**Comparative Study of Panax Notoginseng Saponins and Atropine Alkaloids in Rabbit SMAO Shock Efficacy**
1. **Calcium Levels**: After shock, the calcium levels returned to near pre-shock levels (P > 0.05) in the experimental groups, while the control group showed a declining trend in calcium levels during shock.
2. **Blood pH and BE Values**:
- Post-shock, the blood pH significantly decreased in the control group (P < 0.05).
- The base excess (BE) also decreased in all three groups post-shock (P < 0.05).
3. **Liver Ultrastructural Changes**:
- In the control group, hepatic sinusoids exhibited a large number of neutrophil and platelet-based membrane aggregations, bile canalicular bile stasis, and residual bodies, with liver cell damage and debris entering the liver chamber.
- In both treatment groups, the liver cells and bile canaliculi appeared more normal, with fewer cell debris, rare neutrophils, and relatively smooth sinusoids.
4. **SMAO Shock Model**:
- According to the literature, we simulated the internal organ arterial clamp shock model.
- The results from mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR), blood gases, serum electrolytes, and electron microscopy confirmed the successful replication of the SMAO shock model in this experiment.
5. **Anti-shock Efficacy and Mechanism Comparison between Panax Notoginseng Saponins and Anisodamine Alkaloids**:
- Experimental results indicate that Panax notoginseng saponins significantly prolonged the survival time of shocked animals, with more animals surviving for four hours compared to the 654-2 group.
- Post-treatment, both treatment groups showed significantly higher mean arterial pressure and maintained central venous pressure at an internal balance level.
- The heart rate slowed down but remained stable, suggesting that Panax notoginseng saponins can slow the heart rate while ensuring adequate cardiac output and circulation.
- In the 654-2 group, the heart rate was faster, but other indicators did not show significant differences compared to the Panax notoginseng group.
- Panax notoginseng saponins have the ability to dilate blood vessels and reduce peripheral resistance, maintaining MAP and CVP at relatively high levels in shocked animals.
- Experimental results indicate that Panax notoginseng saponins enhance cardiac contractility and increase cardiac output, showing protective effects on decompensated heart function in hemorrhagic shock by gradually improving the cardiac index, left ventricular peak pressure, left ventricular stroke work, left ventricular pressure change rate, and cardiac output, approaching pre-shock levels.
- Both Panax notoginseng saponins and 654-2 significantly reduced metabolic acidosis after treatment, with no significant difference between their effects, which undoubtedly helps prevent further deterioration of shock.
- The role of Panax notoginseng saponins in improving heart function and increasing cardiac output leads to improved tissue perfusion and metabolism, alleviating hyperkalemia.
- Post-treatment with Panax notoginseng saponins mitigates hyperkalemia, maintaining normal intracellular electrolyte concentration and normal cell function, which is crucial.
- Shock-induced cellular energy metabolism dysfunction, ATP reduction, Na-K pump failure, extracellular K+ increase, and diminished myocardial stress lead to reduced systolic function. In this experiment, Panax notoginseng saponins improved peripheral circulation, increasing ATP production and enhancing membrane stability, thereby reducing hyperkalemia-induced shock and its inhibitory effect on the heart.
- Electron microscopy results revealed typical liver tissue lesions in the control group, consistent with reported findings in the literature. Lesions in the liver tissue of both treatment groups were significantly reduced, indicating that Panax notoginseng saponins and 654-2 can improve liver tissue blood perfusion and reduce liver cell injury.
6. **Gao Ling's Comparative Study on Panax Notoginseng Saponins and Castor-Oil Plant Henbane Base in Rabbit SMAO Shock**:
- In recent years, the pathogenesis of shock at the cellular level has attracted increasing attention. Some researchers believe that shock reversal involves irreversible processes where lysosomal changes play a significant role in releasing plasmin, disrupting mitochondrial structure and function, and participating in the formation of cardiac inhibitors, causing irreversible damage to tissue cells.
- Additionally, intracellular Ca overload during shock can also cause irreversible damage. It has been reported that 654-2 plasmin reduces release and blocks calcium influx, considered part of its anti-shock mechanism.
- This experiment confirmed these two mechanisms of 654-2, while Panax notoginseng saponins exhibit these effects differently. Lysosomal stability and calcium influx blocking are not the primary ways Panax notoginseng saponins exert their anti-shock effects.
**Conclusion**: Panax notoginseng saponins demonstrate significant efficacy in prolonging survival time, improving cardiac function, enhancing tissue perfusion, and reducing metabolic acidosis in shock models, with notable protective effects on liver tissue. These findings underscore the importance of exploring alternative mechanisms beyond lysosomal stability and calcium influx regulation in understanding the anti-shock properties of Panax notoginseng saponins.