Dwivedi Shridhar
Preventive Cardiology Group, University College of Medical Sciences, University of Delhi, Delhi 110095, India.
J Ethnopharmacol. 2007 Nov 1;114(2):114-29. doi: 10.1016/j.jep.2007.08.003. Epub 2007 Aug 10.
Ancient Indian physicians used the powdered tree bark of Terminalia arjuna Wight & Arn. for alleviating "hritshool" (angina) and other cardiovascular conditions. Its stem bark possesses glycosides, large quantities of flavonoids, tannins and minerals. Flavonoids have been detected to exert antioxidant, anti-inflammatory and lipid lowering effects while glycosides are cardiotonic, thus making Terminalia arjuna unique amongst currently used medicinal plants. In this review an attempt has been made to discuss various aspects of its ethnomedical, pharmacognostical, phytochemical, pharmacological and clinical relevance to cardiovascular conditions. Experimental studies have revealed its bark exerting significant inotropic and hypotensive effect, increasing coronary artery flow and protecting myocardium against ischemic damage. It has also been detected to have mild diuretic, antithrombotic, prostaglandin E(2) enhancing and hypolipidaemic activity. There is ample clinical evidence of its beneficial effect in coronary artery disease alone and along with statin. However, toxicological studies in experimental animals are lacking. Considering its anti-ischemic activity and its potential to correct dyslipidemia, reduce left ventricular mass and increase left ventricular ejection fraction, it is essential to examine the molecular mechanism of its action and its core constituents. Proposition to administer Terminalia arjuna along with statins deserves to be explored in depth for defining its place in the over all management and prevention of coronary artery disease.
古印度医生使用诃子（Terminalia arjuna Wight & Arn.）的树皮粉末来缓解“hritshool”（心绞痛）和其他心血管疾病。其茎皮含有糖苷、大量黄酮类化合物、单宁和矿物质。已检测到黄酮类化合物具有抗氧化、抗炎和降血脂作用，而糖苷具有强心作用，因此诃子在目前使用的药用植物中独树一帜。在本综述中，我们试图讨论其在民族医学、生药学、植物化学、药理学以及与心血管疾病临床相关性的各个方面。实验研究表明，其树皮具有显著的变力和降压作用，可增加冠状动脉血流量并保护心肌免受缺血损伤。还检测到它具有轻度利尿、抗血栓形成、增强前列腺素E2和降血脂活性。有充分的临床证据表明，它单独或与他汀类药物联合使用对冠状动脉疾病具有有益作用。然而，缺乏对实验动物的毒理学研究。鉴于其抗缺血活性以及纠正血脂异常、减轻左心室质量和增加左心室射血分数的潜力，有必要研究其作用的分子机制及其核心成分。对于在冠状动脉疾病的整体管理和预防中确定其地位而言，将诃子与他汀类药物联合使用的提议值得深入探讨。
