PHN 1: TNG QUAN

1. Lch s pht trin Nm 1250, mc d digitalis, hoc dng a hong, c miu t trong cc ti liu y hc ca cc thy thuc Welch cng nh digitalis c cp n cy hnh bin bi ngi Aicp c i. H nhn thy tim nng y hc ca n. C dn thnh Roma cng s dng dch trit cy ny cho rt nhiu mc ch bao gm thuc b tim v gy c chut. Vo gia th k 16, Fuchsius i tn thc vt digitalis purpurea thnh cy dng a hong, nhng l kh l ngun chnh thc ca digitalis. Digitalis latana l ngun cy thc vt khc ca cc glycosid tim. Digitalis c bit l 1 thuc y hc quan trng nm 1785 khi William Withening miu t s hu ch ca n trong bnh ph n. Cho n nm 1799 khi John Ferriar nhn thy tc dng trn tim (tc dng ch yu) v tc dng li tiu (tc dng th yu) ca digitalis. Ban u v ngay c hin nay thuc c dng iu tr rung nh c hiu, nhng vic tm ra hiu qu ca thuc nh mt thuc tng co c qua nhiu thp k, mc d tri qua hn 200 nm s dng v nhiu nhng th thch v hiu qu ca n. 2. Cu trc ha hc Xt v mt cu trc ho hc, glucozit cng tm cng nh cc glucozit khc, u c mt phn ng v mt phn khng ng. 2.1. Phn genin

Phn genin ca glycozit tim c cu trc 5 vng A, B, C, D, F. Vng F l mt vng lacton hoc gn vi C17. Da vo vng lacton ngi ta chia thnh hai nhm chnh: - Cacdenolit (I), genin c vng - lacton -, -khng no ( cn gi l butenolit) - Butadienolit (II), genin c vng - lacton khng no vi 2 ni i (cn gi l pentenolit) Cu trc cc genin ca glycozit tim c th khc nhau 3 im:

+ Cu hnh C3, C5 hoc C17 ( hoc ) + C th thm nhm chc cha oxi, ch yu l nhm OH Ti C 1, C2, C5, C11 ,C12 , C15 , C16 , v C19 + C th c cc lin kt i trong khung, thng l vng B 2.2. Phn ng

Phn ng ca glycozit tim kh phc tp. C 3 loi ng ng thng thng ( v d Glucozo, Rhamnozo, Xylozo) ng 2-deoxy: l ng khng c oxi v tr s 2. Loi ny kh ph bin trong glycozit tim ( v d Digitosozo, Oleandrozo) ng c bit Trt t lin kt ca glycozit tim nh sau: Genin gn trc tip vi vi phn t ng 2-deoxy hoc ng c bit, tip n l mt vi phn t ng thng thng, nht l glucozo gn vo cui mch Genin (ng 2-deoxy hay ng c bit)n -(glucozo)n Tc dng ch yu ca glycozit tim ch yu do genin, nhng phn ng c nh hng n tan, s phn b c trng ca thuc trong c th, s tch ly v s thi tr thuc v c tnh. 3. Tnh cht ca glucozit tim: Glucozit cha tim u l nhng cht c tc dng quang hc, c th kt tinh hoc v nh hnh, v ng Mt s glucozit tan trong nc. Mt s khng tan m tan trong cc dung mi hu c. tan trong nc t l thun vi chiu di ca phn ng. Glycozit tim l nhm glycozit c cu trc steroit, c tc dng c hiu i vi tim. Nhng liu cao chng tr nn gy c, dn n cht ngi. Trong cy glycozit tim tn ti dng glycozit ha tan trong dung dch t bo. Di tc dng ca men hoc axit long, cc glycozit b thy phn to thnh genin v cc ng. L glycozit nn chng d tan trong nc v cn long, rt t tan trong cc dung mi khng phn cc hoc phn cc yu nh ete, ete du ha, benzen...Trong dung dch nc cc glycozit tim lm gim sc cng b mt ca dung dch v to bt khi lc mnh.

Glucozit cng tim thng gp trong cc h thc vt hoa mm ch, trc o, hon lin gp trong cc b phn khc nhau ca cy. d ca c hnh bin: Bulbus scillae, thn r: Hellebosis, r: Apocynium; ca v cy: Periploca greca; l: Trc o, ht: Thng thin, vi voi T l hot cht thng rt thp v phn b khng u trong nhng b phn khc nhau trong cng mt cy. Nhng glucozit gp trong cng mt cy thng ch khc nhau rt t v cu trc ho hc. Nhng glucozit cha tim cho mt s phn ng chung do phn genon hoc phn ng. - Phn ng do phn Genon + Phn ng Legal: Ho tan glucozit trong pyridin hoc trong cn mi trng kim NaOH s cho mu nht khi cho thm 0,5% Natrinotro prussiat. + Phn ng Kiliani Ho tan glucozit vo 2-3ml axits axetic c sn vi git clorua st 3. Thm mt th tch tng ng H2SO4 m c. Mt tip xc gia 2 dung dch ny s c mu nu, v sau ton dung dch s ng mu xanh l. Tc dng ca glucozit cha tim: Ni chung l rt c. liu lng rt nh (liu iu tr) c tc dng iu ho li nhp p ca tim v lm tng nhp p ca tim, do dng tr tim trong cng tc iu tr. Nhn dn cn dng cc loi tn c c tm glucozit cng tim trong qu trnh sn bt th rng. Trong chn nui, nhng cy c glucozit c, trnh khng cho gia sc n ln phi.

PHN 2: MT S CY C CHA GLUCOZIT TIM

1. Cy Hnh Bin

Tn khoa hc: Urginea maritima (L.) Bak.), thuc h Hnh bin Hyacinthaceae. M t: Cy tho mc thng sng nhiu nm cao 18-20cm, c c to 10-15cm, mu nu o nhiu l vy kt hp. L hp, di 30-40cm hay hn, khng lng. Cm hoa xut hin khi cy tri l, vo ma h, cao 30-150cm, c l bc di 1,21,5cm, mng, mu lc mc mc. Hoa c 3 l i, 3 cnh hoa cao 1cm mu trng trng, 2 nh, 3 l non; cung hoa di 1,5cm. Qu nang c 3 gc, mi ngn c 34 ht. Cy ri l vo ma h v xut hin l mi vo ma thu ng. B phn dng: C - Bulbus Scillae. C th dng ton cy. Ni sng v thu hi: Cy gc sng a Trung Hi, c nhp trng lm thuc nhng cha pht trin rng. Thu hi c vo ma h, dng ti hay phi kh.

Tnh v, tc dng: V ngt v hc ng, khng mi, tnh mt, hi c; c tc dng tr tim, li tiu, long m, tiu vim. Cng dng, ch nh v phi hp: chu u, chu Phi, ngi ta dng nc ngm v nc sc hoa dit su b. Dng lm thuc thng tiu, nht l trong vim thn v b i nit; cn dng lm thuc long m trong bnh kh thng phi, ho g, vim ph qun. Liu dng 0,10-0,30g mi ngy, ti a 1g trong 24 gi. Cng dng lm thuc dit chut v dit su b (ct nh c, vi hi cn acetic, sau un si vi cn acetic, lc ly ring nc ra, b cn li chit bng cn si; hp c hai th dch chit li v c ti cao mm; Cao ny c tc dng mnh gp 4 ln bt, gp 3 ln cao ch theo phng php thng thng). Ghi ch: Ton cy c c. N gy vim ng tiu ho, nn ma, i a lng, lm mt s bi niu, do khng dng Hnh bin khi vim thn hay vim rut. Nu dng qu liu hoc dng lu ngy s c cc triu chng i ra mu, v niu, nn ma, a chy, mch nhanh v nh, vt v, cht do ngng tim. (theo trang tin cng thng tin sc khe cng ng) Thnh phn ha hc: C cha Scilliroside, glucoscillaren A, scillaren A, proscillaridin A, scillaridin A, scilliglancoside, scilliphaeoside, glycoscilliphaoside, scillicyanoside, scillicoeloside, scillazuroside, scillicryptoside. Cn c cc flavonoid v stigmasterol, phytosterol v oxalat calcium.

Scilliroside

2. Cy digital (dng a hong)

Tn khc: Mao a hong, a chung hoa, Digital Tn khoa hc: Digitalis purpurea L.; Digitalis lanata Ehr. v mt s loi Digitalis khc, h Hoa mm ch (Scrophulariaceae). M t: Cy sng 2 nm, to thnh trong nm u mt vng l hoa th gc; phin l di 10-30cm, hnh bu dc v c lng mm; nm th hai, cy mi to mt cn hoa v l, cao ti 1-2m. t khi phn nhnh. Hoa c mu ta p, hnh chung, dng nh ngn ca gng tay; phn di v trong ca hoa hi sng hn vi cc chm mu sm. Ra hoa thng 5-9. B phn dng: L (Folium Digitalis). Phn b: Cy ca chu u, ta nhp trng H Ni (Vn in), Vnh Ph (Tam o) v Lo Cai (Sapa). Thu hi: Thu hi l nm u vo ma thu, phi kh. Tc dng: Vi liu dc dng, n lm cho tim hot ng, lm cho hng phn, cng tim, tng thm sc co bp ca tim v lm cho tim p du; cn c tc dng li tiu. Vi liu cao, n gy c mnh. Cng dng: Lm thuc tr tim trong trng hp suy tim nhp khng u; lm nguyn liu chit xut cc glycosid tim.

Cch dng, liu lng: Bt l: Ngi ln: Ung mi ln 0,05 - 0,1g, ung 3 - 4 ln trong ngy. Tr em: Ung mi ln 0,005 - 0,006g tu theo tui. Cn dng di dng vin, cn thuc, nc sc. Thnh phn ho hc: Cc glycosid tim: trong c digitoxin (0,15-0,79g/kg l kh), gitoxin (0,1-0,7g/kg l kh) v gitalin, girorin, girotin... Cn c tanin, inositol, luteolin v nhiu acid v cht bo.

Diginatigenin

Diginorgin

Diginatigenin

Digitoxigenin

Digoxigenin

Digitoxin

Gitoxigenin 3. Chi Sng tru

Gitoxin

Tn khc: Cy sng d, sng b, dng gic o

Tn khoa hc: Strophanthus H: trc o (Apocynaceae) Ngun gc: ch yu khu vc chu Phi nhit i, tri di ti Nam Phi, vi ch mt vi loi chu , t min nam n ti Philippines v min nam Trung Quc. Tn gi khoa hc ca chi ny c ngun gc t ting Hy Lp strophos anthos, "hoa dy xon" do cc on ging nh si ch xon v di ca trng hoa, vi mt loi (S. preussii) c cc si ny di ti 30-35 cm. Chi ny bao gm cc loi dy leo, cy bi v cy thn g nh. L mc i hay mc vng, dng l n hnh mi mc rng bn, di 2-20 cm, vi mp l nhn. Mt vi b lc chu Phi s dng Strophanthus lm thnh phn c bn trong cc loi thuc c tm vo u mi tn. M t: Cy ng hay dy leo c m trong. Thn trn c nhiu l b. L to, thun ngn gio hay thun bu dc, c mi hay gn nhn nh, thnh gc gc, hi dai, di 12-32cm, rng 4-7cm. Hoa , thnh xim ngn, di 4-5cm. L i nhn, cnh hoa di. Qu i 2, rt to di 18-22cm, rng 2,5cm gc. Ht nhiu, di 1,75cm, rng 6mm, c lng mo di 3,5cm mu trng. Ra hoa thng 8-12, c qu thng 12. B phn dng: Ht v nha - Semen et Latex Strophanthi Caudati. Ni sng v thu hi: Cy ca min ng dng mc hoang vng ni t H Bc, Ho Bnh, Ninh Bnh, Ngh An, Tha Thin - Hu, n Gia Lai. Thu nha cy quanh nm. Tnh v, tc dng: Cng nh Sng d; c tc dng cng tm, li niu, tiu thng. Cng dng: Ht l nguyn liu ch strophathin pha thuc tim tr bnh tim. Nha c c, thng dng trn ln vi nha cy Sui lm thuc bn. Khi ch xong, pha thm dch l thuc l lm mm. Campuchia, nha c dng trong Y hc dn gian lm thuc h nhit. Tc dng: Theo ch nh thng thng, loi thuc ny tc ng ln tim trc khi c nh hng ti cc c quan hay m khc. Hin ti, ngi ta vn cha thy tc ng ph no khc. N c s dng sn xut thuc Ouabain, c ch nh dng nh l thuc kch thch tim mch nhm iu tr suy tim huyt, v n

l tng t nh thuc Digoxin c sn xut t mao a hong tm (Digitalis purpurea). Thnh phn ha hc: Cc loi cy trong chi ny sinh ra cc ancaloit c v cc glicozit tim nh g-strophanthin (ng ngha: ouabain), k-strophanthin v estrophanthin

K-Strophanthidin

hellebrin

Ouabagenin

Ouabain

4. Linh lan

Tn khoa hc : Convallaria majali H : Ruscaceae Ngun gc: n c ngun gc trong khu vc n n mt ca Bc bn cu ti chu , chu u v Bc M. hoa ny trong ting Anh cn c gi l Our Lady's tears (Nc mt ca M) do, theo mt truyn thuyt, t nhng git nc mt ca Eva ri xung, khi b ui ra khi thin ng, tr thnh hoa linh lan. M t: N l mt loi cy thn tho sng lu nm c kh nng to thnh cc cm dy t nh loang rng theo cc r ngm di mt t gi l thn r. Cc thn r ny to rt nhiu chi mi mua xun. Thn cy cao ti 15-30 cm, vi hai l di 10-25 cm v cnh hoa bao gm 5-15 hoa trn nh ngn thn cy. Hoa c mu trng (t khi hng), hnh chung, ng knh 5-10 mm, c mi thm ngt; n hoa v cui ma xun. Qu ca n l loi qu mng mu , nh vi ng knh 5-7 mm. N l mt loi cy cnh trng ph bin trong vn v cc hoa c mi thm ca n. Thnh phn: khong 40 glycozit tim c xc nh c ngun gc t 9 genins. Nhng glycozit chinh bao gm convallatoxin (4-40%), convalloside (4-24%), convallatoxol (10-20%), desglucocheirotoxin (3-15%) and lokundjoside (125%). Dc ng hc: nng pha long 1:1000 trong ch cha ti a 0,1% nguyn liu thc vt ban u. Linh lan dng chng li s ri lon chc nng tim. Tiu

chun ha l thuc bt ch cha 0,2-0,3% cc glucoszit tim v c iu chnh hot ng dc l tng tng vi 0,2% convallatoxin. Liu lng trung bnh hng ngy l 0,6g bt thuc tng ng vi 1,2 -1,8mg glucozit tim. C th ngi ch hp th khong 10% liu dng ca Convallatoxin. Th nghim trn ng vt cho thy nng cao nht trong thn (7.4mg/kg), c (6,6mg/kg) v gan( 4,4mg/kg). Convallaria c bi tit ch yu trong nc tiu v phn. Vi tng liu ngi c bi tit trong vng 2 ngy. Cng dng: . Linh lan dng chng li s ri lon chc nng tim

5. Trc o

Tn khoa hc: Nerium Oleander Phn h: Apocynoideae Ngun gc: N l loi cy bn a ca mt khu vc rng t Morocco v B o Nha ko di v pha ng ti khu vc a Trung Hi v min nam chu . Thng thng loi cy ny mc xung quanh cc lng sui kh. M t: N cao ti 2-6 m, vi cc cnh mc gn nh thng. Cc l mc thnh cp hay trong cc vng xon gm ba l, cc l dy v bng nh da, mu lc sm, hnh mi mc hp, di khong 5-21 cm v rng 1-3,5 cm, cc mp l nhn. Hoa mc thnh cm u mi cnh; mu trng, vng hay hng (ty theo ging), ng knh 2,5-5 cm, trng hoa 5 thy vi tua bao quanh ng trng trung tm ca trng hoa. Thng thng (nhng khng phi lun lun) th hoa trc o c

hng thm. Qu l loi qu nang di nhng hp, kch thc di 5-23 cm, nt ra khi chn gii phng cc ht nh ph y lng t. Thnh phn: leandroside, kaneroside, neriaside, nerigoside, neriu-moside, neridiginoside, nerizoside, neritaloside, proceragenin, neridienone A, cardenolides Chng c mt trong ton b cc b phn ca loi cy ny, nhng ch yu tp trung trong nha cy. Cng dng dng : c tc dng tt n van tim, lm gim hin tng nhi mu c tim, ngn chn ph n v gim hin tng kh th. Cng thc ha hc