General

Scientific Names: Crataegus cuneata Sieb. Et Zucc, CrataeguspinnatifidaBge. Var. major N. E. Br, Fructus Crataegi.

Common Names: Ye Shan Zha, Hawthorn Fruit, Fruit of chinese Hawthorn, Fruit of Large chinese Hawthorn, Fruit of Nippon Hawthorn, Fruit of Hupeh hawthon, Fruit of Redhaw Hawthorn, Fruit of Yannan hawthorn.

BOTANICAL:

Crataegus is a deciduous shrubby tree with smooth thorny shoots and three-lobed stipulate leaves. Small white or pink five-petalled flowers with short triangular sepals are arranged in corymbs and on long stalks, each with prominent stamens around the nectary and carpels. The berry is red with white mealy flesh and a large stone. Crataegus grows in hedgerows and copses throughout Britain and all temperate regions of the northern hemisphere.

Parts used: Flowering tops, dried ripe fruits, leaves.

Collection: The flowering tops are harvested in late spring and early summer, the berries in September and October.

Hawthorn was traditionally used in Europe for kidney and bladder stones and as a diuretic. In China, the berries of Crataegus pinnatifida , known as shan zha, are mainly taken for symptoms of 'food stagnation', which can include abdominal bloating, indigestion, flatulence and diarrhoea. They are believed to 'move' the blood, and are used to relieve stagnation in dysmenorrhoea and after childbirth. Ayurvedic medicine recommends hawthorn for heart and circulatory complaints.

Hawthorn flowers are reputed to have magical properties, and are believed to bring about a death in the family if they are taken into the home. This may have something to do with the trimethlamine present in the flowers - this substance is one of the first products formed when body tissue starts to decay. Until recently, corpses were kept in the house prior to burial, and people would have been familiar with the odour of death and decay. Hawthorn is said to have been the source of Christ's crown of thorns. During the First World War, the young leaves were used as a substitute for tea and tobacco, and the seeds were ground in place of coffee. The Hawthorn is the badge of the Ogilvie clan.

植物形态: 落叶乔木，高达 7m 。小枝紫褐色，老枝灰褐色。叶片宽卵形或三角状卵形，长 4 ～ 10cm ，宽 3 ～ 7cm ，基产截形或宽楔形，两侧各有 3 ～ 5 羽状深裂片，基产 1 对裂片分裂较深，边缘有不规则锐锯齿。复伞房花序，花序梗、花柄都有长柔毛；花白色，直径约 1.5cm ；萼筒外有长柔毛，萼片内外两面无毛或内面顶端有毛。梨果深红色，近球形。花期 5 ～ 6 月，果期 9 ～ 10 月。

植物资源分布: 1.山楂栽培于东北南部、华北以至江苏一带。2.野山楂分布江苏、浙江、安徽、湖南、湖北、河南、四川、贵州、江西、福建、广东、广西、云南、陕西等地。药材：北山楂主产山东、河北、河南、辽宁等省。陕西、山西、江苏亦产。南山楂主产江苏、浙江、云南、四川等地。同属植物的果实在少数地区亦作山植入药：山里红分布东北、华北及陕西、山东、江苏等地。湖北山楂分布我国中部及陕西、江苏各地。辽山楂分布东北及山西、内蒙古、新疆等地。云南山楂分布西南及广东、广西等地。

生药材鉴定: 1.北山楂为植物山楂的果实，呈球形或梨形，径约2，5cm。表面深红色，有光泽，满布灰白色细斑点；顶端有宿存花萼，基部有果柄残痕。商品常为3-5mm厚的横切片，多卷缩不平，果肉深黄色至栈棕色，切面可见5-6粒淡黄色种子，有的种子已脱落；有的片上可见短果柄或下凹的花萼残迹。气微清香，味酸微甜。以个人、皮红、肉厚者为佳。主产山东、河北、河南、辽宁等省。陕西、山西、江苏亦产。 2.南山楂为植物野山楂的果实，呈类圆球形，直径0.8-1.4cm，间有压扁成饼状。表面灰红色，有细纹及小斑点，顶端有凹窝，其边缘略突出，基部有果柄残痕。质坚硬，核大，果肉薄，棕红色。气微，味酸微涩。以个匀、色红、质坚者为佳。主产江苏、浙江、云南、四川等地。此外尚有下列同属植物的果实在少数地区亦作山植入药。山里红CrataeguspinnatifidaBge.叶片宽卵形，3-5羽状深裂。果实近球形，直径约1.5cm，红色。分布东北、华北及陕西、山东、江苏等地。湖北山楂C.hupensisSarg.叶卵形至矩圆状卵形，中部以上3-5裂；刺长1.5cm；果实圆球形，直径约1-2.5cm，黑赤色，有显著的小斑点。分布我国中部及陕西、江苏各地。辽山楂C.sanguineaPall.叶先端3-5裂，基部楔形，花药淡红色或紫色，果实鲜红色。分布东北及山西、内蒙古、新疆等地。云南山楂C.Scabrifolia（Franch.）Rehd.叶片卵状披针形或卵状椭圆形，常不裂，边缘具锯齿；果实近球形，暗红色或黄色带红褐色晕斑。分布西南及广东、广西等地。显微鉴定：山里红粉末：深棕色。石细胞类圆形、长圆形、圆多角形、长条形、类三有形或不规则形，直径18-173cm，长约至185cm，壁极厚，约至53cm，层纹明显，常可见细胞壁有1-3圈裂缝，有的完整地开裂，孔沟较粗，有分叉，胞腔小，有的含橙色物。草酸钙簇晶直径27-41cm，棱角较钝。果肉薄壁细胞（原花托部分）皱缩，细胞界限不甚清楚，细胞内含棕色物，常包埋有淀粉粒及草酸钙方晶，方晶直径13-52cm。纤维有时上下层交错排列，直径11-36cm，壁极厚，有纵裂缝。果皮表皮细胞内含棕色或橙红色物，断面观角质层厚约18cm。山楂粉末：红棕色。石细胞类圆形、卵圆形、长条形、类多角形或类三角形，直径25-92cm，长至176cm，壁厚至20cm，内含棕色或橙红色物。草酸钙簇晶直径17-54cm，方晶直径13-47cm。纤维直径13-27cm，壁较薄或极厚。果皮表皮细胞内含黄棕色或红棕色物。此外，可见果肉薄壁细胞，淀粉粒等。本品以个大、皮红、果肉厚、核小者为佳。

Pharmacology

Crataegus is one of the tonics for the heart and circulation, acting upon the heart by either stimulating or depressing its activity depending upon the need. The precise mode of action which results in the dilating of the coronary blood supply and the tendency to slow down or stabilise the contractility of the heart muscle is not yet fully understood, but it is safe to use as a long-term treatment for a weak or failing heart, and has a beneficial effect on cardiac arrhythmias, especially extrasystoles and paroxysmal tachycardia. Crataegus is also a useful diuretic. A clinical study of 80 patients in Japan showed statistically significant improvement in cardiac function, oedema and dyspnoea in those treated with a preparation made from the fruits and leaves. Other clinical observations included a reduction in elevated blood levels of pyruvic and lactic acid, normalisation of prolonged systole and prevention of ECG changes due to hypoxia. As a tonic for the circulatory system Crataegus finds its primary use in the treatment of hypertension, atherosclerosis and angina pectoris. It is also applicable to peripheral circulatory conditions, such as intermittent claudication and Raynaud's disease.

The flavonoids in Crataegus are vasodilatory, as is the condensed tannin phlobaphene. These dilate the peripheral blood vessels and have a specific action on the coronary circulation. The cyanogenic glycosides are sedative and increase the parasympathetic (vagal) tone of the heart, thus slowing it down. Trimethylamine stimulates the pulse rate slightly, and has a peripheral vasoconstrictor effect. The combination of these actions helps to explain the paradoxical effect of exerting a sympathetic action on the coronary circulation and a parasympathetic action on the myocardium. The sedative effects of the cyanogenic glycosides combine with the vasodilatory effects to lower high blood pressure, but the cardiotonic activity actually helps to raise low blood pressure. Crataegus does not contain digitalis-like substances, but is a gentle remedy requiring extended use. It is of benefit in the treatment of middle-aged patients showing the first signs of coronary artery disease, and also in older patients with 'senile' heart. It should also be used in the follow-up therapy of myocardial infarction.

中药化学成分: 山里红果实中含酒石酸、柠檬酸、山楂酸（Crat-egolicacid）、黄酮类、内酯、糖类及甙类。野山楂果实中含柠檬酸、苹果酸、山楂酸、鞣质、皂甙、果糖、维生素C、蛋白质及脂肪等。欧洲产的山楂Crataegusoxyacantha 等的果实中含熊果酸、齐墩果酸、山楂酸、鞣质、金丝桃甙（Hyperin）、咖啡酸、绿原酸、乙酰胆碱、胆碱、脂肪油、谷甾醇、酒石酸、苹果酸等。种子含苦杏仁甙（Amygdalin）、金丝桃甙、脂肪油等。树皮含马栗树皮甙（Aesculin）。山里红、山楂果中均含山楂酸（cuataegolicacid）、表-儿茶精[（-）epicpatechin]、金丝桃甙(hyperoside)、枸橼酸及其甲酯、二甲酯、三甲酯，以及苹果酸、皂甙、维生素C、核黄素、胡萝卜素、鞣酐等。山里红果中尚含牡荆素鼠李糖甙（vitexin-rhamnoside），果核中含廿九烷醇-10，熊果酸、齐墩果酸、胡萝卜甙、豆甾醇、香草醛、延胡索酸、琥珀酸。

1. Gao GY, et al., [Comparison of morphological and microscopical diagnostic characters of Hawthorn fruits (Crataegus species)]. Yao Xue Xue Bao. 1995.

Efficacy

对免疫功能的作用 3.1对家兔血清溶菌酶含量作用 取家兔24只，随机分为山楂组和对照组。每组12只，山楂组平均体重2704.17g，每天sc山楂0.2ml（新鲜生山楂果实切块，加水煮沸后，用酒精沉淀法制得100%的山楂注射液（即含生药1g/ml）200mg/kg。对照组平均体重2693·33g，每天sc相同容量的生理盐水，均连续注射9d。在注药后d2、d5，分别给两组家兔sc抗原（20%SRBC）昆悬液，每ml含红细胞20亿）0.2ml。于d10将两组家兔分别取血清做溶菌酶测定，其测定系采用琼脂平板打孔法：将混有ysodeikticus菌的琼脂平板打孔，孔直径4mm，每孔加0.05ml兔血清。置26℃温箱经24h后测量孔周围溶菌环直径，根据溶菌环大小，对照标准曲线查出家兔血清中溶菌酶的含量（ug/ml）。山楂组家兔血清溶菌酶含量平均高于对照组，二者间差异极显著（P＜0·01＝。 3.2对家兔血清血凝抗体滴度的作用 动物分组、给药、取血清同前。血凝抗体滴度测定系用生理盐水将两组血清作对倍稀释。将不同稀释度的血清分别置于试管内，每管0·5ml，再加入0.5%SRB（绵羊红细胞）悬液0.5ml，混匀，置37℃过夜，次日观察血球凝集滴定。山楂组家兔血清血凝抗体滴度高于对照组，两者间差异显著（P＜0.05＝。 3.3对家兔T淋巴细胞E玫瑰花环形成的作用E玫瑰花环形成试验系采取两组家兔心血T淋巴细胞与绵羊RBC做E玫瑰华环试验，计算E玫瑰花环形成细胞的百分率。结果山楂组家兔心血T淋巴细胞E玫瑰花环形成率（%）高于对照组，两者间差异极显著（P＜0.01。 3.4对兔T淋巴细胞转化的作用T淋巴细胞转化试验系采取两组家兔心血T淋巴细胞加PHA做转化试验（形态学全血法），计算T淋巴细胞的转化率。山楂组家兔心血T淋巴细胞转化率高于对照组，两者间差异极显著P＜0·01。

IN VITRO:

1. Satoh K, et al., Enhancement of radical intensity and cytotoxic activity of ascorbate by Crataegus cuneata Sieb et. Zucc. extracts. Anticancer Res. 1998 Jul-Aug.
2. Yesilada E, et al., Inhibitory effects of Turkish folk remedies on inflammatory cytokines interleukin-1alpha, interleukin-1beta and tumor necrosis factor alpha. J Ethnopharmacol. 1997 Sep.
3. Saenz MT, et al., Extract from Viscum and Crataegus are cytotoxic against larynx cancer cells. Z Naturforsch [C]. 1997 Jan-Feb.
4. Yao M, et al., [Expression of the integrin alpha 5 subunit in hepatocellular carcinoma]. Zhonghua Yi Xue Za Zhi. 1997 May.
5. Yao M, et al., Expression of the integrin alpha5 subunit and its mediated cell adhesion in hepatocellular carcinoma. J Cancer Res Lin Oncol. 1997.

Safety

用药忌宜： 脾胃虚弱者慎服。1.《纲目》：生食多，令人嘈烦易饥，损齿，齿龋人尤不宜。2.《本草经疏》：脾胃虚，兼有积滞者，当与补药同施，亦不宜过用。3.《得配本草》：气虚便搪，脾虚不食，二者禁用。服人参者忌之。4.《随息居饮食谱》：多食耗气，损齿，易饥，空腹及羸弱人或虚病后忌之。