Intravenous injection of Shengmai injection can quickly and comprehensively improve the hemodynamic parameters of hemorrhagic shock animals and promote the improvement of shock state. Its action intensity is obviously stronger than that of normal saline group, and there is no significant difference between it and mannitol group, but its anti-shock effect lasts longer than that of mannitol group. And its anti-shock effect has a certain dose-effect correlation. Sufficient intravenous injection of Shengmai injection can obviously delay the blood pressure drop of toxic shock animals, and also has obvious protective effect on animal death after endotoxin attack, but it has no protective effect on animal body temperature drop. Shengmai injection can obviously reduce the mortality of animals infected by Shigella, which shows that Shengmai injection has obvious anti-infection effect on Shigella infection. Shengmai injection has no bacteriostatic effect, but it has obvious antagonistic effect on the increase of capillary permeability caused by histamine or a certain dose of 60co irradiation, which shows that Shengmai injection has anti-inflammatory effect. Shengmai injection can obviously activate the phagocytic function of normal and tumor-bearing monocyte-macrophage system, and can resist the inhibition of endotoxin on phagocytic function of macrophages, promote humoral immunity and improve cellular immunity through IgE pathway, so that the immune function of the body is relatively activated. Shengmai injection can significantly improve the level of endogenous glucocorticoid in experimental animals and healthy people, especially in the case of infection stress and adrenal insufficiency. On the other hand, Shengmai injection can also reduce the level of PGE in the plasma of experimental animals, which is very important for maintaining the tension of vascular smooth muscle and reducing inflammatory reaction. Shengmai injection is suitable for the treatment of angina pectoris of coronary heart disease with deficiency of both qi and yin. It has the advantages of quick onset, safety and reliability, long duration, superior to nitroglycerin, convenient use and easy popularization, and no obvious toxic and side effects have been found in clinical application.
Clinical and experimental studies show that the main mechanism of Shengmai injection is: 1. Increase coronary blood flow and myocardial nutrient blood flow, improve myocardial ischemia, regulate myocardial metabolism, reduce myocardial oxygen consumption and energy consumption, and improve hypoxia tolerance. It can promote DNA synthesis, accelerate its repair, regulate blood pressure, inhibit ATPase activity of myocardial cell membrane, enhance myocardial contractility, increase cardiac output and improve left ventricular function. 2. Reduce blood viscosity and platelet aggregation, reduce fibrinogen, promote fibrinolysis, inhibit thrombosis, and improve hemorheology and microcirculation. It can improve hemodynamic parameters rapidly and comprehensively, and has the effect of resisting hemorrhagic shock. Delaying endotoxin-induced shock, obviously improving high-shear and low-shear whole blood viscosity, and having anti-toxic shock effect. It can significantly resist the increase of capillary permeability and has non-specific anti-inflammatory effect, and significantly improve the level of endogenous glucocorticoid, especially under the condition of insufficient adrenal cortex function under infection stress. 3. Reduce plasma PGE level, maintain vascular smooth muscle tension, reduce inflammatory reaction, activate phagocytosis, inhibit humoral immunity mediated by lgE, and significantly improve cellular immune function, vitality and liver energy metabolism. 4. Clinical symptoms, routine hematuria, liver and kidney function and electrocardiogram observation show that Shengmai injection has no toxic and side effects. Only a few patients feel dry mouth and can relieve themselves without any treatment.
Indications: Supplementing qi and nourishing yin, quenching thirst and resolving stagnation, astringing sweat and dredging pulse. Can be used for treating cardiothoracic colic, dizziness, palpitation, weak pulse, excessive sweating and thirst, dyspnea, red tongue with scanty fluid, and weak or thin pulse. Mainly used for angina pectoris, hemorrhagic, septic shock, arrhythmia, myocarditis, hypotension and other diseases. 1. 2 19 cases of coronary heart disease and angina pectoris were treated with this product. The results show that the effective rate of pain relief is 95%, the remission rate of syndrome is 93.6%, the reduction rate of nitrate ester is 665438 0.5%, and the improvement rate of ECG ischemia is 68.5%, which also has a good effect on improving hemorheology. 2. 37 cases of septic shock were treated with this product, supplemented by comprehensive measures such as correcting electrolyte disorder, relieving brain edema and improving ventilation and ventilation function. Results 24 cases were stable and 3 cases were enhanced/kloc-0, all of which were effective; 3. 36 cases of epidemic hemorrhagic fever were treated with this product, which has the functions of strengthening the heart, boosting blood pressure, resisting shock, regulating blood volume, shortening the course of disease and reducing complications; 4. 78 cases of arrhythmia caused by various reasons were treated by intravenous drip of this product combined with Danshen injection, and the total effective rate was 89.8%; 5. 76 cases of viral myocarditis were treated with this product, and 54 cases were markedly effective. The total effective rate was 89.5%, which was significantly higher than that of the control group treated with Energy Mixture (79.2%). 6. Treating 5 cases of cor pulmonale/kloc-0 can significantly improve arterial oxygen partial pressure and blood oxygen saturation, and has a good effect on improving hypoxemia in patients with cor pulmonale. Yiqi Yangyin, Fumai Sanjie. Can be used for treating palpitation, shortness of breath, cold limbs, hyperhidrosis, cardiac arrest, cardiogenic shock and septic shock caused by deficiency of both qi and yin.
Toxic and side effects of Shengmai injection
According to the clinical data collected by the director of pharmacy department of Xijing Hospital of the Fourth Military Medical University, the adverse reactions of Shengmai injection mainly include the following:
Take allergic skin rash as an example. When the patient was treated with Shengmai injection due to mitral stenosis, mild prolapse of mitral valve and premature ventricular contractions, red maculopapules with small blisters appeared on the surface of his fingers, hands, neck and face. The patient's lips and laryngeal mucosa were slightly edematous. The doctor immediately gave 500 ml glucose injection and dexamethasone intravenous drip, diphenhydramine and vitamin C colloidal calcium intramuscular injection, and took a large amount of vitamin C orally for 3 days, and the rash completely subsided.
For example, a female patient developed dizziness, fatigue, insomnia, palpitation and other symptoms, and was slowly injected with Shengmai injection through vein. When injecting about 20 ml, the patient suddenly felt low back pain, and continued to push the medicine, which aggravated the pain, that is, stopped pushing the medicine, and the pain improved after about two minutes, and disappeared after a short rest. Push another 5 ml, and the above situation appears again.
Abdominal distension Some patients with coronary heart disease have abdominal distension after intravenous infusion of 80 ~ 100 ml Shengmai injection. When it drops to 60 ml, the abdominal distension is still unbearable, and when it drops to 40 ml, the abdominal distension disappears.
Regarding the causes of adverse reactions, Fan and others believe that the main reasons are:
First, the composition is complex. Shengmai injection is mainly composed of red ginseng, Ophiopogon japonicus and Schisandra chinensis.
Ginseng Rubra, a Chinese patent medicine, is a kind of ginseng, and its effective component is ginsenoside, which has the functions of strengthening heart, regulating blood pressure, improving circulation, promoting substance metabolism and protein synthesis. Ophiopogon japonicus saponin is an effective component of Ophiopogon japonicus, which has the functions of improving myocardial contractility and heart pump function, protecting myocardium, resisting arrhythmia, resisting hypoxia, lowering blood sugar and resisting bacteria. The effective component of Schisandra chinensis is schisandrin A, which has the functions of enhancing liver detoxification and promoting liver protein and glycogen biosynthesis. The curative effect of Shengmai injection is reflected by the interaction and synergy of these three drugs, and its adverse reactions are also a comprehensive reflection of many factors.
Second, individual differences. Due to the differences in constitution, sex, age and pathological state, patients have different sensitivities to drugs, which leads to different reactions to drugs. Generally speaking, patients with weak constitution or a history of multiple drug allergies should use drugs with caution. Traditional Chinese medicine injection contains protein, sugar and other substances, which can stimulate the body to produce corresponding antibodies after entering the body, so a few people with allergic constitution are prone to allergic reactions after taking the medicine.
Third, the production process is unreasonable. Unreasonable preparation technology will increase the toxic components in Chinese patent medicine and reduce the content of effective components. Impurities that are not completely removed in the preparation process, such as sugar, will cause adverse reactions.
4. Storage and transportation do not meet the requirements. During the transportation and storage of Shengmai injection, environmental factors (such as temperature, humidity, ultraviolet rays, oxygen, etc. ) can change its quality to a certain extent.