B Y T

TRNG I HC DC H NI

NGUYN VN KHANH

TNG QUAN

20 V THUC C TRUYN C TC

DNG THANH NHIT

KHA LUN TT NGHIP DC S

H NI - 2014

B Y T

TRNG I HC DC H NI

NGUYN VN KHANH

TNG QUAN

V THUC C TRUYN C TC

DNG THANH NHIT

KHA LUN TT NGHIP DC S

Ngi hng dn:

TS. o Th Thanh Hin

Ni thc hin:

B mn Dc hc c truyn

H NI - 2014

LI CM N

Trc tin, ti xin by t lng bit n su sc ti TS. o Th Thanh

Hin, ngi lun quan tm, gip , hng dn v ng vin ti trong sut qu

trnh thc hin v hon thnh ti ny.

Ti xin gi li cm n ti PGS. TS. Nguyn Mnh Tuyn, ngi gip

, hng dn ti trong sut thi gian qua.

Ti xin chn thnh cm n cc thy c, v cc anh ch k thut vin B

mn Dc hc c truyn gip v to iu kin cho ti trong qu trnh

nghin cu, thc hin ti.

Ti cng xin chn thnh cm n cc cn b vin chc trong th vin

trng i hc Dc H Ni tn tnh gip , to iu kin cho ti trong qu

trnh nghin cu v thc hin ti ny.

Cui cng, ti xin gi li cm n ti gia nh v bn b, nhng ngi

lun ng vin, gip v ng gp kin cho ti hon thnh ti ny.

H Ni, thng 5 nm 2013

Sinh vin

Nguyn Vn Khanh

MC LC

Trang

T VN .. 1

CHNG I. KHI NIM V NHIT V THUC THANH NHIT

TRONG Y HC C TRUYN..

2

1.1. KHI NIM NHIT. 2

1.2. THUC THANH NHIT. 3

1.2.1. Cc loi hnh sinh nhit trong c th 3

1.2.2. nh ngha 4

1.2.3. Tnh v...... 4

1.2.4. Tc dng chung 4

1.2.5. Phn loi thuc theo nguyn nhn 5

1.2.6. Thnh phn ha hc. 5

1.2.7. Tc dng sinh hc. 6

1.2.8. Nhng im cn ch khi s dng thuc thanh nhit. 6

1.2.9. King k....... 7

1.3. CC LOI THUC THANH NHIT 7

1.3.1. Thuc thanh nhit gii th 7

1.3.2. Thuc thanh nhit gii c....... 9

1.3.3. Thuc thanh nhit ging ha (thanh nhit t ha) 12

1.3.4. Thuc thanh nhit to thp....... 13

1.3.5. Thuc thanh nhit lng huyt. 16

CHNG II. I TNG V PHNG PHP THU THP

THNG TIN.

24

2.1. I TNG NGHIN CU 24

2.2. NI DUNG THU THP THNG TIN. 24

2.3. PHNG PHP THU THP THNG TIN. 24

CHNG III. KT QU V BN LUN....... 25

3.1. THUC THANH NHIT GII C....... 25

KIM NGN HOA.. 25

B CNG ANH 29

LIN KIU 31

X CAN. 37

3.2. THUC THANH NHIT T HA.. 42

THCH CAO. 42

CHI T... 44

HUYN SM 50

H KH THO 54

TRI MU....... 58

3.3. THUC THANH NHIT GII TH.. 62

H DIP 62

DA HU. 64

3.4. THUC THANH NHIT TO THP. 65

HONG B... 65

HONG LIN... 70

HONG CM... 78

NHN TRN 84

THO QUYT MINH.. 87

3.5. THUC THANH NHIT LNG HUYT 92

SINH A... 92

A CT B... 99

MU N B 102

BCH MAO CN. 108

3.6. BN LUN 118

3.6.1. Tnh v 118

3.6.2. Cng nng, ch tr ca thuc thanh nhit trong YHCT. 118

3.6.3. Thnh phn ha hc... 120

3.6.4. Tc dng sinh hc. 120

3.6.5. Mi lin quan gia cng nng v tc dng sinh hc ca thuc

thanh nhit. 123

KT LUN V XUT.. 127

KT LUN. 127

XUT.. 127

DANH MC CC CH VIT TT

ADN Acid deoxyribonucleic

ADP Adenosin diphosphat

AMPK Protein kinase hot ha bi AMP (AMP-activated protein

kinase)

ARN Acid ribonucleic

AT1R Receptor AT1 ca angiotensin II (Angiotensin II type 1

receptor)

ATP Adenosin triphosphate

CCl4 Cacbon tetraclorua

COX Cyclooxygenase

DDPH 1,1-diphenyl-2-picrylhydrazyl

EC50 Nng 50% tc dng ti a (Effective Concentration)

ED50 Liu tc dng ti a trn 50% i tng th (Effective Dose)

ERK L trnh kinase iu ha tn hiu ngoi bo (Extracellular

signalregulated kinase)

HDL Cholesterol c t trng cao (High density lipoprotein)

IL Interleukin

IC50 Nng c ch 50% i tng th (Inhibitory

Concentration)

iNOS Men tng hp NO cm ng (Inducible nitric oxide synthase)

IB Cht c ch B (Inhibitor of nuclear factor-kappa B)

JNK L trnh Janus kinase

LD50 Liu gy cht 50% i tng th (Lethal Dose)

LDL Cholesterol c t trng thp (Low density lipoprotein)

LOX Lipooxygenase

LPS Lipopolysaccharid

MAO Monoamine oxidase

MAPK L trnh tn hiu protein kinase hot ha phn bo (mitogen-

activated protein kinase)

mARN ARN thng tin

MIC Nng c ch ti thiu (MIC (Minimum Inhibitory

Concentration)

NF-B Yu t nhn B (Nuclear Factor-kappa B)

NO Nitric oxide

ONOO- Peroxynitrit

PG Prostaglandin

PPAR Peroxisome Proliferator Activated Receptor

TNF- Yu t hoi t m alpha ( Tumor Necrosis Factor )

TNG Thanh nhit gii c

TNGH Thanh nhit ging ha

TNGT Thanh nhit gii th

TNLH Thanh nhit lng huyt

TNTT Thanh nhit to thp

YHCT Y hc c truyn

DANH MC CC BNG

Bng 3.1: Tng hp v tn khoa hc cy thuc, thnh phn ha hc, tnh v, quy

kinh, cng nng, tc dng sinh hc ca 20 v thuc thanh nhit 111

Bng 3.2: Tng hp mt s tc dng sinh hc ca 20 v thuc thanh nhit.115

1

T VN

Nhit t l nhit gy ra bnh cho c th. Nhit t c th do qu trnh hot

ng ca tng ph gy ra hoc do t bn ngoi a vo nh nng nng ca ma

h. Nhit t lm hao tn tn dch, gy st cao, kht nc, nhiu m hi, mt ,

chy mu xut huyt, mn nht, rm sy, sng lot.

Theo YHCT, nhng biu hin trn do chng t bn trong c th gy nn.

Nguyn nhn lm c th b nhit l ung khng nc, do nh hng ca khi,

bi, sc nng ca mi trng, do nhim siu vi, vi trng, mt nc do to bn,

tiu chy, cc trng thi tm l bt li ko di, cc loi t kh xm nhp vo c

th m ha nhit gy kh chu cho ngi bnh. V vy vic iu tr bnh v nhit

l rt cn thit v quan trng.

T xa xa trong dn gian bit s dng mt s cy c v thuc c tnh

mt thanh nhit gii c c th con ngi. Trong YHCT nhng thuc dng

loi tr nhit c ra khi c th, lm cho c th trong sch, ht nhit c, ly li

s cn bng m dng l thuc thanh nhit. Tc dng ca thuc thanh nhit cng

c y hc hin i chng minh, nhng kt qu thu c gp phn lm sng

t cc tc dng theo YHCT. tm hiu s tng ng v mi quan h gia tc

dng thanh nhit ca cc v thuc c truyn vi kt qu nghin cu y hc hin

i, chng ti thc hin ti Tng quan 20 v thuc c truyn c tc dng

thanh nhit nhm mc tiu:

1. Tng hp mt s thng tin v thnh phn ha hc, tc dng sinh hc v

ng dng trong YHCT ca 20 v thuc thanh nhit thng dng.

2. Phn tch mi lin quan gia cng nng ca v thuc theo YHCT v cc

tc dng sinh hc ca cy thuc c cng b.

2

PHN I. KHI NIM V NHIT V

THUC THANH NHIT TRONG Y HC C TRUYN

1.1. KHI NIM NHIT

Nhit l biu hin hi chng nhit. C th biu hin l st cao, khi st

khng rt, c khi st rt cao m sng vt v, mt nh, mi nt n, mt

do sung nhit, ming kht, tiu tin ngn , i tin to kt, ru li vng y,

cht li i khi phng rp, mch hng sc Tuy nhin nhiu khi c th

khng st song cng c gi l nhit nu nh c nhng biu hin pht ban, d

ng nga m nng, hoc ho kht, hoc tiu vng , i tin b kt

Khi c th mc chng trng nhit, thuc phi dng l m dc. Thuc

thanh nhit, thuc tn lng gii biu, thuc tnh hn lng. Tuy nhin cng cn

lu dng thuc hn phi trnh hn.

Cn lu 2 trng hp sau:

- Chn nhit gi hn (chnh bnh l nhit, song biu hin ra bng mt s

triu chng li nh hn): chn tay cng lnh, ru li en, mch t (thuc hn).

Tuy chn tay lnh song khng thch si m, khng thch ung nc nng, ru

li en song cht li li , mch t nhng hu lc (thuc chng nhit). Tt

c iu chng t rng t nhit cn n nu bn trong. Do vy cn phi xc

nh tht r nu khng s dng thuc sai chiu. Trong trng hp ny phi dng

m dc (thuc hn), ng vi ngha nhit hn gi chi. Nu lm ngc li th

bnh khng nhng khng thuyn gim m cn trm trng hn.

- Chn hn gi nhit (chnh bnh l hn, song th hin ra bng mt s triu

chng li nh nhit): c st ming kht, ru li vng, din mch to, trong ngi

phin mun, mt hng (thuc chng nhit). Song tuy c st, ming kht

3

nhng li mun ung nc m, thch mc m, s lnh. Ru li vng nhng cht

li nht nht, din mch to nhng v lc (thuc chng hn). Tt c iu ni

ln rng m hn cn ang thnh bn trong. Trong trng hp ny phi dng

dng dc (thuc dng). ng vi ngha hn gi nhit chi. Nu lm ngc

li bnh s nng thm.

Bi vy, ng trc ngi bnh phi nh ra hn nhit r rng [2].

1.2. THUC THANH NHIT

1.2.1. Cc loi hnh sinh nhit trong c th

Theo YHCT, nhit c th chia ra lm 2 loi chnh:

- Sinh nhit, nhit to ra sc nng cn thit cho chuyn ha ca tng ph

v cc c quan trong c th.

- T nhit, nhit xu, nhit gy ra bnh tt cho c th. Loi nhit ny c

th t ni tng, do qu trnh hot ng ca tng ph gy ra, v d do m h ha

vng, do can ha vng, tm ha vng gy ra. Hoc do t ngoi a vo nh

do nng nng ca ma h thm nhp vo c th lm cho c th st cao, vt qua

nhit hng nh (37oC), lc ny c th mc chng thc nhit ming kh kht,

mun ung nhiu nc mt, nu thm nhp vo phn dinh, phn huyt th st

cao m sng.

Ngoi trng thi nhit ni trn, nhiu triu chng khc cng c gi l

nhit: To bn do i trng thc nhit. Tiu vng ngn l thn nhit hoc

bng quang thp nhit. Nga l, pht ban chun nhiu khi l do huyt nhit

Nh vy, cc loi hnh nhit trong c th rt phc tp. Ty theo nhit xut

hin theo cch no ngi ta c thuc thanh nhit theo cch [2].

4

1.2.2. nh ngha

Thuc thanh nhit l loi thuc dng loi tr nhit c ra khi c th,

lm cho c th trong sch, ht nhit c, ly li s cn bng m dng cho c

th [2].

T thanh trong thanh nhit l ch s lm trong sch, lm mt i, tc l

thanh tr phn nhit c. Thuc thanh nhit l thuc lm trong sch phn nhit

c, nhit gy bnh, ni cch khc l loi tr cc yu t gy bnh cho c th.

Thuc thanh nhit l mt loi thuc chim t l ln trong cc loi thuc c

truyn. Trn thc t thuc thanh nhit cng c s dng nhiu. V chnh loi

thuc ny cng c gi tr cao trong vic iu tr nhiu chng bnh kh [4].

Thuc thanh nhit l cc phng dc c tc dng ch yu thanh gii l

nhit, t m ging ha, to thp, lng huyt v lng huyt gii th, gii c

[11].

1.2.3. Tnh v

Tnh cht ca cc v thuc thanh nhit l hn, lng, ng hoc ngt [11].

1.2.4. Tc dng chung: thanh nhit, chng vim.

Gii c: cha cc bnh nhim khun, truyn nhim.

Dng m, sinh tn: cha, lm gim cc hin tng bnh do mt nc:

st ko di, kht nc, hng kh, to bn.

An thn: do st gy vt v, phin mun, m sng

Chng co git gy st cao

Cm mu do st cao nhim c, gy ri lon thnh mch lm chy mu

[1].

5

1.2.5. Phn loi thuc theo nguyn nhn

Nh ta bit, thuc thanh nhit l loi thuc chim t l ln trong thuc

c truyn, c ngha quan trng trong phng v tr bnh ni chung. Phm vi s

dng ca chng tng i rng, c lin quan n nhiu chng bnh khc nhau,

t cc chng say nng, say nng (trng th) n cc chng huyt nhit (mn

nht mn nga), hoc st cao pht cung m sng, hoc cc triu chng bnh

thp nhit, chng huyt nhit. Do phm vi s dng rng nn thuc thanh nhit

c phn ra nhiu nhm phn loi khc nhau p ng cc yu cu cha bnh

ca chng. YHCT chia thuc thanh nhit ra lm 5 nhm: thanh nhit gii th,

thanh nhit gii c, thanh nhit ging ha, thanh nhit to thp, thanh nhit

lng huyt.

Mi nhm thuc c tc dng ring. Tuy nhin, pht huy c hiu qu

cao, trn thc t lm sng, YHCT c th s dng ring tng nhm, hoc kt hp

gia cc nhm thuc thanh nhit vi nhau, hoc phi hp mi nhm vi cc

loi thuc c truyn ca cc loi khc [4].

1.2.6. Thnh phn ha hc

i vi thnh phn ha hc trong thuc thanh nhit, ch yu c mt s

nhm cht sau y:

- Nhm polyphenol, trong ng k l cc hp cht flavonoid (ch yu

trong TNG). V d nh luteolin v cc hp cht flavonoid ca kim ngn hoa,

quercetin, isoquercetin trong ng tinh tho, irigenin, iridin trong x can,

forsythol trong lin kiu, cc flavonoid trong n l

- Nhm alcaloid, ch yu trong thuc TNTT: berberin trong hong lin,

hong b, palmatin trong hong lin, hong ng, vng ng Chng u c tc

6

dng khng khun, tiu vim, h st, li mt iu gp phn gii thch cho

tc dng thanh nhit ca nhm thuc ny.

- Nhm iridoid ch yu c trong sinh a ca nhm thuc TNLH, c tc

dng h ng huyt [4].

1.2.7. Tc dng sinh hc

Tc dng chung nht ca cc loi thuc thanh nhit l tc dng h st, n

c hu nh trong tt c cc nhm thuc ca loi thuc ny, sau l tc dng

khng khun. Nhiu v thuc tc dng vi cc vi khun c gram (-) v gram (+).

Ngoi cc tc dng sinh hc chung gii thiu, cc v thuc trong cc nhm

ca loi thuc thanh nhit cn th hin tc dng chng oxy ha (antioxydant) do

cc hp cht polyphenol ca cc v thuc nh kim ngn hoa, hong cm, n

a li. Ngi ta chng minh, cc thnh phn ny, ngoi tc dng khng

khun tt, cng c tc dng kha cc gc t do trong c th, do c th lm

tng c kh nng min dch v chng lo ha cho c th, bo v mng t bo,

chng x va mch mu do gim tnh thm thnh mch, chng ri lon chc

nng tnh mch, bo v gan, chng vim lot, chng co tht c trn, thng tiu

[4].

1.2.8. Nhng im cn ch khi s dng thuc thanh nhit

- Bnh cn biu, khng nn dng cc loi thuc ny qu sm, nu biu

bnh vn cn m xut hin l chng, th phi kt hp biu l cng cha.

- Cc v thuc thanh nhit v ngt, tnh lnh hay gy n tr, nh hng ti

t v th phi kt hp vi cc thuc kin t, ha v nh cam tho, bch trut, cc

v thuc ng lnh, tnh cht hay gy to, lm tn thng tn dch nn phi hp

vi cc thuc dng m.

7

- Khng c dng thuc thanh nhit trong cc trng hp:

+ Nhit t biu chng cha gii ht.

+ T v h pht st (t v i h).

+ m h ha vng (hay hm hp st v chiu).

+ T v h hn (hay i a chy).

+ Chng chn hn gi nhit.

+ Sn ph huyt h, pht st kh chu vt v.

- Thuc thanh nhit l thuc hn lng, khng c dng vi chng hn

(hn ng hn tc t).

- Ngi th cht suy yu, ph n sau khi sinh dng phi thn trng theo

di n ung nu thy chn n phi dng ngay.

- Mt s thuc thanh nhit ung d nn nn thm nc gng hoc ung

nng.

- Cng cc loi thuc thanh nhit khc nhau: nhit nhiu dng thuc

mnh, nhit t dng thuc nh.

- Ma h dng lng nh, ma ng dng liu cao [1], [11].

1.2.9. King k

- Khng dng khi bnh cn biu.

- T v h nhc, n khng ngon, a chy dng cn thn.

- Mt mu nhiu sau khi , chy mu c hin tng h dng, hin

tng gi nhit: khng nn dng thuc thanh nhit [1].

1.3. CC LOI THUC THANH NHIT

1.3.1. Thuc thanh nhit gii th

8

Thuc thanh nhit gii th l loi thuc c tc dng tr th t (t nng,

nng) ra khi c th.

Khi c th b th t xm nhp, nh th chong vng au u, nng th

chong say, ng bt tnh, mt nh, m hi v ra, mt cht in gii nhiu, bt

tnh. Bnh ny c gi l t bnh, trng th hay say nng (nu lm vic ngoi

tri), say nng (nu lm vic ni l un nng bc) [2].

- Tc dng ca thuc thanh nhit gii th: do thuc thanh nhit gii th

thng c v ngt, tnh bnh hoc hn (Ty qua, ng qua b), c tc dng gii

th, gip c th sinh tn dch, ch kht, nht l khi b trng th, do c th b mt

nhiu m hi lm tn dch kh kit, ming kht, tm phin. Mt khc thuc gii

th li thng dng di dng ti, thng c mu xanh (H dip, Tch tuyt

tho, Hn lin tho), do bn thn chng cha nhiu cht dip lc t

(chlorophyll), c tc dng chng vim, h nhit tt. Bi vy dng thuc thanh

nhit gii th gip c th nhanh chng khi phc li tn dch.

- Tc dng khc: ngoi tc dng gii th, mt s v thuc trong nhm

thuc ny cn c tc dng cm mu tt: H dip (l sen), sao en tc dng cm

mu tng gp i, Hn lin tho (c nh ni) [4].

Thuc thanh nhit gii th c chia thnh 4 loi:

- Thuc kh thanh nhit: l nhng phng dc c dng cha ngoi

cm th nhit: say nng (ngi nng, st ra nhiu m hi, kht nc).

- Thuc kh th gii biu: l nhng phng dc dng cha chng th

kh phc trong km thm ngoi cm phong hn c cc triu chng: nng,

st, s lnh, khng c m hi, au u, tm phin ming kht.

9

- Thuc kh th li thp: l nhng phng dc dng cha cm th km

thp c cc triu chng: ngi nng, phin kht, ngc bng trn tc y, tiu

tin kh khn

- Thuc kh th ch kh (thanh th ch kh): l nhng phng dc dng

cha th nhit lm tn thng kh, tn dch b chng gy nn ngi nng, ho

kht, mt mi, kh on, ra nhiu m hi, mch h [11].

1.3.2. Thuc thanh nhit gii c

Thuc thanh nhit gii c l nhng thuc c tc dng thanh nhit t ha,

tiu c, gii c cha nhng bnh do nhit c, ha c gy ra: ban si, mn

nht, inh c, vim ty au nhc, vim ng h hp, d ng vim nhim ngoi

da, mm li lot, nn ra mu, chy mu cam, nc tiu , vim i trng, to

bn, kit l [11].

Cc v thuc ny c tc dng khng sinh v chng vim nhim, tnh hn,

lng [1].

Nhit c trong c th do hai nguyn nhn dn n:

- Nguyn nhn bn trong: do chc nng hot ng ca cc tng v ph qu

yu, khng sc thanh thi cht c trong qu trnh chuyn ha sinh ra v

ngng tch li. V d chc nng can qu yu khng kh nng lm nhim v

gii c ca mnh, thn thy qu yu kh nng thanh lc km, chc nng truyn

tng cn b ca i trng qu yu khin tch li cc cht c, to iu kin

pht sinh ra mn nht, sang l, mn nga, d ng (d ng ni sinh).

- Nguyn nhn bn ngoi dn n tch c cho c th nh cn trng, rn

rt cn, hoc hi ca ha cht, cy c, hoc n phi cc thc n c, hay thc n

mang tnh cht d ng

10

Nh vy khng k l nguyn nhn bn trong hay bn ngoi lm c th b

nhit c th dng thuc thanh nhit gii c [2].

Tc dng ca thuc thanh nhit gii c:

- H nhit khi st cao: trong trng hp c th b st, thng khi c th

st cao do cm mo phong nhit, YHCT dng cc v thuc thanh nhit gii

c nh lin kiu, kim ngn, ng tinh tho phi hp vi cc v thuc tn

lng gii biu: tang dip, cc hoa, bc h iu tr.

- Tc dng gii c, tiu vim:

+ Dng tr rn cn: x can, tht dip nht chi hoa Dng r ti, nhai ly nc,

b p ngoi.

+ Dng tr vim nhim: ng tinh tho tr sng, au mt nhim trng (ung dch

p ti, b p ngoi), m x hin gi nt, ch xt vo ni b vim nga, l lot,

nht l b nga do lm vic ni bn ly nc ng b nhim nhiu.

- Tc dng d ng:

+ Nhiu v thuc TNG c s dng cha d ng, mn nht, mn nga, c

bit do trng hp huyt nhit nh kim ngn hoa, n , lin kiu, b cng

anh, si t.

+ C th dng phng bnh trc ma vim nhit xy ra nh dng si t, b

cng anh, sc ung hng ngy, c bit vi tr em hoc nhng c a c tin s

d ng, nga

+ C th dng ngoi, nu nc tm ra khi b mn nga: si t, kim ngn

+ Mt s v thuc trong c chng minh v tc dng chng d ng trn

ng vt th nghim: n l , n tng qun

11

- Tc dng khng khun: nhiu v thuc TNG c tc dng khng khun

tt, c bit kim ngn hoa c ph khng khun rt rng i vi vi khun gram (-)

v gram (+). Ngoi ra cng phi k n v ng tinh tho v lin kiu, l nhng v

thuc c tc dng c ch tt i vi trc khun m xanh.

- Tc dng khc: tc dng cm mu. Kim ngn hoa c tc dng ch huyt

l, tc dng c gii thch l do cc flavonoid c v thuc lm bn mao

mch [4].

pht huy tc dng tt ca thuc thanh nhit gii c thng phi hp vi:

+ Thuc hot huyt chng huyt , hoc xut huyt.

+ Thuc li niu nhun trng h st nhanh.

+ Thuc thanh nhit lng huyt thanh tr nhit c phn huyt,

gim bt tnh trng tn dch hao tn.

+ Vi thuc bi p ngoi chng nhim khun da.

+ Khi dng thuc thanh nhit gii c cn dng nhiu v thanh nhit gii

c cng mt lc chng khng thuc (3-4 v) v dng liu thp trnh gy

ho (mt).

- Nu bnh lu ngy, c th h nhc cn kt hp thuc b dng (b m,

b kh, b dng, b huyt) [11].

Ch nn dng thuc thanh nhit gii c khi c th b nhim c, cng c

th dng vi tnh cht d phng, gip c th tng kh nng loi c trc mt

hon cnh no . Khng nht thit dng theo ma, song ma c dng thuc

thanh nhit nhiu nht vn l ma xun v ma h [2].

12

1.3.3. Thuc thanh nhit ging ha (thanh nhit t ha)

Thuc thanh nhit ging ha l nhng thuc c tc dng h ha (h thn

nhit), khi c th st cao, pht cung m man, i khi khng ch ng c li

ni, m sng.

Tc dng thuc thanh nhit ging ha:

- Tc dng h st: nh ta bit, khi c th b cm mo phong hn (cm

lnh), nu vic iu tr cha trit , hoc l vic s dng thuc pht tn phong

hn (thuc tn n gii biu) cha liu lng, i khi cha ng phng php,

hoc s phi ng cha tht ph hp, hoc qu trnh ch bin, bo ch lm mt

i phn hot cht, cng c th l do sc khng ca c th bnh nhn qu yu,

lm cho yu t phong hn vt qua hang ro biu, thm nhp su vo tng

ph trong c th, gy ra chng phong hn nhp l vi cc triu chng st cao,

thn nhit c khi ln ti 40oC, pht cung, m sng Lc ny cn c s can

thip ca cc v thuc THGH: Thch cao, Tri mu, Hong lin, Chi t, H kh

tho, Huyn sm. Vi cc trng hp st cao m sng do phong hn nhp l,

YHCT dng phng Bch h thang (Thch cao, Tri mu, i m, Cam tho),

rt c hiu qu. Ngi ta chng minh ion Ca++ trong thch cao c tc dng trc

tip vo trung khu iu ha thn nhit no b, lm h nhit. Mt khc, mt

lng ion Ca++ nht nh c hp thu vo mu, do trnh c hin tng co

git, co c khi st cao. Trong phng thuc cn c v tri mu, mt v thuc c

tc dng t m ging ha, do va c tc dng h nhit va li nui dng

phn m. Chnh v vy m phng ny va c tc dng h st tt m khng lm

ra m hi, khng mt tn dch, hn na phn m li c nui dng. Do

ngi bnh va h c st m c th mt mi. Ring im ny cng cn so

13

snh vi tc dng h st ca loi thuc tn n gii biu l h st nhng lm ra

m hi, do m lm cho tn dch hao tn, gy mt mi nhiu cho c th.

- Tc dng khng khun: nhiu v thuc trong nhm TNGH, c tc dng

khng khun tt: Tri mu c ch trc khun i trng (Escherichia coli), t cu

(Staphylococcus aureus), lin cu khun (Streptococcus). Huyn sm tc dng

c ch nhiu loi vi khun gy bnh da [4].

Phn ln v thuc trong nhm c tc dng thanh tm nhit, tr phin ch

kht, sinh tn dch, khi dng c th phi hp vi cc loi thuc thanh nhit khc.

Hoc thuc b m khi m h ha vng. Hoc thuc an thn, bnh can, tt phong

[2].

i vi ngi bnh thuc h chng khi cn dng thuc thanh nhit ging

ha th phi dng liu thp km thm thuc b dng trnh s khc, pht qu

mnh.

Nhit t c th xm phm vo cc tng, ph, v tr khc nhau nn cn cn

c vo s quy kinh ca thuc s dng cho thch hp [1], [11].

1.3.4. Thuc thanh nhit to thp

Thuc thanh nhit to thp l nhng thuc c tc dng thanh tr nhit c

v lm kh ro nhng m thp trong c th. Bnh thp trong c th c hnh

thnh do ngng ng phn nc trong qu trnh chuyn ha. Phn nc li

c nhit c trong c th nung nu l mi trng pht sinh ca bnh thp

nhit. Bnh thp nhit thng xy ra mt s tng ph nht nh nh can m

thp nhit, t v thp nhit, bng quang thp nhit Khi c bnh thp nhit th

phi dng thuc thanh nhit to thp [2].

14

Bnh thp nhit trong c th thng xy ra mt s tng, ph, nh can

m thp nhit, t v thp nhit, bng quang thp nhit trn thc t lm sng l

c s vim nhim ca cc c quan : vim gan, vim ti mt, vim bng

quang Khi c th mc bnh ni trn, YHCT thng s dng cc v thuc trong

nhm TNTT iu tr, vi cc v thuc nh hong lin, hong b, hong cm,

Nha am t, long m tho Bn cht ca chng thng c v rt ng, tnh

hn, vi cng nng chnh l TNTT. Ta bit rng cc v thuc trong nhm TNTT,

a phn c mu vng, do chng thng c tn gi u tin l ch hong:

hong lin (Hong lin chn g, hong lin r, hong lin ba gai, th hong

lin), hong cm, hong b, hong ng, vng ng. Qua iu tr lm sng,

YHCT thy rng tuy cng c tc dng l TNTT, song mi b mang tn hong

ni trn, li c th pht huy mnh mi vng khc nhau trong c th. Chng

hn, v hong cm c tc dng u tin thng tiu, dng iu tr cc bnh ca

tng ph: vim phi, vim ph qun, hong b c tc dng u tin h tiu,

dng tr cc bnh ca tng thn, ph bng quang: vim thn, vim bng quang,

nc tiu nng , tiu but rt hoc cc chng thp nhit, l nga h tiu.

Hong lin c tc dng u tin trung tiu, dng tr ch yu cc bnh ca tng

ph: can, m, t, v thp nhit: vim gan, vim ti mt, vim ng tiu ha.

Tuy nhin, cc u th ni trn ch mang tnh cht tng i. Ngoi ra, pht

huy c u th mt cch ton din cc v thuc , cn thng qua vic ch bin

c truyn. V d, a kh v ca hong lin ln thng tiu, tr cc chng do

can ha vng, mt sng, au, , ngi ta trch hong lin vi ru.

- Tc dng h st: nhm TNTT c tc dng h st khi c s vim nhim

ca cc tng ph trong c th. Trong trng hp ny, ngi ta thng dng phi

hp 3 v thuc hong lin, hong b, hong cm trong phng tam hong thang

15

hoc hong lin gii c thang (Tam hong thang + Chi t), s pht huy c tc

dng h nhit tt hn, khi st cao. Hong lin, hong b, hong cm, c

thc nghim chng minh c tc dng h st tt, nht l khi chch vi gng (tt

hn hong lin sng), tc dng h st tt ca chi t c chng minh ch yu l

do thnh phn acid ursolic.

- Tc dng li mt: nhiu v thuc trong nhm TNTT c tc dng li mt

tt nh: nhn trn, long m tho, chi t, h kh tho c dng khi st do

vim gan mt Li mt cng l hnh thc gip cho h nhit. Trn thc nghim

nhn trn, hong lin c chng minh c tc dng li mt, c bit hong lin

chch gim c tc dng li mt tt hn hong lin sng.

- Tc dng khng khun: Nhiu v thuc trong nhm TNTT c tc dng

khng khun tt, n c s dng khi c th b vim nhim cc tng ph hoc b

d ng, mn nht ngoi da. Hong lin l v thuc c ph khng khun rt rng

i vi c vi khun gram (-) v gram (+). Nc sc ca n th hin tc dng c

ch vi khun nng long khc nhau. Nhiu v thuc TNTT, cng c tc

dng khng khun tt.

- Tc dng li niu: mt s v thuc TNTT thng qua tc dng li niu

to thp, tc loi tr c cc m thp trong c th, nh cc v thuc l cn,

hong b, m trc dip Chng va c tc dng thanh nhit li va c tc

dng li niu v gii c. Do , trn thc t lm sng chng c dng iu

tr cc bnh vim nhim ng tit niu: tiu ra mu, tiu but dt.

- Tc dng ch huyt: nhiu v thuc TNTT c dng vi tc dng cm

mu. Trong phi k n hong cm, chi t (sao chy) c dng khi vim

phi, ho ra mu hoc ng thai chy mu (hong cm). Hong lin, hong b u

c tc dng cm mu: hong lin chng vim xut huyt mt v nim mc

16

ming, hong b chng vim xut huyt ng tit niu, hong cm dng khi

ng thai chy mu Tc dng ny c gii thch do kh nng bo v tiu cu

ca alcaloid berberin c trong cc v thuc.

- Tc dng khc: tc dng h huyt p: hong lin, hong b, tc dng h

ng huyt [4].

Khi dng thuc TNTT cn ch :

- Phi hp vi cc thuc thanh nhit ging ha, thanh nhit lng huyt

tng hiu lc.

- Phi hp vi cc thuc hot huyt khi ngi bnh c xut huyt.

- Phi hp vi cc thuc hnh kh khi ngi bnh c co tht, mt rn, i

dt.

- Phn ln cc v thuc ca loi thuc ny c v rt ng, tnh li hn, do

trong qu trnh s dng cn ch nm vng nguyn tc thuc hn phi trnh

hn, tc l khng dng thi gian di, liu cao, s lm nh hng ti vic tiu ha

hp thu ca c th, do m nh hng n chc nng ch kh ca t, ngi s

mt mi chn n [2].

1.3.5. Thuc thanh nhit lng huyt

Thuc thanh nhit lng huyt l nhng thuc dng cha cc chng

bnh gy ra do huyt nhit. Cc thuc ny c tc dng lng huyt.

Huyt nhit gy ra cc bnh:

- phn dinh v huyt (n bnh) gy cc chng mt , mt , nc tiu

, phin to khng ng, m sng hoc hn m co git, kht, gy chy mu, chy

mu cam, th ra mu, ban chun (nhit nhp huyt phn).

17

- Cc trng hp mn nht l nga, au cc khp do tng nhit (tnh trng

d ng nhim trng).

- Cc trng hp st cao ko di do mt tn dch, hoc thi k hi phc

ca cc bnh truyn nhim (giai on m h, cn d nhit).

Cc v thuc TNLH thng c v ng, tnh hn, a phn quy kinh tm,

can, thn, th hin mt s tc dng chnh nh:

- Tc dng h st: khi c th b st cao do nhit t xm nhp vo phn

dinh, phn huyt gy st cao pht cung m sng, tn dch b suy kit, YHCT

thng s dng cc v thuc TNLH: t gic, sinh a, mu n b, a ct b,

bch mao cn, xch thc Trn thc t, c hiu qu tr liu cao, ngi ta

thng dng di dng phi hp gia cc v thuc trong nhm nh nhau, nh

phi hp gia t gic vi sinh a hong trong phng T gic a hong hon

va c tc dng h nhit khi st cao, va sinh tn dch lm mt huyt m h

nhit.

- Tc dng ch huyt: mt s v thuc TNLH c tc dng ch huyt trn c

s c tc dng lng huyt tt. T gic dng khi th huyt, chy mu cam, xut

huyt di da. Sinh a lng huyt, ch huyt khi huyt nhit, chy mu cam, tr

ra mu. Bch mao cn (sao en) c tc dng cm mu khi vim ng tit niu,

i ra mu.

- Tc dng ch thng: trong YHCT c nhiu v thuc c tc dng ch

thng (tc dng gim au), nh cu tch, ct toi b c tc dng tr au xng,

tc on, r cm chy tr au xng khi gy xng. Cn cc v thuc trong

nhm TNLH l ch thng do bnh ct chng gy ra.

18

Nh ta bit, bnh ct chng l bnh thuc chng thp nhit, biu hin

cc triu chng va au va nng m trong xng. V chnh chng bnh ny

li th hin ra hai triu chng c bit, mt l au nng song m hi khng

thot ra c. Do to nn cm gic bun bc, bt rt, kh chu cho ngi

bnh. Trng hp ny c th s dng v mu n b tr. V mu n b va c

tc dng ch thng, li va c tc dng pht hn thanh nhit lng huyt.

Trng hp th hai cng c triu chng au nng song li ra rt nhiu m hi

khin cho c th mt nhiu tn dch. V nh vy c th mt mt b huyt

nhit, li thm mt tn dch. Do c th cng b suy kit. Trng hp ny c

th s dng v a ct b tr. V a ct b va c tc dng ch thng, li va c

tc dng ch hn.

- Tc dng khng khun: Mu n b c tc dng c ch t cu vng, trc

khun thng hn (Salmonella typhi), ph thng hn (Salmonella paratyphi),

trc khun m xanh (Pseudomonas aeruginosa), trc khun i trng

(Escherichia coli), trc khun ho g, lin cu khun (Streptococcus) v mt s

nm ngoi ra. Xch thc c tc dng c ch trc khun l (Shigella

dysenteriae), trc khun m xanh (Pseudomonas aeruginosa), trc khun

thng hn (Salmonella typhi), t cu khun (Staphylococcus aureus). Sinh a

c tc dng c ch mt s nm ngoi da.

- Tc dng khc: tc dng h ng huyt (sinh a, a ct b) [4].

Khi dng thuc thanh nhit lng huyt cn ch :

+ Phi hp vi thuc b m bi b tng tn dch trong cc trng hp st cao

mt nc.

19

+ Phi hp vi thuc thanh nhit gii c trong cc bnh nhim khun truyn

nhim.

+ Phi hp vi cc thuc khu phong tiu vim trong bnh au nhc cc khp, d

ng.

+ Khng dng thuc TNLH trong cc trng hp:

a chy do t h.

Cc bnh thuc kh phn [1], [11].

20

1. Bch mao cn (Rhizoma Imperatae cylindricae)

2. B cng anh (Herba Lactucae indicae)

3. Chi t

(Fructus Gardeniae)

4. Da hu (Endocarpirum Citrulli hoc Pericarpium Citruli)

5. a ct b (Cortex Lycii) 6. H Dip (Folium Nelumbilis)

21

7. H kh tho (Spica Prunellae) 8. Hong b (Cortex Phellodendri)

9. Hong cm (Radix Scutellariae) 10. Hong lin (Rhizoma Coptidis)

11. Huyn sm (Radix Scrophulariae) 12. Kim ngn hoa (Flos Lonicerae)

22

13. Lin kiu (Fructus Forsythiae suspensae)

14. Mu n b (Cortex Paeoniae suffruticosae)

15. Nhn trn

(Herba Adenosmatis caerulei)

16. Sinh a

(Radix Rhemanniae glutinosae)

23

17. Thch cao

(Gymsum fibrosum)

18.Tho quyt minh

(Semen Sennae torae)

19. Tri mu (Rhizoma Anemarrhenae) 20. X can (Rhizoma Belamcandae)

Hnh 1.1: Hnh nh cc v thuc thanh nhit.

Ngun:

- Yhoccotruyen.org ( 1, 2, 3, 7, 8, 9, 10, 11, 12, 13, 14, 16, 17, 18, 19,

20)

- Duoclieu.net (5)

- Duoclieudonghan.com.vn (6)

- Namthaoduoc.com (4)

- Alobacsi.vn (15)

24

PHN II. I TNG V

PHNG PHP THU THP THNG TIN

2.1. I TNG

20 v thuc trong danh mc thuc thanh nhit.

2.2. NI DUNG THU THP THNG TIN

- Tn khoa hc, b phn dng

- Tnh, v, cng nng, ch tr

- Thnh phn ha hc

- Tc dng sinh hc

- Cch dng, liu dng

- King k

2.3. PHNG PHP THU THP THNG TIN

- Thu thp thng tin t cc ngun:

+ Dc in Vit Nam.

+ Sch: Dc hc c truyn, Y hc c truyn, Dc liu, Cy thuc v

ng vt lm thuc vit nam, Nhng cy thuc v ng vt lm thuc

Vit Nam

+ Cc bi bo, bo co khoa hc ca Vit Nam v quc t.

- X l thng tin: Sp xp, h thng ha cc d liu thu thp c theo b

cc cht ch, hp l, logic, theo nhm vn , thng qua mt s bng biu.

25

PHN III. KT QU V BN LUN

3.1. THUC THANH NHIT GII C

KIM NGN HOA

(Flos Lonicerae)

V thuc l n hoa c ln mt s hoa phi hay sy kh ca cy kim ngn

(Lonicera japonica Thunb.) v mt s loi khc cng chi nh L. dasystyla Rehd.;

L. confusa DC. v L. cambodiana Pierre. H kim ngn (Caprifoliaceae) (KNH).

- Tnh v, quy kinh: v ngt, tnh hn, vo 3 kinh ph, v, tm [2], [3].

- Cng nng: thanh nhit gii c, phong nhit [2], [3], st khun [2].

- Ch tr: ung nht, ban si, my ay, l nga, cm mo phong nhit, n

bnh pht nhit, nhit c huyt l [3], sng au hu hng, vim amian, au

mt [2].

Thnh phn ha hc

- N hoa c nhm hp cht: cc dn cht cafeoyl quinic, flavonoid, irioid

v saponin.

- Acid chlorogenic v cc ng phn: acid crytochlorogenic, acid

neochlorogenic v cc acid isochlorogenic a, b, c (3,4-,3,5- v 4,5-di-O-cafeoyl

quinic). Hm lng trong n hoa c th ti 6% [5].

- Cc flavonoid: rutin, luteo-7-O--D-galactosid, lonicerin, hyperosid,

luteolin-7-O-neohesperidosid, tricin-7-O--D-glucospyranosid, ochna-flavon L,

chrisoeirol-7-O--D-hesperi-dosid, tricin-7-O- -D-neohesperidosid, chrysoeriol-

7-O--D-neohesperi-dosid, avicularin, quercetin [5], ochnaflavon [226].

- Iridoid: loniceracetalid A,B, swerosid, centaurosid v secoxyloganin.

26

- Saponin triterpen nhm hederagenin (lonicerosid A-C, macranthoidin B),

mt s cht carotenoid nh -caroten, -cryptoxanthin v auroxanthin [5].

- 20 hp cht c phn lp: sophoraricosid, luteolin-7-O-beta-D-

glucopyranosid, rutin, quercetin, acid 3,5-O-dicaffeoyl quinic methyl ester, acid

4,5-O-dicaffeoyl quinic methyl ester, acid 3,4-O-dicaffeoyl quinic methyl ester,

acid 4,5-dicaffeoyl quinic, acid 3,4-dicaffeoyl quinic, acid chlorogenic, epi-

vogelosid, swerosid, vogelosid, secoxyloganin, macranthoidin A, macranthoidin

B, lonicerosid A, lonicerosid B, lonicerosid C, dipsacosid B [246].

Tc dng sinh hc

- Tc dng khng khun: Kim ngn hoa c tc dng c ch Shigella

dysenteria, Salmonella typhi, Bordetella pertussis, Pneudomonas aeruginosa,

Corynebacterium diphteriae, Mycobacterium tuberculosis, Escherichia coli,

Staphylococcus aureus, Streptococcus pyogenes, Diplococcus pneumonia [4].

Nc sc c c 100% ca KNH c tc dng khng khun mnh i vi cc trc

khun l, dch hch, thng hn, cn thng hn, lin cu tan mu, phy khun

t. Tc dng yu hn i vi cc trc khun bch hu, E.coli, ph cu, t cu

khun vng [9]. Tc dng khng khun ca KNH c nghin cu trn cc vi

khun gy bnh rng ming. Kt qu cho thy 73,9% vi khun gy bnh c

th nghim b c ch nng di 6.25 mg/ml, trong Streptococci mutants,

actinomyces viscosus v bacteroides melaninogenicus tng i nhy cm vi

KNH [229]. KNH c tc dng c ch Porphyromonas gingivalis [253],

Hyliocobater pylori [56].

- Tc dng chng vim: Acid chlorogenic (CGA) v ng phn ca n c

ch NF-B, sn xut NO kch thch bi LPS trong cc i thc bo phc mc, c

27

tc dng khng vim lm gim t l t vong chut b nhim trng gy ra bi

LPS [205]. Luteolin c ch cc cytokine gy vim nh TNF-, IL-8, IL-6. Ngoi

ra Luteolin cn c ch COX-2, MAPK p38, ERK , NF-B, suy gim IkappaB

[108]. Trn m hnh chut b sng gan bn chn gy ra bi Candida albicans,

c tim lonicerin mng bng 1 hoc 2 g/ln, ngy 3 ln trong 20 ngy, cho

thy lonicerin lm gim ph n mi liu [149]. Ochnaflavon c ch COX-2 v

PGD2 trong t bo mast bt ngun t ty xng vi IC50 l 0,6 microM. Ngoi

ra, hp cht ny c ch sn xut leukotriene C4 ph thuc vo liu, vi IC50 l

6.56 microM [226].

- Tc dng chng d ng: Dch chit ethanol 35% ca KNH c tc dng

phng nga d ng. Loganin, morronisid, catalpol l nhng hp cht cho thy tc

dng phng nga d ng hiu qu [201].

- Tc dng chng oxy ha: Dch chit methanol v ethanol ca KNH c

tc dng dn gc t do DPPH. Acid chlorogenic l hp cht c tc dng chng

oxy chnh [138]. Luteolin, acid caffeic, acid protocatechuic, isorhamnetin 3-O-

beta-D-glucopyranosid, quercetin 3-O-beta-D-glucopyranosid, luteolin 7-O-beta-

D-glucopyranosid c tc dng dn gc t do vi gi tr IC50 l 2,08-11,76

microM i vi gc DPPH v 1,47-6,98 microM i vi ONOO- [42]. 14 hp

cht trong dch chit KNH c tm thy c tc dng chng oxy ha l

acid chlorogenic, acid 1-O-caffeoylquinic, acid caffeic, 4-O- caffeoylquinic,

rutin, isoquercitrin, luteolin-7-O-glucosid, lonicerin, acid 4,5-O-dicaffeoylquinic,

3,5-O-dicaffeoylquinic, 1, 3-O-dicaffeoylquinic, 3,4-O-dicaffeoylquinic, 1,4-O-

dicaffeoylquinic v luteolin [235].

28

- Tc dng khng nm: KNH c tc dng c ch mt s nm ngoi da [2].

Lonicerin c tc dng khng nm Candida albicans [149].

- Tc dng khng virus: Chito-oligosaccharid liu 25 mg/kg c hiu qu

lm tng cng hp thu ci thin sinh kh dng ca acid phenolic v hot tnh

khng virus ca dch chit KNH in vitro [305], [306].

- Tc dng trn chuyn ha cht bo: Kim ngn c tc dng tng cng

chuyn ha cht bo [9], ngn cn s tch t m bng [5].

- Tc dng khc: Nc sc KNH dng ng ung lm tng lng ng

huyt trn th tc dng ko di 5-6 gi [9]. Loganin l mt iridoid glycosid c

trong KNH, liu 20 v 40 mg/kg loganin ci thin tnh trng gim tr nh v c

ch cc hot ng do scopolamin gy ra. Ngoi ra, loganin cn c ch hot ng

ca acetylcholinesterase trong vng hippocampus v vng trn ca v no [137].

- c tnh: Chut nht trng sau khi c cho ung nc sc kim ngn

lin tc 7 ngy vi liu gp 150 ln iu tr cho ngi, vn sng bnh thng,

gii phu cc b phn khng thy c thay i g c bit [9].

Cch dng, liu dng

Ngy dng t 12g n 16g, dng thuc sc hoc hm. C th ngm ru

lm hon tn [3]. Mt s ngi ung kim ngn i a lng, ch cn gim liu

xung hoc ngh ung l ht [9], [10].

King k

T v h hn a chy, hoc vt thng, mn nht c m long do kh h,

mn nht c m, v lot khng nn dng [2], [3], [12].

Nhn xt

29

Kim ngn hoa c tc dng khng khun rng, chng vim v d ng ph

hp vi cng nng thanh nhit gii c trong YHCT.

Ngoi ra kim ngn hoa cn c tc dng chng oxy ha, khng nm, virus.

Acid chlorogenic v lonicerin l nhng cht c hot tnh sinh hc quan

trng trong kim ngn hoa.

B CNG ANH

(Herba Lactucae indicae)

V thuc l thn mang l phi hay sy kh ca cy b cng anh

(Lactuca indica L.). H cc (Asteraceae).

- Tnh v, quy kinh: v ng, ngt, tnh hn, vo 2 kinh can, v [3].

- Cng nng: thanh nhit gii c, tiu vim tn kt [3].

- Ch tr: mn nht, sang l, tc tia sa, vim tuyn v, nhim trng

ng tit niu [3].

Thnh phn ha hc

- B cng anh cha 91,8% nc, 3,4% protid, 1,1% glucid, 2,9% x, 1,2%

tro, 3,4mg% caroten, 25mg% vitamin C, 2 cht ng chnh l lactucin v

lactucopicrin, -amyrin, taraxasterol, germanicol [8].

- Flavonoid v cc glycosid ca n: luteolin (0,0024%), luteolin-7-O-

glucuronid, apigenin, quercetin, rutin (0,001%), isoquercitrin, cc triterpenoid

(-amyrin, germanicol), sesquiterpen lacton (lactucain A-C), acid clorogenic

(0,0033%) v dn cht ca acid quinic, lactucasid, stigmasterol, -sitosterol [37].

- 7 Terpen v 5 phenolic [120].

Tc dng sinh hc

30

- Tc dng khng khun: c ch l trc khun Shigella flexneri v

Shigella shiga [2]. c ch vi khun Escherichia coli trong cc bnh nhim trng

ng tit niu [173].

- Tc dng chng vim,chng oxy ha: Flavonoid ca b cng anh c tc

dng c ch men oxy ha kh peroxidase v catalase mu chut cng trng.

Nhng th nghim tin hnh vi huyt thanh ngi cng cho nhng kt qu c

ch men oxy ha kh r rt [8]. Dch chit ca b cng anh c tc dng chng

oxy ha do stress trong t bo HL- 60 v c ch cc yu t gy vim NO, mARN

ca iNOS gy ra bi LPS kch thch trn i thc bo RAW 264.7 vi liu 100

g/mL. 6 hp cht phenolic: acid protocatechulic, methyl p-hydroxybenzoat,

acid caffeic, acid 3,5-dicaffeoylquinic, luteolin 7-O-beta-glucopyranosid v

quercetin 3-O-beta-glucopyranosid c tm thy trong b cng anh c tc dng

chng oxy ha [248].

- Tc dng an thn: B cng anh c th nghim vi phng php lng

c ng th hin tc dng an thn [8].

- Tc dng h ng huyt: Latucain C v lactucasid c tc dng tt i

vi bnh i tho ng [37].

- Tc dng h cholesterol mu: Dch chit methanol ca b cng anh lm

gim nng cholesterol ton phn v LDL-cholesterol trong huyt thanh

chut. Triterpen acetat trong b cng anh c tc dng h cholesterol huyt thanh

[121].

- Tc dng khng virus: Mt s dn xut ca acid quinic v flavonoid c

tc dng chng li virus vim gan B [119].

31

- Tc dng khc: B cng anh c tc dng li mt, nhun trng, tng

cng loi tr cht c, cht gy nhim qua gan thn [2].

Cch dng, liu dng

- Ngy dng t 20g n 40g cy ti p ly nc hoc 8g n 30g dc

liu kh, dng thuc sc, thng phi hp vi cc v thuc khc, p ngoi tr

mn nht, sng v tc tia sa [3], [8].

- Cha sng v, tc tia sa: hi 20 n 40g l b cng anh ti, ra sch,

thm t mui gi nt, vt ly nc ung, b dng p ln ni v sng au.

Thng ch dng 2-3 ln l [10].

- Cha n ung km tiu, hay b mn nht: l b cng anh kh 10 n

15g, nc 600ml (3 bt), sc cn 200ml (1 bt). Ung lin tc trong 3 - 5 ngy,

c th ko di hn [10].

King k

Cc chng m h hoc trng nhc, ung nht v cm dng [3], [7], [8].

Nhn xt

B cng anh c tc dng khng khun, chng vim ph hp vi cng nng

thanh nhit gii c trong YHCT.

Ngoi ra b cng anh cn c tc dng an thn, chng oxy ha, h

cholesterol, h ng huyt, li sa

Cc flavonoid c tc dng sinh hc chnh trong b cng anh.

LIN KIU

(Fructus Forsythiae suspensae)

32

V thuc l qu chn phi hay sy kh ca cy lin kiu (Forsythia

suspensa (Thunb.) Vahl.). H nhi (Oleaceae).

- Tnh v, quy kinh: v ng, hi hn, vo cc kinh tm, m, tam tiu, i

trng [3].

- Cng nng: thanh nhit gii c, tiu sng tn kt [3].

- Ch tr: inh nht, trng nhc, m hch, nh ung, an c (vim qung

), cm mo phong nhit, n bnh vo tm bo st cao gy ho kht, tinh thn

hn m (m sng), pht ban, lm lu km b tiu tin [3].

Thnh phn ha hc

- Nhm lignan nh philygenin, phillyrin (Forsythin), pinoresinol [9],

syrigaresinol Sesamin v fargesin [30], 8-hydroxypinoresinol, 7-epi-8-

hydroxypinoresinol, lariciresinol, isolaraciresinol, olivil, cedrusin [27], glucosid,

matairesinosid, arctigenin, arctiin [9].

- Cc phenolglycosid l forsythosid A, forsythosid C, forsythosid D,

forsythosid E, rutin 3,1% [9], isoforsythiasid [214], lianqiaoxinosid B,

forsythosid H [135].

- Rengyol, cc rengyosid A, B, C, rengyoxyd, rengyolon, cornosid,

salidrosid, suspenol, cafeoylglycosid.

- Tinh du: -pinen, sabinen, -phelandren, -phelandren, -thuyen,

terpinen-4-ol, -terpineol, myrtenal, bornyl acetat, anethol [9].

- 2 monoepoxylignan mi l forsythialan A v B [209], 2 glycosid mi:

suspensasid C v 2,3,5,6-tetrahydro-jacaranon-4-O--d-glucopyranosid [270].

- 4 alcaloid l suspensin A, 7'-O-methylegenin, egenin v bicucullin [50].

Tc dng sinh hc

33

- Tc dng h st: Nc sc lin kiu dng vi liu 4g/kg bng ng

ung th nghim trn th gy st thc nghim, c tc dng h st r rt, thn

nhit sau khi hi phc bnh thng cn c th tip tc gim xung di mc

bnh thng [9].

- Tc dng khng khun: Lin kiu c tc dng c ch Shigella

dysenteria, Salmonella typhi, Bordetella pertussis, Pseudomonas aeruginosa,

Escherichia coli, Staphylococcus aureus [4]. Cc cht forsythosid A, C v D c

tc dng dit khun i vi Staphylococcus aureus nng nh hn 2mM.

Tinh du t ht lin kiu th nghim trn ng knh vi nng 1: 1012 c tc

dng c ch Staphylococcus aureus vi nng 1: 512 c ch cc chng:

Diplococcus pneumonia, streptococcus A, B, Bacillus dysenteriae, B. paratyphi

A v nng 1: 256 c ch Entercoccus. Nc sc hoa qu lin kiu cng c tc

dng c ch cc chng Staphylococcus aureus, Streptococcus hemolyticus,

Bacillus dysenteriae, B. pestis, B. tuberculosis, B. diphtheria [9]. Isoforsythiasid

v forsythiasid c tc dng c ch Escherichia coli, Pseudomonas aeruginosa,

Staphylococcus aureus. 2 cht ny cn c ch Staphylococcus aureus mnh hn

tetracyclin [215]. Lianqiaoxinosid B v forsythosid H c hot ng khng khun

cao i vi 4 loi vi khun ph bin l Bacterium vulgare, Aeruginosus bacillus,

Micrococcus pneumoniae v Bacillus dysenteriae [135]. Phillygenin,

isolariciresinol, phillyrin, forsythiasid v lianqiaoxinsid A c tc dng chng li

8 chng vi khun: Staphylococcus aureus, Escherichia coli, Beta-hemolytic

streptococci, Bacterium vulgare, Aeruginosus bacillus, Micrococcus

pneumoniae, S. albus v B. dysenteriae [136].

- Tc dng chng d ng: Dch chit lin kiu c tc dng chng d ng,

ngn chn phn ng phn v gy ra bi u nnh [76].

34

- Tc dng khng virus: Th nghim trn phi g, tinh du ht lin kiu

vi nng 1: 32 c tc dng c ch s pht trin ca virus cm [9]. Forsythosid

A c kh nng ngn nga nhim trng IBV trn phi g in vitro [156].

- Tc dng khng nm: Th nghim in vitro, tinh du ht lin kiu vi

nng 1: 1024 c tc dng c ch nm Candida albicans v mt s nm khc

gy bnh ngoi da [9].

- Tc dng chng vim: Dch chit cn ca lin kiu tim xoang bng cho

chut cng trng vi liu 20mg/kg, c tc dng chng hin tng thm thu tng

ca cc mao mch vng gy vim thc nghim. Dch tim chit t lin kiu

dng vi liu 3 - 4g/kg (tnh theo dc liu), tim xoang bng cho chut cng

trng c tc dng c ch ph bn chn chut do avalbumin gy nn [9].

Arctigenin c tc dng khng vim ng k l do c ch s tit dch v tng

cng bch cu vo cc m vim. C ch l do c ch sn xut cc cht trung

gian gy vim nh acid arachidonic [106]. Pinoresinol tim mng bng chut b

tn thng gan gy ra bi CCl4 vi liu 50 v 100mg/kg lm tng glutathione

gan v gim lipid peroxy. C ch l c ch TNF-, iNOS v COX-2, NF-B

v ngn chn qu trnh phosphoryl ha c-Jun [115]. Phillyrin ngn chn c tnh

tn thng cp trn phi chut gy bi LPS. C ch lin quan n s c ch

MAPK, NF-B, gim sn xut cc cytokine gy vim (IL-1, IL-6 v TNF-) v

nng myeloperoxidase trong m phi [302]. Rengyolon c tc dng chng

vim, c ch iNOS, COX-2, MAPK p38 v NF-B gy ra bi LPS kch thch

trn t bo RAW 246.7 [116].

- Tc dng chng ung th: Rengyolon gy ra qu trnh apoptosis i vi t

bo ung th mu gy ra bi t bo ung U937 [117]. Suspensasid C v 2,3,5,6-

tetrahydro-jacaranone-4-O--D-glucopyranosid, suspensasid A, acid rengynic-1 '

35

-O--D-glucopyranosid, forsythosid A v acid rengynic c tc dng chng li

cc dng t bo ung th gan, c t cung, i trng, phi [270].

- Tc dng chng oxy ha: Cc lignan tetrahydrofurofuran c tc dng

chng oxy ha. Tc dng ny l do c ch qu trnh oxy ha LDL gy ra bi

Cu2+. Nhng lignan c cha nhm phenol nh Pinoresinol, phillygenin,

syrigaresinol c hot ng chng oxy ha mnh hn probucol, cn lignan khng

cha nhm phenol nh Sesamin v fargesin c hot ng oxy ha km hn

probucol. Nh vy nhm phenolic trong lignan ng vai tr quan trng trong

hot ng chng oxy ha ca cc lignan. Rutin trong lin kiu cng c tc dng

chng oxy ha mnh [31]. Pinoresinol v lariciresinol nng 3,0 M c ch

qu trnh peroxy lipid ca HDL gy ra bi Cu2+ [27]. Isoforsythiasid c tc dng

dn gc t do DDPH [215]. Nghin cu tc dng chng oxy ha ca forsythiasid

v forsythin bng cch s dng gc t do DDPH, kt qu cho thy forsythiasid

c hot ng chng oxy ha mnh hn forsythin [216].

- Tc dng trn lipid: Trn m hnh chut vi ch n nhiu cht bo,

phillyrin c tc dng chng bo ph. Phillyrin lm gim lng cht bo, ch s

cht bo, ng knh t bo cht bo, gim triglycerid v cholesterol trong huyt

thanh chut [298].

- Tc dng chng nn: Nc sc lin kiu dng bng ng ung th

nghim trn b cu, c tc dng c ch nn do tim tnh mch ch phm digitalis

gy nn, trn ch c ch nn do tim di da apomorphin gy nn. Tc dng c

ch nn tng ng vi tc dng ca chlorpromazin sau khi dng thuc 2 gi

[9].

36

- Tc dng li tiu: Dch tim ch t lin kiu (100%) dng vi liu 0,25

g/kg, tim tnh mch cho ch gy m, c tc dng li tiu r rt, sau khi dng

thuc 30, 60 pht, lng nc tiu tng gp 2,2 v 1,6 ln so vi i chng [9].

- Tc dng i vi tim mch: Acid oleanolic chit tch t lin kiu c tc

dng cng tim nh. Dch tim ch t lin kiu dng vi liu 0,25 g/kg tim tnh

mch cho ch gy m, c tc dng h huyt p, dng vi liu 0,5g/kg tim tnh

mch cho th gy m th huyt p h rt nhanh, nhng khng nh hng n h

hp, dng nhiu ln khng c hin tng quen thuc [9].

- Tc dng khc: Cc cht pinoresinol v pinoresinol glucosid c

chng minh c tc dng c ch men c.AMP phosphodiesterase. Cc cht ny c

mi quan cht ch gia cu trc v tc dng, trong cc cht tng t nh

pinoresinol th cu trc ca 2 vng benzen l rt quan trng i vi tc dng gy

c ch trn [9], [194]. Dng cao chit bng chloroform t qu lin kiu cng c

tc dng c ch men phosphodiesterase. Cc cht caffeoylglycosid c tc dng

c ch s hnh thnh acid 5-hydroxy-6, 8, 11, 14-eicosatetraenoic t acid

arachidonic trong t bo xoang bng chut cng trng. Acid oleanolic v acid

ursolic th nghim trn m hnh gy tn thng gan thc nghim bng CCl4, u

c tc dng lm gim s tng cao ca men transaminase [9].

Cch dng, liu dng

Ngy dng t 6g n 15g, dng thuc sc, thng kt hp vi cc v thuc

khc.

King k

Khng dng cho ngi t v h hn, m h ni nhit, nht v song m

long [2], [3].

37

Nhn xt

Lin kiu c tc dng khng khun, chng vim, d ng ph hp vi cng

nng thanh nhit gii c trong YHCT.

Lin kiu c tc dng h st c s dng trong YHCT tr cm mo

phong nhit.

Lin kiu c tc dng chng ung th c ng dng trong YHCT cha

bnh trng nhc (loa lch).

Ngoi ra lin kiu cn c tc dng chng oxy ha, khng nm, virus, h

lipid, cng tim, li tiu, chng nn.

Cc lignan v phenolglycosid l nhng cht c tc dng sinh hc chnh

trong lin kiu.

X CAN

(Rhizoma Belamcandae)

V thuc l thn r phi kh ca cy x can (Belamcanda chinensis L.).

H la dn (Iridaceae).

- Tnh v, quy kinh: v ng, cay, tnh hn c c, vo 2 kinh ph can [2].

- Cng nng: thanh nhit gii c, tiu m, thng kinh hot lc, li niu

[2].

- Ch tr: sng au hu hng, vim hng, vim amian, ho nhit nhiu

m, sng v, b kinh, i tin b kt [2].

Thnh phn ha hc:

- Thn r x can cha tectorigenin, irigenin, tectoridin, 5,3-dihydroxy-4,

5-dimethoxy-6, 7-methylendioxyisoflavon, dimethyltectorigenin, irisflorentin,

38

muningin, cc iristectorigenin A v B, cc cht (6R, 10S, 11S, 14S, 26R-26-

hydroxyl-15-methylidenespiroirid-16-enal, iso-iridogermanal, 28-acetoxy-14,

15-dihydro-26-hydroxyl-19-methyldepenespiroirida-15, 17-dienal,

noririsflorentin (5-hydroxyl, 6,7-methylendioxy-3, 4, 5-trimethoxyisoflavon

[9]; 5,4 '-dihydroxy-6 ,7-methylenedioxy-3'-methoxyflavon v 3 ', 5'-dimetoxy

irisolone-4'-O-beta-D-glucosid [99], rhamnotricin [5].

- Dn cht c cu trc triterpenoid kiu iridal: belamcandal,

desacetylbelamcandal, belamcandol A [4].

- 3 hp cht mi: belallosid A belallosid B v belamphenon [186].

- 12 hp cht c xc nh t thn r x can: neomangiferin, Mangiferin,

tectoridin, iristectorin B, iristectorin A, iridin, tectorigenin, iristectorigenin A,

irigenin, irisflorentin, irilon v dichtomitin [295].

Tc dng sinh hc:

- Tc dng khng khun: Trong th nghim in vitro cao cn thn r x can

c tc dng c ch cc chng vi khun: ph cu, lin cu tan mu, trc khun ho

g, Bacillus subtilis v c tc dng yu i vi chng vi khun: t cu vng,

Shigella dysenteriae, Sh. Shigae, Enterococcus. L x can khng th hin tc

dng c ch cc chng vi khun trn vi liu tng ng vi thn r [9]. X

can c tc dng c ch Shigella dysenteria, Sh shigae, Bordetella pertussis,

Streptococcus pyogenes, Diplococcus pneumonia, Bacillus subtilus [4].

Tectorigenin c tc dng c ch 8 chng vi khun: Escherichia coli, Klebsiella

pneumoniae, Pseudomonas aeruginosa, Proteus vulgaris, Salmonella

typhimurium, Bacillus subtilis, Micrococcus luteus, Staphycoccus aureus [199].

39

- Tc dng chng vim: Thn r x can c tc dng chng vim trong m

hnh gy ph bn chn vi kaolin v gy u ht thc nghim vi amian chut

cng trng v c c tnh thp [9]. Tectorigenin c ch sn xut PGE2 do c ch

s cm ng enzyme COX-2 i thc bo phc mc chut. Tectorigenin c ch

chn lc trn COX-2 m khng c ch COX-1. iu ny cho thy c ch chng

vim ca tectorigenin l c ch sn xut PGE2 chn lc trn COX-2 [218].

Tectorigenin c tc dng c ch hnh thnh ca NO, COX-2, PEG2, IL-1 b

cm ng bi interferon gamma (IFN-)/LPS thng qua biu hin gen. Tc dng

c ch ny l do tectorigenin kha NF-B hot ha i thc bo [204].

Tectorigenin v tectoridin c tc dng c ch sn xut PGE2 v c ch COX-2

i thc bo phc mc chut [127], [79]. Irigenin c ch sn xut NO, PGE2,

iNOS, NF-B, protein v mARN ca COX-2 m khng c mt tc dng gy c

t bo [14].

- Tc dng chng nhim khun: Flavonoid ton phn ca x can c tc

dng c ch yu hot tnh ca men polyphenoloxydase huyt thanh ngi in

vitro. Hot tnh ca men ny trong huyt thanh ngi tng r rt trong cc bnh

nhim khun, trong cc trng thi vim cp tnh hoc mn tnh, trong cc bnh

bch cu, x gan, tng nng tuyn gip [9].

- Tc dng chng d ng: Tectorigenin c ch s biu hin ca receptor

IgE trn t bo mast ca ngi. Receptor ca IgE chnh l cha kha phn t

kch hot cc phn ng d ng thng qua IgE. Receptor ny c 3 tiu n v l ,

, , tectorigenin lm gim s hnh thnh ca tiu n v nn lm gim biu

hin receptor ca IgE. Tectorigenin c pht hin l cht c ch mnh nht

trong s cc cht ca 400 dc liu khc nhau c kho st [232].

40

- Tc dng khng nm: Tectorigenin c tc dng khng nm [5].

Tectorigenin c ch 17 chng nm nh Trichophyton vi MIC: 3,12-6,25 g/ml,

Candida v Saccharomyces vi MIC: 25-50 g/ml [199].

- Tc dng chng oxy ha: Dch chit methanol ca thn r x can cha

cc isoflavonoid c tc dng dn gc t do, lm gim cc ion kim loi v bo v

cc acid bo khng bo ha bi qu trnh peroxy ha. Cc isoflavon c hot tnh

sinh hc chnh l tectoridin v iridin trong cc phn glycosid v aglycon irigenin,

tectorigenin, v 5,6,7,3 '-tetrahydroxy-4'-methoxyisoflavon [254]. Dch chit

thn r x can c tc dng dn gc t do DPPH vi EC50 = 63,4 microg/ml, lm

gim cc ion kim loi, phng nga cc hydroxyl gy ra qu trnh peroxy ha acid

linoleic [255].

- Tc dng bo v t bo gan: Trn m hnh th nghim in vitro v in vivo

chut nhim c gan bi CCl4 , tectorigenin v tectoridin c tc dng bo v

gan. Tectorigenin v tectoridin lm gim men gan v malondialdehyde, lm tng

hot tnh cc enzyme chng oxy ha l superoxide dismutase, catalase,

glutathione peroxidase [145]. Tectorigenin c tc dng bo v t bo gan gy

c bi tert-butyl hydroperoxid [146].

- Tc dng trn bnh i tho ng: Cao chit vi nc nng t thn r

x can vi nng 0,5% x 10-3 mg/ml c hot tnh c ch aldose reductase l

enzyme gy tch ly sorbitol trong t bo. Aldose reductase c vai tr quan trng

trong bnh sinh nhng bin chng ca i tho ng mn tnh nh bnh vng

mc, bnh thn kinh v bnh thn [9], [103].

- Cc tc dng khc: Thn r x can c tc dng chng co tht gy bi

histamin trn c trn rut chut lang c lp, v c tc dng li tiu nh.

Flavonoid ton phn ca x can c tc dng c ch yu hot tnh men

41

polyphenoloxydase huyt thanh ngi in vitro. Hot tnh ca men ny trong

huyt thanh ngi tng r rt trong cc bnh nhim khun, trong cc trng thi

vim cp tnh hoc mn tnh trong cc bnh bch cu, x gan, tng ng huyt.

Nghin cu sng lc trn cao nc thn r x can v hot tnh c ch HIV - 1

protease trong th nghim sinh fluor cho thy nng c tc dng l 25

microgam/ml [9]. Tectorigenin v cc cht khc t dch chit ca thn r x can

c nghin cu tc dng c ch khi u trn chut thc nghim. Kt qu cho

thy tectorigenin c tc dng c ch s tng sinh ca cc t bo ung th tuyn

tin lit. C ch c th do tectorigenin c tc dng sa cha nhng bt thng

trong biu hin mt s gen lin quan n ung th tuyn tin lit [238].

Tectorigenin c tc dng lm gim s tng sinh ca cc t bo HSC-T6 ph

thuc vo thi gian v liu dng. Thm vo , tectorigenin gy ra s cht theo

chng trnh ca cc t bo HSC-T6 v c kh nng chng li s hnh thnh x

[260]. Tectorigenin c ch s tng sinh ca cc nguyn bo si phi v tng

hot ha miR-338* [285]. Tectorigenin c s dng nh gi c tnh cp

v bn cp tnh, tc dng gim au v chng vim. Kt qu: LD50 ca

tectorigenin l 1,78 g/kg chut v khng c triu chng ng c c quan

st liu ln n 300 mg/kg trong mt th nghim c tnh bn cp khi iu tr

trong 28 ngy. Tectorigenin liu 50 v 100 mg/kg c tc dng gim au do

acid acetic gy ra au ni tng cp tnh chut. Trong m hnh vim chut,

tectorigenin 60 mg/kg gim ng k ph do carrageenan gy ra [72].

Cch dng, liu dng

Ngy dng 3 - 6g di dng thuc sc hoc lm vin ngm, ung hoc

dng 10 - 20g thn r ti ra sch, nhng qua nc vi, gi nt vi vi ht

42

mui, vt nc ngm v nut dn, b p ngoi. cha rn cn, dng c cy,

gi nt, thm nc gn ung, b p [9].

King k

Nhng ngi t v h hn khng nn dng [2], [12]. Ph n c thai khng

nn dng [7], [9].

Nhn xt

X can c tc dng khng khun, chng vim, d ng ph hp vi tc

dng thanh nhit gii c trong YHCT.

X can tc dng gim au c s dng cha au bng kinh trong YHCT.

Ngoi ra x can c tc dng chng oxy ha, bo v gan, khng nm, khng

u.

Tectorigenin l cht c tc dng sinh hc chnh ca x can. Cn nghin

cu thm tc dng gim au, chng vim ca tectorigenin, c tnh ca x can.

3.2. THUC THANH NHIT T HA

THCH CAO

(Gymsum fibrosum)

V thuc l cht khong thin nhin c thnh phn ch yu l calci sulfat

ngm 2 phn t nc (CaSO4.2H2O).

- Tnh v, quy kinh: v ngt, cay, tnh hn, vo 3 kinh ph, v, tam tiu [2].

- Cng nng: thanh nhit t ha, thanh ph nhit, gii c chng vim, thu

lim sinh c [2].

43

- Ch tr: phn kh b thc nhit (st cao, ra m hi, li , ming kht),

ph nhit, vim kh qun, kh huyt b nhit thiu t, pht ban, mn nht l lot

[2].

Thnh phn ha hc

Thnh phn ch yu l calci sulfat ngm 2 phn t nc CaSO4.2H2O

(95%). 1 lng nh Al(OH)3, Fe2(SO4)3, MgSO4, SiO2 v lng rt t cc nguyn

t Mn, Pb, Cu, Ba, Sr [85], [279].

Tc dng sinh hc

- Tc dng h st: Thch cao c tc dng c ch trung khu iu ha thn

nhit m sinh ra tc dng thanh nhit, ng thi c ch trung khu m hi do

v thuc va c tc dng h nhit nhng khng lm ra m hi, khng hao tn tn

dch [2], [85], [279].

- Tc dng an thn: Thch cao c ch s hng phn ca thn kinh c nhc

do vy m c kh nng trn kinh chng co git. Tc dng ny l do ion calci sau

khi c hp thu vo mu [2].

- Tc dng trn h min dch: Ca2+ c tc dng lm tng t l thc bo ca

i thc bo nang phi, y nhanh qu trnh thanh thi cc tiu phn bi do n

ng vai tr quan trng trong chc nng sinh l ca thc bo [85], [279].

- Tc dng khc: Thch cao c tc dng cng tim nng long, c xu

hng chng nng khi nng nhit ln chut th nghim [2]. Cho chut s

dng thch cao trong thi gian di s lm gim lng calci tuyn yn, tuyn

thng thn, tuyn di hm, tuyn ty v huyt thanh nhng li tng tuyn c

v lch. chut ct b tuyn gip v tuyn cn gip, thch cao lm tng

lng calci tuyn c nhng lch li gim. Thch cao c th lm tng 1 cht

44

s bi tit mt chut v mo. N cng lm tng lng nc tiu ca chut v

lm gim nhu ng rut [85], [279].

Cch dng, liu dng

Ngy dng t 10 - 36g dng thuc sc (sc trc cc loi thuc khc) [3],

Dng sng cho vo thang thuc, dng ngoi phi rang cho mt nc [1].

King k

Chng h hn khng dng [3]. V nhit thc nhit khng dng [7]. Nhng

ngi yu d dy, yu tim, mch vi t hoc khi b chng dng h th khng

dng [2].

Nhn xt

Thch cao c tc dng h st, an thn, li mt ph hp vi cng nng

thanh nhit t ha trong YHCT.

Calci sulfat (CaSO4) l thnh phn ch yu v c tc dng sinh hc chnh

trong thch cao.

CHI T

(Fructus Gardeniae)

V thuc l qu chn phi hay sy kh ca cy dnh dnh (Gardenia

jasminoides Ellis). H C ph (Rubiaceae) (DD).

- Tnh v, quy kinh: v ng, tnh hn, vo cc kinh tm, ph, tam tiu [3].

- Cng nng: thanh nhit tr phin, lng huyt ch huyt [3], thanh li

thp nhit [2].

45

- Ch tr: st cao, tm phin, nn ra mu, chy mu cam, mt sng au,

dng ngoi tr sng au do sang chn, hong n tiu , i tiu ra mu [3], vim

gan, vim ti mt [2].

Thnh phn ha hc:

- Thnh phn ha hc chnh l cc iridoid glycosid: gardosid, scanzhisid,

geniposid, acid geniposidic, genipingentiobiosid, scandosid methylester,

desacetyl asperulosid methyl ester, gardenosid [5], [8].

- Gardenosid l thnh phn c t l cao (khng di 1,8%), l hp cht

chnh [8].

- Cc acid hu c: acid picrocrocinic, acid dicafeoyl-5-(3-hydroxyl-3-

methyl glutaroyl quinic, acid 3-cafeoyl-4-sinapoyl quinic [8], acid ursolic [150].

- Cc sc t: crocin, crocetin [8].

- Ngoi ra qu DD cn c nonacosan, -sitosterol, D-manitol [5].

- 18 hp cht c phn lp t qu DD: 12 iridoid glycosid, 3

monoterpenoid n vng, 3 glycosid crocetin [207].

Tc dng sinh hc:

- Tc dng h nhit: Dch chit cn qu DD tim xoang bng cho chut

nht trng sau mt gi xut hin tc dng h thn nhit. Tc dng ny ko di

trong nhiu gi [8]. Acid ursolic c trong v qu DD c tc dng h nhit [2].

- Tc dng trn h thn kinh: Cao cn qu DD th nghim trn chut nht

trng tim xoang bng vi liu 5,69 g/kg c tc dng gy trn tnh, lm gim

hot ng t nhin ca chut, c tc dng hp ng vi hexobarbital ko di thi

gian ng, nhng khng c tc dng khng co git do corazol, strychnin v kch

thch in gy nn [8]. Genipin c tc dng hiu qu trong vic ngn nga thoi

46

ha thn kinh trong bnh Alzheimer v bnh Parkinson [269]. Acid ursolic c tc

dng an thn [2].

- Tc dng khng khun, khng nm: Bng phng php c l khuych

tn thuc trong mi trng nui cy, qu DD c tc dng c ch s pht trin

ca t cu khun vng v no m cu. Th nghim trn ng knh, nc ngm qu

DD c tc dng c ch mt s nm gy bnh ngoi da [8]. Dch chit

dichloromethan ca DD c ch Candida albicans; c ch nh vi khun E. coli,

Pseudomonas aeruginosa, Staphylococcus aureus v Trichophyton

mentagrophytes; v c tc dng chng li Bacillus subtilis v Aspergillus niger

[217].

- Tc dng chng vim: Dch chit bng ethanol, methanol t qu DD v

gardenosid c tc dng chng vim [8]. Genipin ngn chn sn xut IL-1 v IL-

6 trong bnh nha chu ngi [223]. Crocin, crocetin, gentiobiosyl glucosyl

crocetin v mono-gentiobiosyl c phn lp t DD lm gim sn xut NO gy

ra bi LPS kch thch trn i thc bo RAW 264.7 vi gi tr IC50 tng ng l

58,9 mM, 29,9 mM, 31,1 mM v 37,6 mM. Cc dn xut crocetin c tc dng

c ch iNOS, protein v m-ARN ca COX-2 trong i thc bo kch thch bi

LPS [81]. Geniposid c tc dng chng vim kch thch trn cc i thc bo

chut bi LPS. Geniposid c ch TNF-, IL-6 v IL-1 gy ra bi LPS in vitro

v in vivo, c ch phosphoryl ha IB, p65, p38, ERK v JNK [63].

- Tc dng trn h tiu ha: Dch chit bng cn t qu, cc cht crocin,

crocetin v genipin u lm tng s phn tit mt. Genipin lm tng s phn tit

mt, lm gim nng acid cholic trong dch mt. Th nghim trn th tht

ng dn mch ch, cho thy cao cn, cao nc ca qu DD, mui natri ca

crocin, crocetin u c tc dng c ch s gia tng bilirubin trong mu. Trn

47

chut cng tht mn v, genipin cho thng vo hong t trng vi liu 25mg/kg

lm gim s phn tit dch v. Genipin c tc dng c ch nhu ng t nhin ca

d dy v c ch co bp do pilocarpin gy nn. Trn tiu bn rut c lp chut

lang, genipin i khng cnh tranh vi tc dng gy co bp ca acetylcholin v

physostigmin [8]. Genipin c ch bi tit acid d dy gy ra bi carbachol,

nhng khng c tc dng c ch vi tetragastrin hoc histamin. Genipin khng

cholinergic v c tc dng li mt ng k v khng nh hng n nng ion

natri, kali, clorua, hoc bicarbonat trong mt [147]. Acid ursolic v genipin c

tc dng trung ha acid, chng oxy ha v c ch vi khun Helicobacter pylori,

gim nguy c acid clohydric v ethanol gy ra tn thng d dy. Acid ursolic

c hot ng gy c i vi t bo ung th d dy AGS v SUN638 [150].

Gardenosid, geniposid u c tc dng gy tiu chy, trn chut nht trng liu

c hiu lc 50% - ED50 ca gardenosid l 300 mg/kg v ED50 ca geniposid l >

800 mg/kg [8].

- Tc dng trn h tim mch: Trn tim ch c lp, dch chit qu DD lm

gim sc co bp c tim. Nc sc qu DD v dch chit cn trn mo, th, chut

cng gy m hoc khng gy m, dng thuc bng ng ung, tim xoang

bng hoc tim tnh mch u c tc dng lm h huyt p. Tc dng h huyt

p ca DD l do tng cng mc hng phn ca khu i giao cm hnh no

[8]. Crocetin v crocin c tc dng h huyt p, tc dng ny l do gim

cholesterol, triglycerid, LDL trong huyt tng [148], [52].

- Tc dng chng huyt khi: Dch chit nc qu DD c tc dng c ch

kt tp tiu cu gy ra bi thrombin/collagen [286]. Genipin vi nng 5mM

v geniposid 7,7mM c ch collagen-kt tp tiu cu in vitro nhng khng c

ch ADP v acid arachidonic. Geniposid c tc dng chng huyt khi in vivo do

48

c ch kt tp tiu cu. C ch c th l do c ch phospholipase A2 [230].

Iridoid glycosid c tc dng chng huyt khi thng qua c ch kt tp tiu cu,

t nh hng n thi gian ng mu ngoi vi. Iridoid glycosid (100 hoc 200

mg/kg) khng c nh hng ng k n thi gian thromboplastin tng phn

hot (APTT) v thi gian prothrombin (PT), nhng ko di thi gian

thrombin (TT) liu cao hn [247].

- Tc dng h cholesterol mu v chng x va ng mch: Trn m hnh

th c nui bng thc n c 1% cholesterol cn crocetin c 2 ngy mt ln

tim bp tht vi liu 50 g/kg, kt qu cho thy hm lng cholesterol trong

huyt thanh l dng thuc gim 50% so vi l khng dng thuc, cn lng

triglycerid l dng thuc vn duy tr c mc bnh thng trong khi l

khng dng DD tng 200% [8]. Crocetin lm gim nng cholesterol ton

phn, triglycerid, LDL trong huyt thanh v c ch s hnh thnh cc mng x

va ng mch [300], [78]. Crocin l thnh phn quan trng ca qu DD vi t

l 2,24%. Crocin lm gim cholesteryl ester v LDL b oxy ha, c ch t bo

bt mi ni, ngn cn s hnh thnh v pht trin ca mng x va ng mch

[77], [303].

- Tc dng h ng huyt: Trn m hnh chut c c tim mng

bng 25mg/kg genipin mi ngy mt ln trong 12 ngy, cho thy genipin lm

tng insulin v h glucose huyt chut. Tc dng ny l do genipin khng ch

ci thin nhy cm insulin bng cch thc y tiu th glucose v tng hp

glycogen, c ch sn xut cc gc t do v gim bt mc in th mng ty th

v ATP, m cn c ch qu trnh stress oxy ha [71]. nhng con chut b i

tho ng type 2, Geniposid ngn cn s tng cn v tch t m ni tng, gim

49

chuyn ha lipid bt thng v gim tch t lipid trong gan. Ngoi ra, geniposid

cn lm gim khng insulin, acid bo t do [130].

- Tc dng chng oxy ha: Dch chit ca DD cha acid chlorogenic v

cc acid dicaffeoylquinic c tc dng chng oxy ha v dn cc gc t do [243].

Cc glycoprotein trong qu DD c tc dng dn gc t do DPPH, lipid peroxyl,

superoxid anion v gc hydroxyl. N ngn chn glucose oxidase/glucose hoc

hypoxanthine/xanthine oxidase gy c t bo v qu trnh apoptosis [152].

- Tc dng gim au: Th nghim trn chut nht trng vi phng php

gy ra qun au bng cch tim acid acetic, cc hot cht genipin, gardenosid v

dch chit nc qu DD u c tc dng gim au, gim mt cch r rt s ln

qun au ca chut [8].

- Tc dng chng virus: Geniposid c tc dng chng li enterovirus 71

[166].

- c tnh: c tnh cp c xc nh trn chut nht trng, LD50 ca

genipin bng ng tim tnh mch l 153 mg/kg, tim xoang bng l 153 mg/kg

v bng ng ung l 237 mg/kg. Th nghim trn chut cng trng, dng cao

cn qu DD dng vi liu 4 g/kg/ngy, hoc gardenosid dng vi liu 250

mg/kg/ngy, trong 4 ngy lin tip th lng microsom - P450 trong t bo gan

gim [8].

Cch dng, liu dng

Ngy dng t 6g n 9g, dng thuc sc. Dng ngoi, sinh chi t lng

thch hp, bi, p [3], thanh nhit dng sng, cm mu sao en [2].

King k

50

Ngi suy nhc, t v h hn, tiu ha km, a chy khng nn dng [2],

[3].

Nhn xt

Chi t c tc dng h nhit, an thn, li mt ph hp vi cng nng thanh

nhit tr phin trong YHCT.

Chi t c tc dng khng khun, chng vim, c ch s gia tng bilirubin

trong mu c s dng cha cc bnh vim gan, vim ti mt, hong n, tiu

, tiu but trong YHCT.

Ngoi ra chi t cn c tc dng h cholesterol mu, chng huyt khi, h

huyt p

Thnh phn chnh trong chi t l cc iridoid glycosid. Genipin, geniposid

l nhng cht c hot tnh sinh hc chnh ca chi t.

HUYN SM

(Radix Scrophulariae)

V thuc l r phi hay sy kh ca cy huyn sm (Scrophularia

buergeriana Miq. hoc Scrophularia ningpoensis Hemsl.). H hoa mm ch

(Scrophulariaceae) (HS).

- Tnh v, quy kinh: v ng, mn, tnh hn, vo 2 kinh ph thn [3], [7].

- Cng nng: t m ging ha, lng huyt gii c [3], [7], tn kt, ch

kht [2].

- Ch tr: st cao, st nng v chiu, vim hng, pht ban, mn nht, mn

nga to bn [3], [7], m kt hch nh bnh loa lch (trng nhc, lao hch), tiu

kht, i tho ng [2].

Thnh phn ha hc

51

- R HS c scrophularin, harpagid, harpagosid, ningpogenin, O-Me

catalpol, angorosid C.

- Ngoi ra, cn c cht I, cht II, 1 cht c cu trc tng t acetosid,

angorosid A, 2-(3-hydroxyl-4-methoxyphenyl), ethyl 1-O-(-L.arabinopyranosyl

(1 6)-feruloyl (1 4)--L.rhamnopyranosyl (1 3)--D-glycopyranosid,

acid cinamic, alcaloid, ng, steroid, acid amin (L. asparagin), acid bo (acid

oleic, acid stearic), tinh du (vt), caroten, 17 nguyn t vi lng [8], ningposid

D, scrophulosid B4 [192].

- 36 hp cht c phn lp: 14 iridoid glycosid, 19 phenylpropanoid

glycosid, 3 acid hu c l acid p-coumaric, acid ferulic, acid cinnamic [278].

Tc dng sinh hc

- Tc dng khng khun: HS c tc dng c ch nhiu loi vi khun gy

bnh da [2], [4], [8].

- Tc dng chng vim: HS c tc dng iu tr tt i vi vim hng mn

tnh. HS phi hp vi sm cau c hiu qu r rt i vi vim hng cp tnh

[8]. Angorosid A, angorosid C v acteosid c tc dng chng vim kch thch

trn cc i thc bo bi LPS. C ch l angorosid A v acteosid c ch PGE2,

NO v TNF- gy ra bi LPS cn angorosid C ch c ch hot ng trn NO

[54]. Acid ferulic bo v tn thng gan gy ra bi CCl4 chut, acid ferulic c

ch TNF-, iNOS, COX-2, NF-B v lm tng nng cc cht c ch NF-B.

Ngoi ra, acid furelic cn c ch phosphoryl ha JNK v MAPK p38 [233].

- Tc dng chng d ng: Dch chit ethanol ca r HS c tc dng c ch

phng thch histamine, -hexosaminidase, TNF- v cytokine interleukin-4.

52

Ngoi ra, iu tr ti ch vi dch chit r HS c tc dng gim vim d ng m

hnh chut do dinitrofluorobenzen gy ra [118].

- Tc dng chng ung th: Nghin cu tc dng chng ung th ca dch

chit nc HS trn cc dng t bo u c tnh, kt qu cho thy dch chit nc

HS c tc dng c ch s sinh si t bo ung th, chng vim v cm ng qu

trnh apoptosis. Acetosid l mt trong nhng cht c tc dng chng ung th

chnh ca HS [221]. Acid Oleanonic v acid ursolonic c ch s pht trin ca

cc t bo ung th v vi IC50 tng ng l 4,6 v 15,5 microM; 4,2 v 14,5

microM trn t bo ung th mu; 14,8 v 44,4 microM trn t bo ung th da;

24,9 v 43,6 microM trn t bo ung th bng quang; 61,3 v 151,5 microM trn

cc t bo ung th phi [192].

- Tc dng trn h tim mch: Cao lng HS c th nghim trn tim ch

c lp vi nng thch hp, lm tng sc co bp c tim v lm chm nhp tim.

Tim tnh mch cho th, n c tc dng gy h huyt p nh v tm thi v kch

thch mnh h hp [8]. Dch chit ca HS lm gim trng lng tm tht tri v

tim, iu chnh li gen ca AT1R, TNF- v mARN TGF-1 trong c tim. N c

tc dng c li i vi qu trnh ti to li tm tht, gim ph i. Tc dng ny

l do c ch angiotensin II v qu trnh x ha tim, iu ha biu hin mt s

gen lin quan n ph i tim [70]. Dch chit ca HS c tc dng h huyt p v

gim x va ng mch. C ch l c ch gii phng cc hormon c tc dng co

mch nh noradrenalin, angiotensin II, thromboxan B2, endothelin-1 [29].

- Tc dng trn h thn kinh: Cc phenylpropanoid c tc dng bo v

thn kinh chng li glutamate gy ra thoi ha t bo thn kinh trong cc t bo

thn kinh v no chut [123], trong c acid Ep-methoxycinnamic l mt

thnh phn quan trng bo v thn kinh trong cc hp cht phenylpropanoid

53

[125]. 4 iridoid glycosid mi c phn lp t dch chit methanol 90% r HS

l: 8-OEP-methoxy cinnamoylharpagid, 8-OZp-methoxy cinnamoylharpagid, 6'-

OEP-methoxy cinnamoylharpagid, v 6 '-OZp-methoxy cinnamoylharpagid v 3

iridoid bit l E-harpagosid, Z-harpagosid v harpagid. 7 hp cht ny lm

gim c tnh ca glutamate gy c t bo thn kinh khi c nui cy trong

cc t bo thn kinh v no chut nng khc nhau, t 100 nM n 10

microM. Kt qu thu c cho thy rng cc iridoid glycosid c tc dng bo v

chng li glutamate gy ra thoi ha thn kinh trong t bo thn kinh v no

chut [124]. Nghin cu hot ng ci thin nhn thc ca E-harpagoside v 8-

OEP-methoxycinnamoylharpagid chut mt tr nh do scopolamin gy ra, kt

qu cho thy E-harpagosid v 8-OEP-methoxycinnamoylharpagid c tc dng

tng cng kh nng nhn thc chut thng qua 2 c ch l c ch

acetylcholinesterase v chng oxy ha [97].

- Tc dng h ng huyt: nh lng ng huyt ca th bng phng

php Denigea, sau tim dung dch HS di da (5ml/kg th trng) sau cch

mi gi nh lng ng trong mu mt ln, lm nh vy 5 ln: Th nghim

trn 4 con th tim HS, thy lng ng huyt thp hn so vi mc ng

trong mu bnh thng l 15mg/100ml mu [10].

- Tc dng khc: HS cn c tc dng an thn, chng co git, tng tit mt,

gim tnh thm mao mch [10]. Dch chit ethyl acetat ca HS c tc dng chng

trm cm [265].

Liu dng, cch dng

Ngy dng 8g - 12g, dng thuc sc [3], [7]. Ti ch, dng l nghin nh

lau v p [8].

54

King k

T v h hn, tiu ha ri lon i tin lng khng nn dng. Khi dng

khng nn s dng cc dng c bng ng bo ch, k v thuc l l [2], [3],

[7].

Nhn xt

Huyn sm c tc dng khng khun, chng vim, d ng ph hp vi

cng nng gii c tiu vim trong YHCT.

Huyn sm c tc dng chng ung th c YHCT s dng lm mm cc

khi u, khi rn trong cc bnh m kt hch nh bnh loa lch.

Huyn sm c tc dng h ng huyt c s dng trong YHCT cha

bnh i tho ng.

Ngoi ra huyn sm cn c tc dng h huyt p, bo v t bo thn kinh.

Harpagid, harpagosid (iridoid) v angorosid C (phenylpropanoid) l nhng

thnh phn c hot tnh sinh hc chnh trong huyn sm.

H KH THO

(Spica Prunellae)

V thuc l cm qu phi hay sy kh ca cy h kh tho (Prunella

vulgaris L.). H bc h (Lamiaceae) (HKT).

- Tnh v, quy kinh: v ng, cay, tnh hn, vo 2 kinh can, m [2], [3].

- Cng nng: thanh can ha, gii c tiu vim, tn kt, li niu, h p [2].

- Ch tr: st cao, au mt , au con ngi, chy nc mt, nht v,

vim tuyn v, trng nhc, bu c, t thp dn n ph n, cao huyt p [2].

Thnh phn ha hc

55

- H kh tho cha alcaloid tan trong nc, mui v c 3,5% (ch yu l

KCl), tinh du c cha camphor, D - fenchon, t alcol fenchilic, mt glucosid

ng l prunelin phn khng ng acid ursolic, delphinidin, cyaniding.

- 2 cht ursan glucosid pruvulosid A v B cng cc hp cht nigaichigosid

F2, sericosid, quercetin, quercetin-3-glucosid, kaempferol-3-O-glucosid v hn

hp nigaichigosid F1 v arjunglucosid I.

- Tinh du chit t qu c 17 thnh phn, trong acid hexadecanoic CH3-

(CH2)14-COOH l ch yu chim 17,16% [8]

- 4 acid hu c: acid caffeic, acid rosmarinic, acid ursolic v acid

oleanolic [58].

Tc dng sinh hc

- Tc dng khng khun: HKT c tc dng c ch vi lin cu khun, trc

khun m xanh, l trc khun, trc khun thng hn, i trng [2]. Dch chit

HKT c tc dng khng khun i vi Streptococcus agalactiae, Streptococcus

oralis, Streptococcus intermedius, Streptococcus gordonii, khng c tc dng c

ch i vi Staphylococcus aureus v Enterococcus faecalis [211].

- Tc dng khng virus: Dch chit nc HKT c tc dng c ch virus

HIV, c ch giai on u trong vng i ca virus HIV [197], v giai on hp

thu v phin m ngc ca virus HIV [105]. Dch chit nc HKT c tc dng

c ch virus herpes simplex-1 v -2 (HSV-1, HSV-2) [38], [196], [294]. Ngoi ra

n cn c ch virus vim gan B [299].

- Tc dng khng nm: Hai acid polyacetylenic c phn lp t HKT c

tc dng c ch sinh trng ca Magnaporthe oryzae, Rhizoctonia solani,

56

Phytophthora infestans, Sclerotinia sclerotiorum, Fusarium oxysporum f. sp.

raphani, v Phytophthora capsici [276].

- Tc dng chng vim: Dch chit ca HKT c tc dng chng vim kch

thch bi LPS trn i thc bo RAW 264.7. C ch l c ch NO, PGD2, iNOS,

mARN ca COX-2, TNF-, NF-B [92]. Acid rosmarinic c tm thy trong

HKT c hot ng chng vim do c ch COX-2 [90]. Nghin cu tc dng

chng vim ca dch chit HKT v acid rosmarinic trn nguyn bo si nu

rng ngi kch thch bi LPS. Dch chit HKT (5, 10, 25 microg/ml) v acid

rosmarinic (1 microg/ml) c ch IL-1, IL-6, TNF-, iNOS [284].

- Tc dng chng ung th: Dch chit HKT c ch s tng sinh ca cc t

bo ung th hch bng cch gy ra qu trnh apoptosis. C ch gy ra apoptosis

lin quan ti cc protein bcl-2 v bax [62]. Dch chit nc ca HKT c ch t

bo ung th biu m gan bng cch c ch metalloprotease: MMP-2 v MMP-9.

HKT c ch cc t bo ung th bng cch c ch hot ng ca cc enzyme

MMP-2 v MMP-9 giai on phin m v tc ng lm tng nng p53

trong t bo ung th biu m gan [122]. Acid ursolic c tc dng c hi vi

nhng t bo P-388 trong bnh bch cu lympho v vi t bo A-549 trong bnh

ung th biu m phi. N cng c tnh cht c hi i vi nhng t bo HCT-8

trong ung th kt trng v Mcf-7 trong ung th v ngi [8]. Acid oleanolic c

tc dng gy ra qu trnh apoptosis trong t bo ung th phi bng cch tng

biu hin protein bad, bax cn bcl-2 th gim [59]. Acid rosmarinic c ch s di

cn xng t ung th v [266]. Polysaccharid trong HKT c tc dng chng ung

th phi [61].

- Tc dng chng oxy ha: Phn hu c ca dch chit HKT c tc dng

dn gc t do DPPH, c ch qu trnh oxy ha LDL, bo v t bo gan v ty th

57

chut khi tip xc vi tert-butyl hydroperoxid, hoc ion Cu2+ v Fe3+ [212].

Dch chit HKT c tc dng lm tng nng cc enzyme chng oxy ha trong

mu v gan, gim nng lipoprotein trng lng rt thp (VLDL) chut tng

triglycerid mu [225]. Dch chit ethanol 60% ca HKT c tc dng lm tng

hot tnh enzyme superoxide dismutase, gim nng malondialdehyde trong

huyt thanh. Kt qu ny cho thy dch chit ethanol HKT c hot ng chng

oxy ha in vitro, in vivo. Cc phenol nh acid caffeic, acid rosmarinic, rutin,

quercetin c tc dng chng oxy ha chnh [60].

- Tc dng trn h min dch: Dch chit nc HKT c tc dng kch thch

s sinh si t bo lympho T, c ch sn xut NO kch thch bi LPS trong cc

i thc bo [75].

- Tc dng h huyt p: HKT c tc dng h huyt p kh mnh trn ng

vt bnh thng hoc c gy tng huyt p thc nghim, ng thi c tc

dng co mch. Tc dng ny khng b nh hng bi atropin. Cc cht tan trong

nc ca HKT c tc dng h huyt p lu di trn bnh nhn v lm ht cc

triu chng tng huyt p [8].

- Tc dng khc: Cc cht tan trong nc ca HKT, tim tnh mch cho

th, gy h huyt p, kch thch h hp v c tc dng li tiu. HKT c tc dng

an thn. Cao ton phn v b phn khng th x phng ha ca ton cy HKT

khng c tc dng kch thch hot tnh thc bo ca h li-ni m chut nht

gy nhim vi Escherichia coli [8]. Acid triterpenic t HKT c tc dng tt i

vi bnh tiu ng, bng cch kim sot lng ng trong mu, cht chng

oxy ha v bo v tuyn ty [304]. HKT ngn chn s pht trin x va ng

mch bnh i tho ng type 2 [91].

Cch dng, liu dng

58

Ngy dng 9 - 15g. Dng thuc sc [3], [7].

King k

Ngi m h, v yu khng c ut kt khng dng [2], [12].

Nhn xt

H kh tho c tc dng khng khun, chng vim ph hp vi cng nng

thanh can ha, gii c tiu vim trong YHCT.

H kh tho c tc dng chng ung th ph hp vi cng nng tn kt

cha cc bnh trng nhc, bu c trong YHCT.

H kh tho c tc dng li tiu, h huyt p c YHCT s dng lm

thuc cha t thp dn ti ph n, cao huyt p.

TRI MU

(Rhizoma Anemarrhenae)

V thuc l thn r phi hoc sy kh ca cy tri mu (Anemarrhena

aspholedoies Bunge). H bch hp (Liliaceae).

- Tnh v, quy kinh: v ng, ngt, tnh hn, vo cc kinh ph, v, thn [3],

[7].

- Cng nng: thanh nhit, t ho, tr phin ch kht, nhun to [3], [7].

- Ch tr: nhit bnh c st cao kht nc, ph thn m h c ct chng,

tro nhit; ni nhit tiu kht, rut ro to bn [3], [7], tr tiu kht (i tho

ng), i tin b kt [12].

Thnh phn ha hc

- Thn r tri mu cha nhiu saponin v sapogenin steroid, ch yu l

sarsasapogenin cng vi cc sarsasapogenin glycosid [9].

59

- Cc timosaponin: timosaponin A-I, timosaponin A-II, timosaponin A-III,

timosaponin A-IV, timosaponin B-I, timosaponin B-II, timosaponin B-III [9],

timosaponin E, timosaponin J, timosaponin K, timosaponin L [107], timosaponin

E1, timosaponin E2 [180].

- Saponin v sapogenin steroid: anemarsaponin F, anemarsaponin G, nhiu

furostanol saponin trong c anemarsaponin B, anemarsaponin C,

anemarsaponin E [9], anemarrhenasaponin I, anemarrhenasaponin III,

anemarrhenasaponin A [107].

- Cc cht nhm khc:

+ Nhm norlignan: hinokiresinol, oxyhinokiresinol [9], nyasol,

methylnyasol [95].

+ Nhm glycan: anemaran A, anemaran B, anemaran C, anemaran D.

+ Nhm cc cht khc: nonacosanol, acid octacosanoic [9].

Tc dng sinh hc

- Tc dng h st: Tri mu c tc dng h nhit [2], [9].

- Tc dng khng khun, khng nm: Tri mu c tc dng c ch kh

mnh vi t cu khun, lin cu khun, trc khun i trng v hn 10 loi vi

khun khc [2]. Nyasol c tc dng c ch 38 chng nm nh aspergillus sp.,

candida sp., Penicillium sp., Trichophyton sp. v 5 chng vi khun Bacillus

subtilis, Escherichia coli, Proteus vulgaris, Pseudomonas aureginosa,

Staphylococcus aureus. Nng c ch ti thiu (MIC) dao ng t 12,5 - 200

microg/ml [94].

- Tc dng chng vim: Dch chit ethanol 80% ca thn r tri mu c ch

s biu hin ca cc cytokine gy vim nh TNF-, IL-1, IL-6, c ch NF- B,

60

COX-2, iNOS kch thch bi LPS trn i thc bo rut [96]. Nyasol c tc dng

chng vim. C ch l c ch sn xut NO, PGE2, mARN ca TNF- v IL-1

kch thch bi LPS trong cc t bo microglial [144].

- Tc dng chng ng mu: Tri mu c tc dng c ch kt tiu cu [9],

cc timosaponin l thnh phn chnh c tc dng ny [180]. Timosaponin B-II

liu 20, 40 v 80 mg/mL c tc dng c ch ADP. Timosaponin B-II ko di thi

gian thromboplastin hot ha tng phn (APTT), nhng khng nh hng ti

thi gian prothrombin (PT) [172]. Cc glycosid steroid cng c ch kt tp tiu

cu do c ch ADP [107].

- Tc dng chng ung th: Tri mu c ch s sinh si ca cc dng t bo

ung th d dy MKN45 v Kato-III v gy ra qu trnh apoptosis. Tc dng ny

lin quan n vic phng thch cytochrome c t ty th v s gia tng hot ng

ca caspase-3 [231]. Nghin cu tc dng chng ung th ca sarsasapogenin trn

t bo ung th gan ngi, cho thy sarsasapogenin gy ra qu trnh apoptosis

bng cch tc ng ln pha G2/M trn chu k t bo [20]. Timosaponin A-III c

ch s sinh si ca cc t bo ung th. C ch lin quan ti s tc ng trn pha

G0/G1 v pha G2/M1 ca chu k t bo v cm ng qu trnh apoptosis [109].

- Tc dng chng long xng: sasapogenin c tc dng ngn chn cc

acid retinoic gy long xng. Tc dng ny l do sarsapogenin ci thin hot

ng hormon estrogen v c ch qu trnh hy xng [271]. Cc saponin steroid

c tc dng ngn nga mt xng chut bng cch thc y qu trnh hnh

thnh xng [193].

- Tc dng h ng huyt: Cao chit vi nc-methanol t thn r tri

mu c tc dng h ng mu trn chut nht trng [9]. 4 glycan l anemaran

A, B, C v D c tc dng h ng huyt c ngha trn chut nht trng bnh

61

thng v chut nht trng gy tng ng huyt bng alloxan [9]. Trn m hnh

chut mc bnh tiu ng do streptozotocin gy ra, dch chit ethanol 60% ca

thn r tri mu lm tng hot tnh ca cc enzyme Superoxide Dismutase (SOD),

glutathione peroxidase (GSH-Px), gim nng glucose v malondialdehyde

trong huyt thanh chut. Mangiferin v neomangiferin l thnh phn chnh c

ch s tin trin bnh tiu ng [158]. Mangiferin v glucosid ca n lm h

ng huyt bng cch gim khng insulin [93], [183], [184].

- Tc dng khc: Nc sc lng va c th gy t lit trung khu h hp,

h huyt p, lng ln c th lm tim b t lit [2]. Phn on saponin t thn r

tri mu v sn phm thy phn sarsasapogenin cng nh dn cht hemisucinyl

u c tc dng c ch mnh trn Na+/K+ ATPase v lm gim lng oxy thu

nhn trong gan c x l vi thyroxin. Tc dng c ch ca dn cht

hemisucinyl cn mnh hn c tc dng ca ouabain. Sarsasapogenin cng c ch

Na+/K

+ ATPase ca hng cu ngi invitro. Tc dng c ch pht trin chm v

c th tng ln do ion natri t bn ngoi v i khng bi ion rubidi t bn

ngoi. Tc dng c ch trn ATPase c th lin quan vi tc dng h st ca

sarsasapogenin [9].

Cch dng, liu dng

Ngy dng 6 - 12g, dng thuc sc hoc hon tn. Thng phi hp vi

cc v thuc khc [3], [7].

King k

Ngi h hn khng nn dng [3], [7]. Khng dng tri mu cho nhng

ngi t h phn nt. Hoc nhng c a biu chng cha c gii [2].

Nhn xt

62

Tri mu c tc dng h nhit ph hp vi cng nng thanh nhit t ha

trong YHCT.

Tri mu c tc dng h ng huyt c YHCT s dng iu tr bnh i

tho ng.

Tri mu c tc dng li tiu nn dng cha bnh tiu tin b trong YHCT.

Ngoi ra tri mu cn c tc dng chng ung th, kt tp tiu cu v long

xng.

Saponin l thnh phn chnh v c tc dng sinh hc chnh trong tri mu.

3.3. THUC THANH NHIT GII TH

H DIP

(Folium Nelumbilis)

V thuc l l sen, thng dng dng ti ca cy sen (Nelumbo

nucifera Gaertn). H sen (Nelumbonaceae).

- Tnh v, quy kinh: v ng, tnh bnh, vo 3 kinh can, t, v [2].

- Cng nng: thanh nhit gii th, kh ch huyt [2].

- Ch tr: cm th bi th nhit gy ra au u, au rng, ming kh, hng

kht, tiu tin ngn , xut huyt [2].

Thnh phn ha hc

- Flavonoid: catechin, quercetin, quercetin-3-O-glucopyranosid, quercetin-

3-O-glucuronid, quercetin-3-O-galactopyranosid, kaempferol-3-O-

glucopyranosid v myricetin-3-O-glucopyranosid [261].

63

- Alcaloid: nuciferin, nornuciferin, caaverin, armepavin, norarmepavin,

isoliensinin v pronuciferin [55], 2-hydroxy-1-methoxyaporphin, roemerin

[174].

Tc dng sinh hc

- Tc dng h ng huyt: Dch chit l sen c tc dng kim sot ng

huyt nhng bnh nhn i tho ng khng ph thuc insulin bng cch

tng tit insulin [88]. 2-hydroxy-1-methoxyaporphin v pronuciferin c tc dng

kch thch hot ng ca insulin, lm h ng huyt [174].

- Tc dng trn chuyn ha lipid: Trn m hnh ng vt th nghim b

gan nhim m do ru, polyphenol trong dch chit l sen c tc dng chng

vim, ngn nga vim gan nhim m, gim tng hp lipid [234]. Dch chit l

sen lm gim trng lng c th, tch t lipid v cc hot ng ca acid bo

[256].

- Tc dng chng oxy ha: Dch chit methanol ca l sen c tc dng dn

gc t do v gc hydroxyl [261]. Quercetin v glycosid ca n (quercetin-3-O-

glucopyranosid, quercetin-3-O-glucuronid, quercetin-3-O-galactopyranosid) c

ch mnh qu trnh oxy ha LDL, myricetin-3-O-glucopyranosid c tc dng

dn gc t do DPPH mnh m. Tc dng chng oxy ha ca l sen lin quan n

flavonoid ca n [163].

- Tc dng khc: Flavonoid v alcaloid c trong l sen c tc dng chng

li virus HIV [110].

Cch dng, liu dng: 4 - 12g (l kh), ti 40 - 80g [2].

Nhn xt

Trong YHCT h dip c s dng vi cng nng thanh nhit gii th.

64

H dip c tc dng sinh hc chnh l gim lipid, h ng huyt, chng

oxy ha. H dip c ch trong vic iu tr bnh bo ph, i tho ng.

Flavonoid l thnh phn c tc dng sinh hc chnh trong h dip.

DA HU

(Endocarpirum Citrulli, Pericarpium Citruli)

V thuc l rut qu v v qu cy da hu Citrullus vulgaris Schrad,

C.lanatus (thumb) Matsum et nakai. H b (Cucurbitaceae).

- Tnh v, quy kinh: v ngt nht, tnh hn, vo 2 kinh tm, v [2].

- Cng nng: thanh nhit gii th, thanh nhit li niu [2].

- Ch tr: thng th, ra nhiu m hi, tm phin, ming kht, thp nhit,

hong n, bng trng, i but, i rt [2].

Thnh phn ha hc

- Qu da hu chn c ti 50-70% phn n c. 100g tht qu cha nc

90g, protein 0,7g, m 0,1kg, ca