麻黄属植物化学成分及临床应用的研究进展

目的：阐述麻黄属植物化学成分及临床应用的研究现状,为麻黄的临床应用提供新的思路。方法：查阅麻黄属植物相关研究文献,总结其化学成分及临床应用概况。结果：麻黄中主要的化合物有麻黄碱类、挥发油类、黄酮类、多糖类和少量的有机酸。目前在麻黄属植物麻黄中麻黄碱的应用十分广泛,除以中药配方应用于临床,已有60余种化学药品以盐酸麻黄碱和盐酸伪麻黄碱作为有效成分,主治咳嗽。对其挥发油类、黄酮类的临床应用研究不多。麻黄联合化学药品共同使用,弥补了传统中药配方煎熬过程中有效成分的丢失,可以使治疗效果更明显。麻黄多糖抗炎、镇痛、对免疫的影响作用机制尚不确定,有待进一步研究。结论：麻黄作为传统中药,具有较大的药用价值,将为其临床应用提供新的思路。     

中药不良反应的临床特征分析

长期以来,临床上对中药的不良反应（adverse drug reactions,ADR）有所忽视。然而,随着中药制剂在临床的应用日益广泛和药物不良反应监测工作的深入开展,中药不良反应日益受到重视。上世纪末,比利时发现的马兜铃酸肾病导致1／3患者行肾移植治疗;2004年,美国FDA宣布禁止麻黄用于减肥营养品;2006年,我国FDA发出紧急通告,     

浅谈中药指纹图谱对质量控制的意义、作用和实践

1中药的非线性特征需要宏观的、非线性的、多因素的质量控制模式 近年来，国内外对包括中药在内的草药制剂的质量日益给予重视，尤其是在欧美连续发生麻黄、广防己、关木通的毒性反应事件后，中药的质量在国外备受挑战。国内狂轰滥炸式的虚假广告虽然尚未受到有效的遏制，但是消费者对中药（包括保健药品）质量的诉求越来越高。     

麻黄软胶囊的溶出稳定性及影响因素考察

目的：考察中药麻黄软胶囊的溶出稳定性及影响因素,探讨中药软胶囊溶出迟缓机制。方法：采用加速试验,评价麻黄软胶囊的溶出稳定性;以平衡溶胀量和ε-氨基酸残基含量为指标,评价明胶囊壳的交联程度;应用红外光谱和醛类专属反应,鉴定麻黄提取物中醛类成分,并测定其含量。结果：在加速试验条件下（40℃,75％相对湿度）,放置30天后,明胶囊壳的平衡溶胀量和ε-氨基酸残基含量均显著下降（P〈0．01）,其交联度显著增加（P〈0．01）;放置60天后,麻黄软胶囊溶出度显著下降（P〈0．01）。环境因素（高温／高湿）、溶媒介质（聚乙二醇）和药物成分（麻黄提取物）均可导致明胶交联度显著提高（P〈0．01）,其中麻黄提取物的作用明显大于另两种影响因素。麻黄提取物中醛质量分数达约1．6％。结论：麻黄软胶囊溶出迟缓与囊壳明胶发生交联反应有关,而麻黄提取物中醛类成分是促进软胶囊发生交联反应、导致其溶出迟缓的主要原因。     

重视中药的不良反应

阐述了导致中药不良反应产生的因素及中药不良反应的常规处理，为中药不良反应的防治及中药在临床的安全应用提供参考。     

从何首乌致肝损伤看中药不良反应发生特点及预防措施

目的密切关注中药不良反应,探索预防中药不良反应发生的措施。方法从何首乌导致肝损伤在国外发布不良反应信息入手,分析了中药发生不良反应的因素及预防措施。结果与结论中药不良反应的发生与其不合理应用密切相关,并提出一些新的观点和设想,以期服务于中药的合理应用,减少中药不良反应的发生。     

麻黄治疗小儿遗尿症的临床疗效分析

目的探讨麻黄应用在小儿遗尿症的治疗效果及临床应用价值。方法选择我院治疗的小儿遗尿症患儿100例作为研究对象,将患儿随机分为观察组和对照组,每组各50例,对照组给予甲氯芬酯进行治疗,观察组给予患者以麻黄为主的自拟方剂进行治疗,观察两组患儿临床治疗效果。结果观察组总有效率优于对照组,经统计学分析比较,差异有统计学意义(P<0.05)。观察组患儿治疗后膀胱容量改善程度优于对照组,经统计学分析比较,差异有统计学意义(P<0.05)。结论采用以麻黄为主中药方剂治疗小儿遗尿症临床疗效显著,明显改善患儿膀胱容量,值得在临床上大力推广使用。     

HPLC法测定平喘合剂中麻黄碱、伪麻黄碱的含量

医院复方制剂平喘合剂由炙麻黄、白果、款冬花、法半夏等多种中药组成，具有平喘、化痰、止咳的功效。主要用于慢性支气管炎、支气管哮喘等患者。方中麻黄为常用传统中药．具有发汗平喘的功效。临床上已沿用千年。近代大量的实验研究证明，方中麻黄所含的麻黄碱（Ephedrine）、伪麻黄碱（Pseudo—ephedrine），可解除支气管痉挛，松弛支气管平滑肌，且作用较缓而持久。为建立平喘合剂的质量控制方法．采用HPLC法测定该药中麻黄碱、伪麻黄碱的含量。     

中药注射液不良反应成因分析

<正>由于中药注射液有着起效较快~([1])、治疗疗程较短的优点而在临床上被广泛应用,但也有相关研究资料显示中药注射液是导致患者发生不良反应的重要药剂之一,为了确保中药注射液的安全应用,避免以及减少不良反应的发生率~([2]),此次选取67例在我院应用中药注射液产生不良反应的患者的临床资料进行回顾性分析,分析导致中药注射液不良反应发生     

麻黄的活性成分与临床应用进展

麻黄始载于《神农本草经》,化学成分复杂,具有发汗平喘、利尿、降血脂、抗氧化等多种药理活性,临床应用广泛。本文对麻黄的活性成分、药理作用、临床应用及应用禁忌等方面进行了综述,以期为麻黄及其相关制剂的进一步深入研究和临床用药安全提供参考。     

Effects of harvesting time and processing on the contents of five alkaloids in the herbaceous stems of Ephedra sinica

In the present study, we studied the changes of the contents of alkaloids in the herbaceous stems of Ephedra sinicaduring different harvest periods as well as before and after processing. The alkaloid contents of 39 batches of ephedra herb, prepared slices ephedra and honey-fried ephedra, 24 batches of ephedra herb with different harvesting periods, which were all collected from cultivation base in Inner Mongolia, and 38 batches of prepared slices ephedra purchased from the market were detected by taking norephedrine (NE), norpseudoephedrine (NPE), ephedrine (E), pseudoephedrine (PE) and methylephedrine (ME) as indicators by using HPLC method. The content of total alkaloid in prepared slices ephedra (1.71%–3.14%) was higher than that in ephedra herb (1.20%–2.53%) and honey-fried ephedra (1.52%–2.99%). Contents of different alkaloids in these three types of samples were significantly different. Prepared slices ephedra and honey-fried ephedra showed significant differences in the contents of NE, NPE and ME (P<0.05), and the contents of E were significantly different between ephedra herb and honey-fried ephedra (P<0.05). The total alkaloid content of ephedra herb was the highest in September (3.10%). Alkaloid contents of prepared slices ephedra collected in the market were uneven and 13%–91% lower than those collected from cultivation base. The results provided a basis for the quality evaluation of ephedra herb and its processed products, and had certain guiding significance for the selection of processed ephedra according to different drug purposes in clinical application. It also provided data support for the harvesting time of ephedra herb.     

A network pharmacology-based strategy for predicting anti-inflammatory targets of ephedra in treating asthma

Asthma, the most common chronic respiratory disease in the world, is involved in a sustained inflammatory response caused by a variety of immune cells. Ephedra with multi-target, multi-pathway functions is an effective treatment for asthma. However, the ingredients and anti-inflammatory targets of ephedra in treating asthma are unclear. Therefore, there is a need for further research. Ephedra-related and anti-inflammatory targets were found and then combined to get intersection, which represented potential anti-inflammatory targets of ephedra. Moreover, compound-anti-inflammatory target and asthma-target protein-protein interaction network were merged to get the protein-protein interaction network intersection and core genes in asthma-target protein-protein interaction network. For the anti-inflammatory targets of ephedra in treating asthma, Gene Ontology and pathway analysis were executed to confirm gene functions of ephedra in antagonizing inflammation of asthma. Finally, molecular docking, qRT-PCR, WB and ELISA were performed to assess the binding activities between the compounds and anti-inflammatory targets of ephedra in treating asthma. Critical compounds and anti-inflammatory targets of ephedra in treating asthma were identified, including quercetin, luteolin, kempferol, naringenin, beta-sitosterol, SELE, IL-2 and CXCL10. The biological processes of anti-inflammatory targets of ephedra in treating asthma were involved in immune response, inflammatory response, cell-cell signaling and response to lipopolysaccharide. Moreover, 22 pathways were obtained and we proved that critical compounds inhabited the expression of SELE, IL-2 and CXCL10 at mRNA and protein levels.     

Investigation of quality in ephedrine-containing dietary supplements

Ephedra alkaloids in 47 dietary supplements were measured to examine variability within and between products as well as for comparison of actual constituents with label claims of manufactured products. Samples were analyzed for (-)-ephedrine, (+)-pseudoephedrine, (-)-methylephedrine, (+)-methylpseudoephedrine,(-)-norephedrine, and (+)-norpseudoephedrine without derivatization using gas chromatographic mass spectrometry (GC/MS). Samples were then screened for pharmaceutically derived chiral contaminants. The resulting data demonstrated that label claims matched total ephedra alkaloid content to within about 25% for most of the supplements, and no products purporting to be ephedrine-free contained any ephedra alkaloids. Furthermore, chiral analysis of these dietary supplements revealed only naturally occurring ephedra alkaloids. (-)-Ephedrine and (+)-pseudoephedrine accounted for > 95% of the alkaloid content in each of the ephedra-containing products. Examination of identical supplements originating from different lots revealed consistency in total alkaloid content between lots but large variations in specific individual alkaloid content.     

人工种植麻黄中左旋麻黄碱、右旋麻黄碱含量及相关性研究

目的　对不同产地、不同生长期人工种植麻黄生物形态和土壤特征指标进行了同期跟踪测定 ,依次探讨麻黄人工规范化种植的技术条件 ,为麻黄现代化种植 ,提高技术水平打下一定的基础。方法　采用高效液相色谱法 ,测定麻黄中左旋麻黄碱、右旋麻黄碱含量。结果　基地生长期一年半的中麻黄的总碱含量均已超过药典规定标准 ,达到收购标准 ,草麻黄亦接近收购标准。结论　植株含量测定结果表明 ,秋季移栽麻黄的麻黄碱含量较春季移栽麻黄高 ,而传统的麻黄移栽期为春季 ,本研究对指导生产具有一定的现实意义。     

Content versus label claims in ephedra-containing dietary supplements.

The content of ephedra alkaloids in herbal dietary supplements containing ephedra (ma huang) was studied. The ephedra alkaloid content of 20 ephedra-containing supplements was determined by high-performance liquid chromatography. Contents of (-)-ephedrine, (+)-pseudoephedrine, (-)-methylephedrine, (-)-norephedrine, and (+)-norpseudoephedrine were measured. Ephedra alkaloid content varied considerably among products. Total alkaloid content ranged from 0.0 to 18.5 mg per dosage unit. Ranges for (-)-ephedrine and (+)-pseudoephedrine were 1.1-15.3 mg and 0.2-9.5 mg, respectively. (+)-Norpseudoephedrine, a Schedule IV controlled substance, was often present. Significant lot-to-lot variations in alkaloid content were observed for four products. For one product, lot-to-lot variations in the content of (-)-ephedrine, (+)-pseudoephedrine, and (-)-methylephedrine exceeded 180%, 250%, and 1000%, respectively. Half of the products exhibited discrepancies between the label claim for ephedra alkaloid content and actual alkaloid content in excess of 20%. One product was devoid of ephedra alkaloids. Assay of 20 ephedra-containing dietary supplements showed that alkaloid content often differed markedly from label claims and was inconsistent between two lots of some products.     

Concentrations of ephedra alkaloids and caffeine in commercial dietary supplements

Dietary supplements that contain Ma Huang (ephedra alkaloids) and guarana (caffeine) are widely marketed and used in the U.S. for weight loss and athletic performance enhancement, despite a lack of adequate research on the pharmacology of these botanical stimulants. We developed and applied a novel liquid chromatography-tandem mass spectrometry (LC-MS-MS) method to quantitate the various ephedra alkaloids found in dietary supplements that contain Ephedra species. The quantities of ephedrine, pseudoephedrine, norephedrine, norpseudoephedrine, methylephedine, methylpseudoephedrine, and caffeine were determined for 35 commercial dietary supplements and compared with the amounts listed on the product labels. The total ephedra alkaloid content ranged from 5.97 mg to 29.3 mg per serving. Two supplement brands did not list the quantity of ephedra alkaloids on the label, and four did not list the amount of caffeine per serving. Of the products tested, 31% contained > 110% of the total ephedra alkaloids listed on the label, and 6% of the supplements contained < 90% of the listed amount. For caffeine, 86% of the product lots that listed the caffeine amount contained less than 90% of the labeled quantity. No products contained > 110% of the declared caffeine content. The total ephedra alkaloid content varied significantly from lot to lot in 5 of 9 products. Three product brands contained proportions of alkaloids that exceeded amounts reported for E. sinica, including one that was 98% ephedrine, one that had 10% norpseudoephedrine, and one that contained an average of 13% methylephedrine. We conclude that product inconsistency is common among some commercially available dietary supplements that contain ephedra alkaloids and caffeine.     

Determination of ephedra alkaloid and caffeine concentrations in dietary supplements and biological fluids

Dietary supplements containing botanical forms of caffeine and ephedra alkaloids have been widely promoted and used in the U.S. for weight loss and athletic enhancement despite a lack of adequate research on the pharmacology of these botanical stimulants. In order to analyze dietary supplements and perform human pharmacokinetic studies, an analytical approach with good precision and accuracy was needed with sufficient sensitivity to detect very low levels of ephedra alkaloids. A liquid chromatography-atmospheric pressure chemical ionization (APCI) tandem mass spectrometry (LC-MS-MS) method was developed for quantitating the various ephedrine-group alkaloids found in dietary supplements that contain Ephedra species, and in plasma and urine of persons consuming these supplements. Using this method, low nanogram-per-milliliter concentrations of ephedrine, pseudoephedrine, norephedrine, norpseudoephedrine, methylephedrine, methylpseudoephedrine, and caffeine can be quantitated in a 12-min LC-MS-MS run.