Stannous rattan

Stannous rattan

(selected herbs of Simao beetle in Yunnan)

[synonym] yahonglong (Dai name).

[source] it is the whole plant of Stephania tinctoria.

[plant morphology] stannous rattan

Climbing vines, about 1 m long, densely covered with yellowish white tomentose. Leaves alternate, heart-shaped, 1.5-2 cm long and 1.5-2.5 cm wide, apex rounded or concave, base heart-shaped, entire, dark green above, sparsely white pilose, light green below, densely yellow brown pilose. The flower is small, light yellow; the male flower is cyme, axillary, sepals 4 (5-6), petals 4, united into a cup, anthers 4, United, ring on the top of stamen column, transverse split; the female flower is raceme, gathered in the bract axil of leaf, sepals 1, petals United, stamen 1, style 3 split. Drupe ovate, red at maturity. Seeds flat, horseshoe shaped. The fruit period is from April to May.

It is found in tropical river, beach, wasteland, hillside, crevice or shrub. It is distributed in Yunnan.

[collection] all year round. Fresh or sun dried.

[chemical constituents] the whole plant contains stansinomenine. The root contains d-quercetin, haematine, haematine, tubulinine, granodipine, haematine, sinomenine, (+ +) - 4 ″ - methoxytubulinine. The root bark contains curculine, haematine, haematinnine, granodipine, menismine, sinomenine, ranunculine, etc. The results showed that there were three alkaloids in rattan, namely, haematine, tubulinine, granodipine, (+ +) - 4 ″ - o-methyltubulinine.

It remains to be studied whether sinomenine II and haematine are the same substance.

(1) muscle relaxation

A new alkaloid, stansinomenine a, was proposed from the vine and root of stannous vine in Xishuangbanna Autonomous Prefecture and Hekou County of Yunnan Province. Its physical constant is the same as that of haiheting. In the cross head drop test of rabbits, the head drop dose of stansinomenine a was 0.1254 ± 0.0124 mg / kg, which was similar to that of curculine 0.1397 ± 0.0143 mg / kg; in the wire net drop test of mice, the half effective dose of stansinomenine a was 0.161 ± 0.0124 mg / kg, while that of curculine was 0.251 ± 0.0175 mg / kg, which was one and a half times greater than that of curculine. The neuromuscular blockade of stansinomenine a was stronger than that of curculine, but the duration was shorter. The therapeutic index (ED50 / LD50) of sinomenine a was 2.77, while that of curculine was 1.7, indicating that the safety range of sinomenine a was larger than that of curculine a. It has been proved in animals (rats, rabbits, guinea pigs) and human (median nerve thumb adduction test) that the blocking effect of stansinomenine A is at the neuromuscular junction rather than directly on the muscle. Its action mode is similar to that of curare, belonging to "non depolarization" or "competition" type. Stansinomenine B from this plant also has the effect of relaxing striated muscle, but it is weaker and lasts for a shorter time than tubuline, and its action mode is the same as tubuline. The General Hospital of Kunming Military Region put forward stansinomenine II from this plant, which is similar to haiheting. Its chemical structure formula is different from stansinomenine a. the dosage of rabbit drooping head is 0.1379 mg / kg, and the dosage of diaphragm paralysis of non anesthetized rabbit is 0.3 mg / kg. After 22 minutes, the breathing is fully recovered, and after 37 minutes, the jumping is recovered. Haiheting has a strong neuromuscular blocking effect, but haiheting hydrochloride has no effect. Because of its quaternary ammonium salt, haiheting's iodomethane salt has a strong muscle relaxant effect. Its effect on skeletal muscle paralysis in cats and dogs is 1.14 times as much as that of curculine, and 2.13 times as much as that of rabbit head drop test. The duration of the two drugs is similar, and the mode of action is the same. The dose of gastrocnemius paralysis is less than that of complete respiratory paralysis The ratio was 1:2, and the ratio of curculine was 1:1.25. In clinic, the muscle relaxation intensity during endotracheal intubation is 1 / 3 of that of curculine, and the duration is the same, which can be antagonized by neostigmine.

② Other functions

Stansinomenine a has cardiotonic effect on both rabbit heart and frog heart in vitro, and has excitatory effect on isolated intestine of guinea pig. The histamine releasing effect of stansinomenine A is weaker than that of curculine at the same dose by isolated rat diaphragm method and human forearm medial colliculus test. In the course of clinical anesthesia, blood pressure, pulse and heart rate were stable. In the cat experiment, the blocking effect on ganglion was weaker than that of tubuline. Intravenous injection of 2.5mg/kg iodomethane into cats can cause obvious and lasting decrease of blood pressure. Antihistamine can antagonize this effect. This drug can also stimulate the secretion of gastric juice and bile. Positive scratch after intradermal injection indicates that it has the effect of releasing histamine. Low dose of 0.2-0.4 mg / kg did not affect the impulse conduction of ganglion. The highest blood concentration was found in 2 minutes after intravenous injection and disappeared in 15 minutes. 4-8% of the blood was excreted in urine within 3 hours after intravenous injection. Several derivatives of Hague Ting are injected into the lateral ventricle (cerebellomedullary cord), cistern and sheath. 0.4 mg in cat and 0.5 mg in dog can cause blood pressure rise, respiratory excitement, body reflex enhancement and sometimes convulsion, which indicates that the site of action is above the spinal cord. The results showed that the decoction of the leaves and stems of stannum wilfordii and the decoction precipitated by ethanol could inhibit the ileum of guinea pigs and the uterus of rats, and decrease the blood pressure of dogs.

[toxicity] sinomenine Ⅱ had no effect on ECG, blood pressure, liver and kidney function, and blood cells; no allergic reactions such as bronchospasm and urticaria were found. All animals survived for a long time, and no morphological changes were found in the histological examination.

[nature and taste] selected Chinese herbal medicines of Simao in Yunnan Province: "light and mild, warm. "

[functions and indications] ① selection of Yunnan Simao Chinese herbal medicine: "pain relief, hemostasis and muscle regeneration. Treatment of traumatic injury, crush injury, trauma bleeding. It can be used as muscle relaxant. "

② "Clinical application and visit of traditional Chinese medicine anesthesia": "folk used for traumatic injury, low back pain, rheumatism, wheezing, heart disease. "

[usage and dosage] oral: decoction, 3-5 yuan. External use: grind, sprinkle or tamp.

[clinical application] muscle relaxation

Stansinomenine itself has no anesthetic effect and is used as a muscle relaxant in various general anesthesia methods. Nearly 200 cases were treated with stansinomenine Ⅱ combined with ether anesthesia, halothane anesthesia, intravenous procaine combined anesthesia and Flos Datura anesthesia. This article introduces the application of Datura anesthesia as follows: first, it is mainly used in abdominal and limb operations to get muscle relaxation during operation, which is convenient for operation; second, it is used in chest operations to help breathing or control breathing, so as to avoid mediastinal swing interfering with physiological function and hindering operation; third, it can reduce muscle tension during shallow anesthesia.

The dosage of stansinomenine Ⅱ was significantly higher than that of ether group when it was used with Flos Daturae. General upper abdominal surgery, under the condition of endotracheal intubation, once intravenous injection of stansinomenine Ⅱ 0.2-0.3 mg / kg, can obtain abdominal muscle relaxation, lasting for 30-40 minutes. The dosage should be reduced for the patients with weak physique. The second and third supplementary dose can be given 1 / 2-2 / 3 of the first dose according to the situation. There was no significant difference in the total amount of stannic acid used in 5 patients. For patients without endotracheal intubation, the dosage of stansinomenine should be no more than 0.2 mg / kg, and preparation for intubation should be made. The effect of stansinomenine Ⅱ reached its peak in 2-5 minutes after intravenous injection.

The advantages of clinical application of stansinomenine Ⅱ are: as long as the dosage is within the range of clinical application, even in children, hemorrhagic shock and controlled hypotension patients, repeated intravenous injection of stansinomenine Ⅱ has no effect on blood pressure, pulse, electrocardiogram, bronchospasm and histamine release, and there are few clinical side effects. However, with the increase of the dosage of stansinomenine II, it can be seen that there is obvious respiratory inhibition or even respiratory arrest in clinic. Therefore, it is necessary to emphasize the management of respiration and pay great attention to the volume of breath. In addition, we should also pay attention to the sublingual drop caused by paralysis of pharyngeal, laryngeal and lingual muscles, which hinders breathing, and the gastric contents are easy to "reflux" and lead to aspiration due to paralysis of the upper esophageal cricopharyngeal muscles. For this reason, the use of stansinomenine should be inserted into the endotracheal tube in advance, which can effectively and conveniently carry out auxiliary respiration when respiratory depression.

Because of the non depolarization type of stansinomenine Ⅱ, it should be forbidden to use in patients with myasthenia gravis. It should be noted that stansinomenine Ⅱ can cause serious respiratory depression when using neomycin and streptomycin in large quantities. Stansinomenine II can be antagonized by cholinesterase inhibitors such as neostigmine and stanozolol. In adults, intravenous injection of neostigmine 1-2 mg can make muscle relaxation disappear.

Chinese PinYin : Xi Sheng Teng