 4倍量水 (即, 加入水的体积 (L) 为滤渣 重量(kg) 的 4倍)进行第二次提取, 煎煮 1小时, 滤过, 弃去滤澄, 合并滤液。 滤液减压浓缩至药液 体积 (L) 与药材重量 (kg) 比为 1 :0.9-1.1, 缓缓加入 95% (v/v) 的乙醇, 使药液含醇浓度在 69-71% (v/v), 静置 12小时。 取醇沉后药液的上清液, 滤过, 滤液回收乙醇, 浓缩为相对密度为 1.32-1.40的 浸膏。 产品的制备
取丹参三七浸膏, 加入浸膏重量的 2.5-3.5倍重量的聚乙二醇 -6000, 于 85-90°C化料, 化料均匀后, 按处方量加入研细过筛后的冰片, 搅拌混匀, 转移至滴丸机, 于 80-85°C滴制, 得到滴丸产品。

Claims

权利要求书
1. 复方丹参制剂在制备抗肺动脉高压及其相关疾病的药剂中的应用。
2. 如权利要求 1的应用, 其特征在于, 所述抗肺动脉高压是低氧或者药物引起的肺动脉高压疾病。
3. 如权利要求 2所述的应用, 其特征在于, 所述药物为野百合碱。
4. 如权利要求 1的应用, 其特征在于, 所述的相关疾病是与肺动脉高压疾病相关的肺心病、 肺气 肿或充血性心衰。
5. 如权利要求 1的应用, 其特征在于, 所述应用是降低肺动脉压力, 降低右心室压。
6. 如权利要求 1的应用, 其特征在于, 所述应用是改善肺动脉血管增生, 所述改善肺动脉血管增 生为减轻肺小动脉管壁和平滑肌层的增厚、改善肺小动脉管腔的狭窄, 降低肺小动脉管壁厚度与管外径 之比, 以及降低肺小动脉管壁面积与血管总面积之比。
7. 如权利要求 1的应用, 其特征在于, 所述应用是改善右心室肥厚指数。
8. 如权利要求 1的应用, 其特征在于, 所述应用是改善肺动脉血管环的舒张。
9. 如权利要求 1的应用, 其特征在于, 所述应用是改善由肺动脉高压引起的肺组织病理变化。
10. 如权利要求 1的应用, 其特征在于, 相对于丹参、 三七和冰片这三种中药材的总重量, 所述复 方丹参制剂是用丹参 48.0%-97.0%、 三七 1.0%-50.0%、 冰片 0.1%-3.0%制备成的药物组合物。
11. 如权利要求 1的应用, 其特征在于, 相对于丹参、 三七和冰片这三种中药材的总重量, 所述复 方丹参制剂是用丹参 63.0%-94.0%、 三七 4.0%-35.0%、 冰片 0.5%-2.0%制备成的药物组合物。
12. 如权利要求 1的应用, 其特征在于, 相对于丹参、 三七和冰片这三种中药材的总重量, 所述复 方丹参制剂是用丹参 82.87%、 三七 16.21%、 冰片 0.92%制备成的药物组合物。
13. 如权利要求 1的应用, 其特征在于, 所述复方丹参制剂是复方丹参滴丸。
PCT/CN2011/082145 2010-11-23 2011-11-14 复方丹参制剂在制备抗肺动脉高压药剂中的应用 WO2012068962A1 (zh)

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