葶苈子有效成分及治疗心力衰竭研究OA

Tinglizi(Semen Lepidii)is the dried mature seed of Descurainia sophia(southern Tinglizi)or Lepidium apetalum(northern Tinglizi)from the Cruciferae family,and it has the traditional effects of purging the lung to relieve asthma and inducing diuresis to reduce edema.This article systematically reviews the research progress of Tinglizi(Semen Lepidii)in terms of its active ingredients,pharmacological effects,and clinical application in the treatment of heart failure(HF).At present,its main active ingredients have been clarified into four categories.①Flavonoids:about 60 types have been identified,such as quercetin,kaempferol,lepidiumflavonol D,etc.,among which quercetin-3-O-β-D-glucose-7-O-β-D-gentiobioside is unique to southern Tinglizi(Semen Lepidii);②Thioglycosides:such as the newly discovered descurainoside;③Isothiocyanates:such as degradation products like 3-phenylpropionitrile;④Cardiac glycosides:such as strophanthidin,lepidiin,etc.Pharmacological studies have shown that these ingredients exert comprehensive effects through multiple targets and pathways.Flavonoids can target HSP90AA1 and SRC genes,regulate mitochondrial electron transport and MAPK/PI3K signaling pathways,improve myocardial energy metabolism,and protect mitochondrial function by activating the PPARα/PGC-1α/Sirt3 pathway;Cardiac glycosides can significantly enhance myocardial contractility,with effects equivalent to digitalis drugs;Thioglycosides and isothiocyanates can inhibit the activity of the renin-angiotensin-aldosterone system(RAAS),regulate the expression of aquaporins,and play a role in diuresis and detumescence;In addition,it can also improve myocardial fibrosis by inhibiting the TGF-β/Smad signaling pathway,and exhibit anti-inflammatory,immune regulation,blood lipid regulation,and estrogen-like effects.In the clinical application for heart failure,compound preparations containing Tinglizi(Semen Lepidii)[such as the classic prescription Tinglizi Dazao Xiefei Decoction(葶苈大枣泻肺汤)]have shown significant efficacy.Especially in patients with chronic heart failure,they can increase the left ventricular ejection fraction by about 12.3%and the 6-minute walking distance by about 28.5 meters;in the treatment of rheumatic heart disease with heart failure and refractory heart failure,the total effective rate can reach 85%-96.97%when combined with conventional western medicine;in acute heart failure,it can quickly improve the hemodynamic status of patients and reduce mortality.This article systematically sorts out the research status of Tinglizi(Semen Lepidii),providing an important reference for its in-depth development and safe clinical application.