麻黄附子细辛汤是中医治疗缓慢性心律失常的常用方剂,其作用机制有多种观点,众多研究认为这种抗心律失常药理作用是通过调节心肌细胞膜各离子通道完成的。目前研究表明麻黄主要有效成分麻黄碱可分别通过KCNQ1/KCNE1通道和cAMP/PKA途径刺激钾、钙通道激活;附子主要有效成分乌头碱及去甲乌头碱均可通过调节心肌细胞膜钠、钾、钙电流而影响心肌兴奋性和传导性;而细辛的有效成分β-细辛醚则可通过阻滞钙通道而扩张冠脉,并可激活心肌细胞膜钠通道而发挥强心作用。该文将针对这三种药物作用于心肌细胞膜离子通道调节机制、临床研究的不足等问题做一总结。
Aconite and Asarum is the commonly used prescription of TCM treating bradyarrhythmia,there are many views for this mechanism,numerous studies have considered that this kind of anti-arrhythmic pharmacological action was done through the regulation of myocardial cell membrane ion channel.The present study suggests that ephedrine,the main effective component of ephedra,respectively by KCNQ1/KCNE1 channel and cAMP/PKA way to activate potassium,calcium channel;Aconitine and higenamine,the main effective component of monkshood,can affect myocardial excitability and conductibility by regulating the sodium,potassium, calcium current of myocardial cell membrane;β-asarone,the effective components of asarum,can dilate coronary artery by blocking calcium channel and play a role of strong heart by activate the sodium channel of myocardial cell membrane. This text will forcus on the adjustment mechanism of the three herbs on myocardial cell membrane ion channel and the lack of clinical research to make a summary.