10.8
CiteScore
 
5.3
Impact Factor
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Corrigendum
Current Issue
Editorial
Erratum
Full Length Article
Full lenth article
Original Article
Research article
Retraction notice
Review
Review Article
SPECIAL ISSUE: ENVIRONMENTAL CHEMISTRY
10.8
CiteScore
5.3
Impact Factor
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Corrigendum
Current Issue
Editorial
Erratum
Full Length Article
Full lenth article
Original Article
Research article
Retraction notice
Review
Review Article
SPECIAL ISSUE: ENVIRONMENTAL CHEMISTRY
View/Download PDF

Translate this page into:

Review article
06 2022
:15;
103825
doi:
10.1016/j.arabjc.2022.103825

Qualitative and quantitative analysis of multi-components in Xing-Su-Ning Capsules for quality improvement

State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China

⁎Corresponding authors at: Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, West Area, Tuanbo New Town, Jinghai District, Tianjin 301617, China. renming2008@126.com (Ming Ren), miaomiaojiang@126.com (Miaomiao Jiang)

Disclaimer:
This article was originally published by Elsevier and was migrated to Scientific Scholar after the change of Publisher.

Abstract

Background

Xin-Su-Ning Capsules (XSNC) is an effective prescription for the treatment of arrhythmia composed of eleven Chinese herbs. With the wide application of XSNC in clinic, its quality control issues have also received increasing attention. Based on the multi-components characteristics of Chinese herbal compound, there is an urgent need to establish a quality evaluation system.

Methods

Gas chromatography-mass spectrometry (GC-MS) and ultra high-performance liquid chromatography quadrupole electrostatic orbitrap high resolution mass spectrometry (UHPLC-Q-Exactive-Orbitrap-MS) were performed to identify the preliminary chemical profile of XSNC. Subsequently, a rapid ultra high-performance liquid chromatography coupled with electrospray ionization triple-quadrupole mass spectrometry (UHPLC-QQQ-MS/MS) method was developed to evaluate the quality of XSNC through a simultaneous determination of 16 components.

Results

A total of 21 volatile components and 59 non-volatile compounds were tentatively identified from the XSNC, each identified compound is marked on the corresponding chromatogram. Moreover, sixteen chemical constituents (sophocarpine, matrine, febrifugine, berberine, palmatine, Tangeratin, nobiletin, liensinine, neferine, scopoletin, isoliquiritigenin, liquiritigenin, naringenin, naringin, hesperidin and glycyrrhizic acid) were quantified by the developed UHPLC-QQQ-MS/MS method. The method validation of the sixteen compounds was performed with acceptable linearity (R2, 0.9990-1.0000), precision (RSD, 0.25-2.06%), repeatability (RSD, 0.93-2.90%) and recovery (99.65%-104.03%, RSD≤4.35%).

Conclusions

This qualitative analysis method sensitive and reliable for searching the volatile and non-volatile compounds from XSNC. The linearity, accuracy and precision of the quantitative analysis method were satisfactory. It is proposed that the methods described here can be applied for rapid evaluation, quality control and authenticity establishment of XSNC.

Keywords

Xing-Su-Ning Capsules
Constituent identification
Quantitative analysis
UHPLC-Q-Exactive-Orbitrap-MS
UHPLC-QQQ-MS/MS
PubMed

Abbreviations

ESI

electrospray ionization

GC-MS

gas chromatography-mass spectrometry

TCM

Traditional Chinese medicine

UHPLC-Q-Exactive-Orbitrap-MS

ultra performance liquid chromatography tandem quadrupole orbitrap mass spectrometer

UHPLC-QQQ-MS/MS

ultra high-performance liquid chromatography coupled with electrospray ionization triple-quadrupole mass spectrometry

XSNC

Xin-Su-Ning Capsules

1

1 Introduction

Chinese herbal compound has definite curative effect and low side effects. It is the main drug for the clinical treatment of some complex diseases, chronic diseases and other diseases (Li and Du, 2015). Arrhythmia is a common and extremely dangerous cardiovascular diseases, it can not only aggravate the pre-existing heart disease, but also cause sudden death of patients (James and Calkins, 2016; Sossalla and Vollmann, 2018) With the limitation of anti-arrhythmic effect of chemical drugs, Chinese herbal compound represented by Xin-Su-Ning capsules (XSNC) has been more and more recognized in clinical practice because of its remarkable anti-arrhythmic effect in terms of multi-ion channel block and non-ion channel regulation(Li et al., 2019; Sun, 2017; Yao and Fang, 2017). XSNC consists of 11 Chinese herbs, including Coptidis Rhizoma, Pinelliae Rhizoma, Poria, Aurantii fructus Immaturus, Dichroae Radix, Nelumbinis Plumula, Sophorae flavescentis Radix, Artemisiae annuae Herba, Ginseng Radix et Rhizoma, Ophiopogonis Radix, Glycyrrhizae Radix et Rhizoma, it is a good prescription for the treatment of phlegm heat disturbance arrhythmia (Ma et al., 2006). Evidence-based medicine studies carried out from 2014 to 2017 have confirmed that XSNC has a definite clinical effect in treating cardiac arrhythmias caused by phlegm-heat (Zhaiet al., 2017). However, its chemical composition and quality control research are not in-depth, according to the instruction of Committee for the Pharmacopoeia of China in 2015, only berberine was indicated to be a index of XSNC for qualitative identification and quantitative analysis. In view of the complexity of chemical components of traditional Chinese medicine (TCM), its single qualitative and quantitative index is not enough to show the overall quality information of TCM, and it is difficult to fully reflect the effectiveness and safety of TCM. As a result, the comprehensive identification method of chemical composition is of great significance to the research of chemical composition of TCM. A new analytical method is needed to quantitatively determine various active components in XSNC.

In recent years, with the development of analytical technology, ultra high-performance liquid chromatography quadrupole electrostatic orbitrap high resolution mass spectrometry (UHPLC-Q-Exactive-Orbitrap-MS) is widely used in the analysis of TCM and compound prescription due to its fast separation speed, high sensitivity and strong determination accuracy (Eliuk and Makarov, 2015; Yang et al., 2020). Ultra high-performance liquid chromatography coupled with triple-quadrupole tandem mass spectrometry (UHPLC-QQQ-MS/MS) could provide simultaneous quantification of multiple components in the analysis of TCM (Liu et al., 2017, 2017; He et al., 2015).

To achieve the comprehensive chemical characterization of XSNC, we developed methods based on GC-MS and LC-MS to effectively analyze the chemical composition of XSNC. Then, an approach based on UHPLC-QQQ-MS/MS was developed to investigate the content of multi-components in XSNC. The quality of XSNC was comprehensively evaluated by quantifying the content of 16 compounds, which provided a reference for its quality evaluation, and laid a foundation for the later-stage drug-effective material basic research and clinical application.

2

2 Materials and methods

2.1

2.1 Materials and reagents

Methanol and acetonitrile (chromatographic purity) was purchased from Fisher company (USA), formic acid (MS grade) was purchased from ACS company (USA), and distilled water was purchased from Guangzhou Watsonsfood and beverage company (Guangzhou, China). Reference standards of sophocarpine, matrine, febrifugine, berberine, palmatine, Tangeratin, nobiletin, liensinine, neferine, scopoletin, isoliquiritigenin, liquiritigenin, naringenin, naringin, hesperidin and glycyrrhizic acid, jatrorrhizine were purchased from Sichuan Weikeqi Biotechnology Co., Ltd. or Shanghai Yuanye Biotechnology Co., Ltd. XSNC were supplied by Shanxi Momentum Pharmaceutical Co., Ltd (Shanxi, China).

2.2

2.2 Sample solutions preparation

XSNC were completely removed the capsule and weighed 1.77 g of the powder precisely. The powder was placed in a headspace sample bottle and sealed with an aluminum cap. Then, it was injected in the headspace sampler for GC-MS analysis.

The contents of XSNC were extracted by cold leaching with methanol for 24 h and repeated three times, then ultrasonically extracted for three times with methanol, the extracts was combined, concentrated and freeze-dried to obtain freeze-dried powder of non-volatile components. The lyophilized powder was weighed and dissolved in methanol a concentration of 5 mg/mL, then the solution was centrifuged at about 14000 rpm for 10 min. The supernatant was filtered through a 0.22 μm syringe filter and the filtrate was stored at 4 C ready for UHPLC-ESI-Q-Exactive-Orbitrap-MS qualitative analysis.

A total of 0.2 g powder of XSNC was accurately weighed, ultrasound (25 kHz, 35 C, 300 W) for 30 min with 20 mL methanol room temperature. After cooling down, the lost volume of methanol was complemented. Then the extracted solution was centrifuged at 14000 rpm for 10 min and the supernatant was taken. The supernatant 1 mL was accurately measure, diluted it with methanol and constant volume to obtain a test solution diluted 500 times with XSNC extract. The solution was filtered through a 0.22 μm syringe filter and the filtrate was stored at 4 C ready for UHPLC-QQQ-MS/MS quantitative analysis.

2.3

2.3 Standard solutions preparation

The standards for matrine, sophocarpine, jatrorrhizine, palmatine, berberine, liquiritigenin, isoliquiritigenin, Tangeratin, nobiletin, and scopoletin were weighed accurately and dissolved in methanol for preparation of 1 mg/mL single reference solutions. Each reference solution was drew 0.1 mL and obtained a 100 µg/mL mixed standard solution. The solutions were filtered with 0.22 μm syringe filters before UHPLC-ESI-Q-Exactive-Orbitrap analysis.

The standards for sophocarpine, matrine, febrifugine, berberine, palmatine, Tangeratin, nobiletin, liensinine, neferine, scopoletin, isoliquiritigenin, liquiritigenin, naringenin, naringin, hesperidin and glycyrrhizic acid were weighed accurately and dissolved in methanol for preparation of single reference substance mother solution. The concentrations of reference substance mother solutions were as follows: sophocarpine 20 µg/mL, matrine 20 µg/mL, febrifugine 1 µg/mL, berberine 20 µg/mL, palmatine 20 µg/mL, Tangeratin 1 µg/mL, nobiletin 1 µg/mL, liensinine 2 µg/mL, neferine 10 µg/mL, scopoletin 5 µg/mL, isoliquiritigenin 2 µg/mL, liquiritigenin 2 µg/mL, naringenin 10 µg/mL, naringin 300 µg/mL, hesperidin 20 µg/mL, and glycyrrhizic acid 40 µg/mL.

Preparation of the standard curve: The above-mentioned reference substance mother solution was taken 50 µL each and the volume was made up to 1 mL with methanol. It contains sophocarpine 1 µg/mL, matrine 1 µg/mL, and febrifugine 50 ng/mL, berberine 1 µg/mL, palmatine 1 µg/mL, Tangeratin 50 ng/mL, nobiletin 50 ng/mL, liensinine 100 ng/mL, neferine 500 ng/ mL, scopoletin 250 ng/mL, isoliquiritigenin 100 ng/mL, liquiritigenin 100 ng/mL, naringenin 500 ng/mL, naringin 15 µg/mL, hesperidin 1 µg/mL and glycyrrhizic acid 2 µg/mL the highest concentration of mixed standard solution. The highest concentration of mixed reference solution was diluted with methanol 1:1 (v: v) by 2, 4, 8, 16, 32, 64 times to obtain a series of mixed reference solution.

2.4

2.4 GC-MS analysis

Chromatographic analysis was performed on an Agilent 7890B gas chromatograph (American, Agilent). A HP-5 MS quartz capillary column was used for chromatographic separation. Injections were performed in a split mode (ratio 5:1). High-purity nitrogen was used as a carrier gas and injector temperature was 240 C. The initial column temperature was maintained at 50 C for 2 min, then raised to 200 C at a rate of 4 C/min and held isothermally for 2 min. The column flow was 10 ml/min. Mass spectrometry analysis was performed on an Agilent 5977B mass spectrometer (American, Agilent). EI ionization method was adopted; the ion source temperature and quadrupole temperature were 230 C and 150 C respectively; the full scan mode range m/z 40∼400.

2.5

2.5 UHPLC-Q-exactive-orbitrap-MS qualitative analysis

Chromatographic analysis was performed on a Thermo Scientific UltiMate 3000 Ultra Performance Liquid Chromatograph (Thermo Fisher Scientific, USA); A Waters ACQUITY UPLC BEH C18 (1.7 μm, 2.1×100 mm) maintained at 35 C was used for chromatographic separation. The mobile phase consisted of water acidified with 0.1 % (v/v) formic acid (A) and acetonitrile (B), was delivered at flow rate of 0.2 mL/min using the following gradient program: 0-2 min, 5-10% B; 2-5 min, 10-15% B; 5-10 min, 15-25% B; 10-15 min, 25-30% B; 15-20 min, 30-45%; 20-25 min, 45-65% B; 25-30 min, 65-95% B.

The Q-Exactive-Orbitrap mass spectrometer (Thermo Fisher Scientific, USA) equipped with an electrospray ion source. The atomizing gas was nitrogen; the spraying voltage was 3.5 KV; the flow rate of the sheath gas and the aux gas was 35 L/h and 10 L/h, respectively; the capillary temperature and auxiliary heating temperature were 350 C; the first level spectrum adopted the positive and negative ion full scan mode, the scan range was 100-1500 m/z, the full scan resolution was 70000 FWHM; the second level fragment spectrum used the target ion detection mode, the resolution was 17500 FWHM; the collision induced dissociation energy gradient was set to 30/40/50 V.

2.6

2.6 UHPLC-QQQ-MS/MS quantitative analysis

Chromatographic analysis was performed on an ACQUITY UPLC Ultra Performance Liquid Chromatograph (American, waters company); Chromatographic separation was conducted on a Waters UPLC ACQUITY BEH C18 (1.7 μm, 2.1 mm×100 mm) maintained at 35 C, the mobile phase consisted of 0.1% formic acid solution (A) and acetonitrile (B) using a gradient elution as following: 0-2 min, 5-10% B; 2-5 min, 10-20% B; 5-8 min, 20-25% B; 8-10 min, 25-30% B; 10-15 min, 30-45% B; 15-20 min, 45-95% B; the flow rate was kept at 0.3 mL/min.

MS detection was performed on Waters Xevo TQ-S Triple Quadrupole Mass Spectrometer (American, waterscompany). Quantification was performed using multiple reaction monitoring (MRM) mode. The optimized MS conditions for the positive ion mode were as follows: capillary voltage 3.0 KV, cone voltage 30 V, solvent removal temperature 350 C. The optimized MS conditions for the negative ion mode were as follows: capillary voltage 2.0 KV, cone voltage 37 V, desolvation temperature 350 C. The mass spectrometry analysis conditions of the 16 compounds were optimized and summarized in Table 1.

Table 1 Condition parameters of mass spectrometry analysis of 16 compounds in Xin-Su-Ning capsules.
Compound Formula Parent Daughters CV CE Detection mode
Sophocarpine C15H22N2O 247.14 136.13 82 28 positive
Matrine C15H24N2O 249.16 148.16 80 26 positive
Febrifugine C20H18NO4 336.16 320.24 20 28 positive
Berberine C21H22NO4 352.12 308.13 62 28 positive
Palmatine C16H19N3O3 302.11 138.13 32 14 positive
Tangeratin C20H20O7 373.03 343.14 26 26 positive
Nobiletin C21H22NO8 403.10 373.15 84 26 positive
Liensinine C37H42N2O6 611.40 206.17 100 34 positive
Neferine C38H44N2O6 625.42 206.16 100 30 positive
Scopoletin C10H8O4 191.01 176.03 36 16 negative
Isoliquiritigenin C15H12O4 255.11 119.15 46 24 negative
Liquiritigenin C15H12O4 255.17 119.15 40 26 negative
Naringenin C15H12O5 271.04 151.07 30 20 negative
Naringin C27H32O14 579.21 151.05 80 46 negative
Hesperidin C28H34O15 609.22 301.18 48 24 negative
Glycyrrhizic acid C42H62O16 821.56 351.09 38 42 negative

2.7

2.7 Method validation of UHPLC–QQQ–MS/MS

According to “2.6” analysis conditions and “2.2” extraction conditions, the linearity, limit of detection (LOD), limit of quantification (LOQ), precision, repeatability, stability and recovery rate of 16 compound markers were determined. The standard curve was drew with the concentration x (ng/mL) of the reference substance as the abscissa and the corresponding peak area y of each reference substance as the ordinate. Then linear regression was performed on the standard curve to examine the correlation coefficient and linear range of the resulting linear regression equation. LOD and LOQ were determined based on the standard deviation of response value and the slope of standard curve, calculation formula: LOD=3.3δ/S, LOQ=10δ/S (δ, standard deviation; S, slope). XSNC was accurately weighed to test its precision, repeatability and stability. The test solution was continuously injected 6 times within 24 hours to evaluate the accuracy of the instrument, and 16 identical samples were prepared for repeatability analysis. The stability of the samples was studied after being placed at room temperature for 0, 2, 4, 8, 12 and 24 hours. The test solution and the reference solution were added at a ratio of 1:1, and six parts were measured in parallel to calculate the recovery rate of each component.

3

3 Results

3.1

3.1 Identification of chemical composition of Xin-Su-Ning capsules

3.1.1

3.1.1 Analysis of volatile components

The volatile components in XSNC were analyzed by GC-MS. The total ion flow diagram was shown in Fig. 1. A total of 21 volatile components were identified by searching with NIST mass spectrometry database (Table 2).

The total ion current diagram of volatile components in Xin-Su-Ning capsules.
Fig. 1
The total ion current diagram of volatile components in Xin-Su-Ning capsules.
Table 2 Identification List of volatile Components of Xin-Su-Ning capsules.
No tR(min) Compounds Molecular formula possibility Forward match Reverse match CAS
1 4.249 2-Methylbutanal C5H10O 85.02 910 918 96-17-3
2 5.382 Ethylpropenylether C5H10O 65.08 876 888 928-55-2
3 7.184 2-Ethoxyoxolane C6H12O2 64.13 808 811 13436-46-9
4 10.114 (Z)-2-Butenoic acid ethyl ester C6H10O2 78.51 910 911 6776-19-8
5 12.116 Ethyl acetate C8H16O2 90.07 868 875 123-66-0
6 15.183 Methyl lactate C4H8O3 95.95 859 883 2155-30-8
7 15.716 Methylheptenone C8H14O 73.86 778 865 110-93-0
8 19.984 Acetoxy-2-acetone C5H8O3 87.60 898 935 592-20-1
9 21.380 2-Acetylfuran C6H6O2 74.57 943 950 1192-62-7
10 21.581 Pyrrole C4H5N 81.84 939 946 109-97-7
11 21.781 2,4-Dihydroxy-2,5-dimethyl-3 C6H8O4 68.04 740 797 10230-62-3
12 22.113 Propionic acid C3H6O2 79.50 960 977 137-40-6
13 23.515 5-Methylfuran aldehyde C6H6O2 85.14 900 913 620-02-0
14 24.116 Hotrienol C10H16O 73.52 789 811 20053-88-7
15 25.380 γ-Butyrolactone C4H6O2 60.08 961 966 96-48-0
16 25.849 Furfuryl alcohol C5H6O2 67.13 916 916 98-00-0
17 27.583 5-Methyl-2-furanmethanol C6H8O2 86.83 806 806 3857-25-8
18 29.048 2(5H)-Furanone C4H4O2 64.78 735 934 497-23-4
19 34.450 2-Acetylpyrrole C6H7NO 77.55 930 935 1072-83-9
20 40.646 Ethyl palmitate C18H36O2 91.76 901 903 628-97-7
21 40.715 Ethyl hexadecanoate C18H36O2 71.12 700 721 628-97-7

3.1.2

3.1.2 Analysis of non-volatile components

UHPLC-MS was used to analyze the non-volatile components in XSNC. The total ion flow diagram of the sample solution and the reference solution were shown in Fig. 2. For the compounds with chemical standards, according to the retention time, as well as accurate and high-resolution mass and tandem mass spectra, as a results, 10 compounds (peak 1, 2, 9, 26, 34, 37, 38, 43, 49 and 50) were identified as matrine, sophocarpine,scopoletin, jatrorrhizine, liquiritigenin, berberine,palmatine, isoliquiritigenin, nobiletin and Tangeratin, respectively. For the compounds without chemical standards, based on the retention time, exact mass data, fragment information, and molecular formula reported in the literatures, a total of 49 compounds were detected. Take hesperidin as an example to illustrate the fragmentation process, peak 20 exhibited the precursor ion [M−H]- ion at m/z 609.1822 in the negative mode and [M+H]+ ion at m/z 611.1976 in the positive mode. It was speculated that the relative molecular weight of the compound was 610 and the predicted molecular formula was C28H34O15. In the first-order mass spectrum of positive ion mode, there were fragments of m/z 449.1439 and m/z 465.1389, and in the second-order mass spectrum, there were fragment ions of m/z 303.0861 [M+H–Rha–Glc]+, m/z 153.0182 [M+H–Rha–Glc–C9H10O2]+, which was consistent with the fragments of hesperidin in the literature, and speculated that the compound was hesperidin (Chen et al., 2012). All in all, a total of 59 chemical constituents were tentatively identified including 18 alkaloids, 33 flavonoids, 5 coumarins, 2 alcoholamines and 1 triterpenoid (Table 3). Among these compounds, sophocarpine, matrine, febrifugine, berberine, palmatine, Tangeratin, nobiletin, liensinine, neferine, scopoletin, isoliquiritigenin, liquiritigenin, naringenin, naringin, hesperidin and glycyrrhizic acid were mainly active constituents with reported bioactivities. As a result, the quantitative analysis of these 16 constituents was performed in XSNC extracts.

Total ion current diagram of non-volatile components in Xin-Su-Ning capsules (A: positive ion mode Xin-Su-Ning capsules extract TIC; B: positive ion mode reference substance TIC; C: negative ion mode Xin-Su-Ning capsules extract TIC; D: negative ion mode reference substance TIC).
Fig. 2
Total ion current diagram of non-volatile components in Xin-Su-Ning capsules (A: positive ion mode Xin-Su-Ning capsules extract TIC; B: positive ion mode reference substance TIC; C: negative ion mode Xin-Su-Ning capsules extract TIC; D: negative ion mode reference substance TIC).
Table 3 Identification List of non-volatile Components of Xin-Su-Ning capsules.
Peak NO. tR (min) Formula Measured (m/z) Detected (m/z) Delta (ppm) Fragments Identification class source
1# 2.21 C15H24N2O 248.1889 249.1959 –0.642 148.1116 150.1271 112.0760 Matrine Alkaloids Sophora flavescens
2# 2.48 C15H22N2O 246.1732 247.1804 –0.283 229.1705 179.1541 150.1275 136.1132 Sophocarpine Alkaloids Sophora flavescens
3 3.51 C15H22N2O 246.1732 247.1804 –0.525 148.1121 136.1125 112.0763 Sophocarpine Isomers Alkaloids Sophora flavescens
4 3.76 C15H24N2O2 264.1838 265.1909 –0.394 150.1278 138.1277 Hydroxylated matrine Alkaloids Sophora flavescens
5 4.06 C16H19N3O3 301.1421 302.1497 –0.556 284.1398 203.0816 138.0914 Febrifugine Alkaloids Changshan
6 4.52 C19H23NO3 313.1678 314.1748 –0.732 269.1172 237.0911 107.0495 Lotusine Alkaloids Lotus Seed Heart
7 6.48 C20H24NO4 342.1705 342.1696 –1.241 265.0858 297.1119 Magnoflorine Alkaloids Coptis
8 7.45 C27H30O14 578.1636 579.1706 –0.418 271.0599 195.0287 219.0287 153.0181 Rhoifolin Flavone Citrus aurantium
9# 7.53 C10H8O4 192.0423 193.0495 –0.131 178.0261 133.0284 137.0597 145.0958 Scopoletin Coumarin Citrus aurantium
10 8 C27H32O15 596.1741 595.1671 0.347 459.1097 287.0555 269.0454 135.0436 Eriocitrin Flavone Citrus aurantium
11 8.16 C26H30O13 550.1686 549.1609 –0.754 297.0073 255.0655 153.0180 Glycyrrhizin-4'-apirin Flavone Citrus aurantium
12 8.36 C27H30O16 610.1484 609.1465 0.611 301.0341 269.0451 201.0556 151.0022 88.9862 Rutin Flavone Citrus aurantium
13 8.45 C27H32O15 596.1741 595.1669 0.146 459.1134 339.0707 287.0556 235.0556 Neoeriocitrin Flavone Citrus aurantium
14 8.73 C27H30O15 594.1585 593.1513 0.197 447.0923 327.0599 285.0395 Lonicerin Flavone Citrus aurantium
15 9.3 C19H15NO4 322.1079 322.1071 –0.914 307.0837 294.0759 Greenland Xanthine Alkaloids Coptis
16 9.32 C27H32O14 580.1792 579.1718 –0.309 339.9276 295.0617 151.0023 Narirutin Flavone Citrus aurantium
17 9.75 C27H32O14 580.1792 579.1714 0.162 459.1171 271.0607 151.0022 119.0487 Naringin Flavone Citrus aurantium
18 9.8 C15H12O5 272.0685 273.0753 –1.794 153.0182 147.0040 171.0287 177.0546 Naringenin isomers Flavone Citrus aurantium
19 9.85 C21H22O10 434.1163 433.1134 –1.432 363.3987 271.0607 151.0022 83.0123 Prunin Flavone Citrus aurantium
20 10.17 C28H34O15 610.0898 609.1822 –0.498 325.0722 301.0710 164.0102 151.0022 Hesperidin Flavone Citrus aurantium
21 10.41 C28H32O15 608.1691 607.167 0.34 329.1388 299.0554 242.0673 164.0103 125.0228 Neogeranin Flavone Citrus aurantium
22 10.64 C16H14O6 302.0785 303.0858 –1.764 153.0182 285.0758 322.1056 Hesperetin Flavone Citrus aurantium
23 10.7 C28H34O15 610.0898 609.18119 –0.892 555.9461 325.0710 301.0711 286.0476 151.0022 Neohesperidin isomers Flavone Citrus aurantium
24 10.81 C22H24O11 464.1319 463.1247 0.227 301.0709 286.0476 242.0575 151.0021 Hesperetin-7-O-β-D-glucoside Flavone Citrus aurantium
25 10.89 C28H32O15 608.1691 607.167 0.242 489.1394 343.0817 301.0710 267.0657 151.0023 Geranidin Flavone Citrus aurantium
26# 10.9 C20H20NO4 338.1392 338.1383 –1.108 294.1133 97.1016 83.0861 Jatrorrhizine Alkaloids Sophora flavescens
27 11.01 C20H18NO4 336.1236 336.1226 –1.232 320.0917 292.0962 292.0966 Dihydroberberine Alkaloids Coptis
28 11.08 C26H30O13 550.1686 549.16156 0.357 399.1046 255.0655 153.0179 135.0072 Isoliquiritin glucocelium Flavone Licorice
29 11.09 C19H14NO4 320.0923 320.0913 –1.232 277.0729 262.0871 Coptisine Alkaloids Coptis
30 11.17 C20H20NO4 338.1392 338.1385 –2.202 323.1144 294.1122 308.0920 Tetrandrine isomers Alkaloids Coptis
31 11.48 C21H22O9 418.1264 419.1335 –0.426 257.0806 137.0233 239.0702 Liquiritin Flavone Licorice
32 11.71 C20H20NO4 338.1392 338.1385 –0.487 323.1147 294.1121 Tetrandrine isomers Alkaloids Coptis
33 11.96 C19H15NO4 322.1079 322.1072 –0.635 307.0838 279.0880 Berberrubine Alkaloids Coptis
34# 12 C15H12O4 256.0736 257.0808 –0.332 211.0753 147.0441 137.0234 119.0494 Liquiritigenin Flavone Licorice
35 12.23 C21H20NO4 350.1386 350.1387 –0.042 334.1072 322.0706 306.1126 13-methylepiberberine Alkaloids Coptis
36 12.8 C16H12O5 284.0679 285.0756 –0.648 270.052 253.0493 225.0546 Calycosin Flavone Sophora flavescens
37# 12.96 C20H18NO4 336.1236 336.1227 –1.055 321.0984 292.0966 306.0757 Berberine Alkaloids Coptis
38# 13.27 C21H22NO4 352.1549 352.1539 –1.149 337.1296 322.1074 308.1280 Palmatine Alkaloids Coptis
39 13.91 C28H34O14 594.1943 595.2021 0.03 287.0911 153.0182 Poncirin Flavone Citrus aurantium
40 14.93 C15H12O5 272.0685 273.0756 –0.476 153.0182 147.0440 119.0494 Naringenin Flavone Citrus aurantium
41 15.08 C21H20NO4 350.1387 350.1386 –1.358 335.1142 320.0918 306.1123 292.0971 254.0569 13-methylberberine Alkaloids Coptis
42 16.18 C16H14O6 302.079 301.0718 0.261 286.0479 257.0841 242.0574 233.0796 Hesperetin Flavone Sophora flavescens
43 17.95 C15H12O4 256.0736 255.0661 –0.162 211.0753 135.0072 119.0487 Isoliquiritigenin Flavone Licorice
44 18.33 C16H12O4 268.073 269.0805 –1.358 237.0542 137.0233 118.0414 Formononetin Coumarin Citrus aurantium
45 18.53 C15H16O4 260.1043 261.1114 –2.74 189.0545 243.1012 159.0440 131.0492 Hesperitone Coumarin Citrus aurantium
46 19.67 C26H30O8 470.1935 471.2009 –0.414 425.1963 339.1952 213.0911 161.0598 95.0132 Limonin Flavone Citrus aurantium
47 19.64 C19H18O6 342.1098 343.1172 –0.335 313.0704 285.0755 181.0129 373.0918 4',5,7,8-tetramethoxyflavonoid Flavone Citrus aurantium
48 19.97 C42H62O16 822.4038 821.3964 –0.108 683.7745 513.6673 443.4119 351.0563 175.0234 Glycyrrhizic acid Flavone Citrus aurantium
49# 20.7 C21H22O8 402.1315 403.1383 –0.404 388.1163 373.0916 355.0822 Nobiletin Flavone Citrus aurantium
50# 22.17 C20H20O7 372.1209 373.1277 –1.397 343.0811 358.1042 325.0703 Tangeratin Flavone Citrus aurantium
51 22.09 C26H30O6 438.2042 437.1969 –0.142 301.1429 151.0386 91.0539 Kurarinone Flavone Sophora flavescens
52 22.21 C16H35NO2 273.2662 274.2737 –1.261 256.2634 Cetyl-Dihydrosphingosine Alcoholamines Pinellia
53 23.67 C27H32O6 452.2193 453.2268 –0.85 329.1025 303.1590 197.0440 2’-Methoxymatrine Flavone Sophora flavescens
54 23.84 C25H30O6 424.1886 423.1816 0.634 261.1491 161.0231 109.0281 Kushenol E isomers Flavone Sophora flavescens
55 25.97 C25H30O6 424.1886 423.1967 –0.553 261.1491 161.0231 109.0281 Kushenol E isomers Flavone Sophora flavescens
56 26.54 C26H30O6 438.2042 437.1967 –0.553 275.1648 161.0230 109.0277 Kuraridin Flavone Sophora flavescens
57 27.18 C30H46O4 470.3391 469.3312 –0.326 425.3423 409.3109 Glycyrrhetinic acid Triterpene Licorice
58 27.47 C20H43NO2 329.3288 330.3361 –1.623 312.3257 106.0866 88.0762 2-amino-1,3-eicosanediol Alcoholamines Pinellia
59 28.21 C19H22O3 298.1563 299.1633 –0.871 189.0542 163.0389 119.0494 Grapefruit lactone Coumarin Citrus aurantium

Note: # stands for comparison with standard products.

3.2

3.2 Quantitative analysis

Through LC-MS multiple reaction detection mode, the test solution was prepared according to the method under “2.2”, and the prepared test solution was determined under the detection conditions “2.6”. Aiming at the problem of large difference in mass spectrum response and content of various types of compounds in the complex system of XSNC, through the multiple dilution method, the same sample was prepared by preparing a low dilution ratio test solution to detect components with low mass spectrometry response and low content (including febrifugine, liensinine, neferine, scopoletin, isoliquiritigenin, liquiritigenin, naringenin, naringin, hesperidin, and glycyrrhizic acid); then low dilution ratio sample was diluted by times to obtain the test solution with high dilution ratio to detect the components with high mass response and high content (including sophocarpine, matrine, berberine, palmatine, Tangeratin and nobiletin). The rapid detection of various components in the sample was realized by different dilution methods.

3.2.1

3.2.1 Methodology validation

LC-MS was used for the quantitative analysis of sophocarpine, matrine, febrifugine, berberine, palmatine, Tangeratin, nobiletin, liensinine, neferine, scopoletin, isoliquiritigenin, liquiritigenin, naringenin, naringin, hesperidin and glycyrrhizic acid .The 16 index components had a good linear relationship within the corresponding concentration range, and their R2 were all greater than 0.999, the LOD and LOQ were 0.146-60.074 ng/mL and 0.442-182.043 ng/mL, the results were shown in Table 4. The relative standard deviation (RSD) values of accuracy, repeatability, and stability were all less than 2.90 %, indicating that the instrument had good precision, the method had high repeatability, and the sample solution was stable for 24 h at room temperature. The sample recovery rate was between 99.65%-104.03%, and the RSD value was less than 4.35 %, indicating that the recovery rates of the 16 compounds in XSNC were good, and the established method had sufficient reliability and accuracy, the results were summarized in Table 5 (Supporting information Table S1-S5).

Table 4 Linear equation, linear range of, LOD and LOQ sixteen analytes in UHPLC-QQQ-MS/MS.
Compounds Regression equation R2 Linearity range (ng/mL) LOD (ng/mL) LOQ (ng/mL)
Sophocarpine y =8033.50x + 112717.00 R2 = 0.9992 15.625-1000 4.910 14.880
Matrine y = 3834.20x- 25.18 R2 = 0.9997 15.625-1000 3.362 10.187
Febrifugine y =2782.70x- 1136.30 R2 = 0.9994 0.781-50 0.146 0.442
Berberine y = 13757.00x + 16757.00 R2 = 0.9999 15.625-1000 3.722 11.280
Palmatine y = 16658.00x - 3566.10 R2 = 1.0000 15.625-1000 3.236 9.805
Tangeratin y = 92881.00x + 5240.10 R2 = 0.9994 0.781-50 0.320 0.971
Nobiletin y = 73488.00x + 16786.00 R2 = 0.9998 0.781-50 0.498 1.509
Liensinine y = 721.52x - 757.60 R2 = 0.9990 1.563-100 0.429 1.299
Neferine y = 1079.90x - 3426.70 R2 = 0.9993 7.813-500 2.296 6.959
Scopoletin y = 148.42x - 293.17 R2 = 0.9995 3.906-250 1.230 3.729
Isoliquiritigenin y = 418.49x - 279.76 R2 = 0.9994 1.563-100 0.461 1.395
Liquiritigenin y = 233.48x - 115.91 R2 = 0.9992 1.563-100 0.158 0.480
Naringenin y =295.30x - 599.14 R2 = 0.9996 7.813-500 2.435 7.378
Naringin y = 156.15x + 1022.20 R2 = 1.0000 234.375-15000 60.074 182.043
Hesperidin y = 433.93x + 109.30 R2 = 0.9992 15.625-1000 4.831 14.641
Glycyrrhizic acid y = 213.75x - 2960.30 R2 = 0.9993 31.250-2000 5.541 16.792
Table 5 The results of precision, repeatability, stability, and recovery in UHPLC-QQQ-MS/MS (n = 6).
Compounds Precision RSD (%) Repeatability RSD (%) Stability RSD (%) Recovery
Mean RSD (%)
Sophocarpine 0.77 0.93 0.44 100.43 4.35
Matrine 0.28 0.93 0.30 101.14 2.15
Febrifugine 1.94 2.04 2.17 101.58 1.32
Berberine 0.82 1.26 0.81 99.92 0.43
Palmatine 1.65 1.18 1.02 100.35 1.25
Tangeratin 0.77 1.23 0.54 101.65 0.25
Nobiletin 0.49 1.25 0.51 101.19 1.03
Liensinine 1.90 2.34 1.29 101.98 2.79
Neferine 2.06 1.22 1.05 99.65 1.92
Scopoletin 0.45 2.61 0.49 101.81 1.47
Isoliquiritigenin 0.68 2.29 0.73 99.71 0.77
Liquiritigenin 1.98 2.90 1.82 101.50 2.09
Naringenin 1.11 1.90 2.42 99.71 2.50
Naringin 0.37 2.73 0.80 104.03 0.60
Hesperidin 0.25 2.47 0.84 99.89 1.27
Glycyrrhizic acid 0.47 1.90 1.14 101.06 1.27

3.2.2

3.2.2 Determination of sample content

Multiple reaction monitoring (MRM) is a highly specific and sensitive mass spectrometry technique for quantifying predefined compounds of interest. The UHPLC–MS/MS analysis method described above was subsequently used to simultaneously quantify 16 compounds in 10 collected batches. Every sample was analyzed in triplicates to acquire the average contents of the constituents. The results were shown in Table 6.

Table 6 Contents of 16 compounds in 10 batches of Xin-Su-Ning capsules.
Sample batch Sophocarpine (mg/g) Matrine (mg/g) Febrifugine (mg/g) Berberine (mg/g) Palmatine (mg/g) Tangeratin (mg/g) Nobiletin (mg/g) Liensinine (mg/g) Neferine (mg/g) Scopoletin (mg/g) Isoliquiritigenin (mg/g) Liquiritigenin (mg/g) Naringenin (mg/g) Naringin (mg/g) Hesperidin (mg/g) Glycyrrhizic acid (mg/g)
220201 3.06 ± 0.27 11.62 ± 0.75 0.05 ± 0.00 31.05 ± 1.31 7.56 ± 0.32 0.46 ± 0.01 0.55 ± 0.02 0.06 ± 0.01 0.38 ± 0.01 0.36 ± 0.03 0.11 ± 0.01 0.15 ± 0.01 0.43 ± 0.04 28.01 ± 0.01 9.86 ± 0.21 1.66 ± 0.03
220202 2.65 ± 0.10 11.65 ± 0.21 0.06  ± 0.01 31.66 ± 0.64 7.79 ± 0.06 0.46 ± 0.00 0.55 ± 0.01 0.05 ± 0.00 0.37 ± 0.01 0.40 ± 0.01 0.12 ± 0.00 0.17 ± 0.00 0.52 ± 0.01 32.64 ± 0.05 10.99 ± 0.23 1.59 ± 0.04
210701 4.39 ± 0.20 15.90 ± 1.62 0.06 ± 0.00 34.25 ± 1.44 8.77 ± 0.21 0.45 ± 0.01 0.55 ± 0.01 0.07 ± 0.00 0.45 ± 0.11 0.69 ± 0.02 0.12 ± 0.00 0.24 ± 0.01 0.77 ± 0.02 47.02 ± 0.94 13.24 ± 0.13 1.60 ± 0.04
220101 2.52 ± 0.29 10.38 ± 0.99 0.17 ± 0.02 34.96 ± 0.93 8.82 ± 0.03 0.36 ± 0.00 0.43 ± 0.01 0.06 ± 0.01 0.41 ± 0.03 0.42 ± 0.02 0.20 ± 0.01 0.23 ± 0.01 0.44 ± 0.01 34.38 ± 0.36 13.46 ± 0.08 1.25 ± 0.04
210901 3.15 ± 0.05 12.16 ± 0.07 0.15 ± 0.01 25.35 ± 1.21 6.31 ± 0.26 0.27 ± 0.00 0.30 ± 0.01 0.05 ± 0.00 0.33 ± 0.03 0.53 ± 0.02 0.10 ± 0.00 0.16 ± 0.01 0.37 ± 0.02 24.66 ± 0.49 6.77 ± 0.10 1.66 ± 0.04
210502 4.05 ± 0.03 14.39 ± 0.77 0.10 ± 0.01 37.07 ± 0.54 8.79 ± 0.13 0.59 ± 0.02 0.58 ± 0.01 0.07 ± 0.01 0.55 ± 0.02 0.45 ± 0.01 0.19 ± 0.00 0.20 ± 0.01 0.42 ± 0.03 26.34 ± 0.84 7.57 ± 0.21 1.59 ± 0.04
210301 1.72 ± 0.08 9.20 ± 0.39 0.04 ± 0.01 20.60 ± 0.62 5.18 ± 0.17 0.37 ± 0.01 0.41 ± 0.01 0.05 ± 0.00 0.40 ± 0.01 0.32 ± 0.01 0.12 ± 0.01 0.15 ± 0.01 0.36 ± 0.01 19.03 ± 0.01 5.11 ± 0.05 1.72  ± 0.03
210501 3.96 ± 0.05 11.79 ± 0.03 0.07 ± 0.01 30.90 ± 1.30 7.50 ± 0.22 0.46 ± 0.01 0.53 ± 0.01 0.08 ± 0.01 0.68 ± 0.01 0.29 ± 0.01 0.12 ± 0.01 0.18 ± 0.00 0.61 ± 0.02 35.63 ± 0.40 9.46 ± 0.03 2.97 ± 0.02
201001 2.86 ± 0.06 10.56 ± 0.76 0.02 ± 0.00 17.13 ± 0.78 4.46 ± 0.15 0.35 ± 0.01 0.39 ± 0.01 0.04 ± 0.01 0.32 ± 0.01 0.35 ± 0.02 0.05 ± 0.00 0.09 ± 0.00 0.32 ± 0.02 17.33 ± 0.33 3.31 ± 0.05 0.55 ± 0.01
211101 2.16 ± 0.03 9.40 ± 0.03 0.05 ± 0.00 26.73 ± 0.49 6.34 ± 0.26 0.34 ± 0.01 0.37 ± 0.00 0.07 ± 0.01 0.66 ± 0.01 0.37 ± 0.00 0.09 ± 0.00 0.16 ± 0.01 0.40 ± 0.02 23.38 ± 0.34 6.40 ± 0.14 1.89 ± 0.09

Note: values are expressed as the mean ± SD of three parallel samples.

4

4 Discussion

How to combine the basic requirements of “safe, effective and controllable quality” with the characteristics of TCM is the key problem of TCM quality research and control. In this context, Academician Liu Changxiao and his team put forward the concept of Chinese medicine quality marker (Q-Marker) (Liu, 2019; Liu et al., 2016). In view of this, a method for simultaneous quantitative analysis of 16 chemical components in XSNC was established. Berberine and palmatine are derived from the prince drug Coptidis Rhizoma. A large number of studies have shown that berberine mainly exerts anti-arrhythmic effects by affecting potassium ion channels (Chen et al., 2018); Palmatine and berberine have similar structures and have higher content in Coptidis Rhizoma, it also has better anti-arrhythmic activity (Liu et al., 2017, 2017). Sophocarpine and matrine are derived from the official medicine Sophorae flavescentis Radix, and liensinine, neferine come from the central medicine Nelumbinis Plumula. These alkaloids can exert their anti-arrhythmic effects by influencing myocardial cell ion channels and prolonging APD (Jain and Parmar, 2011). Hesperidin is derived from the adjuvant Aurantii Fructus Immaturus, and isoliquiritin is derived from the drug Glycyrrhizae Radix et Rhizoma. These ingredients are all antiarrhythmic active ingredients (Ojha et al., 2013). Another research report glycyrrhizic acid has a protective effect on the heart (Ding et al., 2018). Dichroae Radix has small poison and febrifugine is the active component of Dichroae Radix, the content of febrifugine is determined to ensure the safety of TCM compound preparation. The active ingredients and characteristic ingredients contained in each component of the TCM are selected as indicators for quantitative analysis, which can provide a better reference for the quality evaluation and the material basis of the medicinal effect of the traditional Chinese medicine compound.

The chemical components of XSNC are complex and it is difficult to achieve baseline separation by liquid chromatography. In this experiment, multi reaction monitoring technology (MRM) in LC-MS technology was selected for quantitative analysis of the selected 16 chemical components. MRM monitoring mode can detect and analyze specific compounds with strong specificity, high sensitivity and high accuracy. Different compounds have different mass spectrometric responses, and the content of each component is completely different. To solve this problem, a multiple dilution method was constructed to realize the simultaneous quantitative analysis of 16 components in XSNC.

In this study, qualitative analysis of the chemical components of XSNC was carried out by GC-MS and LC-MS techniques. A total of 21 volatile components and 59 non-volatile components were identified, which further clarified the chemical composition of XSNC. It provides a reference for the characterization of chemical components of other TCM preparations; on the basis of LC-MS technology, considering the active components and characteristic components contained in various components of XSNC, the quantitative analysis of 16 chemical components with great content difference in XSNC was realized by constructing the double ratio dilution method. The method has high sensitivity and good selectivity, which can provide experimental basis for formulating a comprehensive quality control method of XSNC.

Acknowledgements

This work was supported by the National Key Research and Development Plan of China (No.2018YFC1707403); the Science and Technology Program of Tianjin (No.20ZYJDJC00120 and 21ZYJDJC00080).

Funding information

National Key Research and Development Plan of China, Grant Number: 2018YFC1707403; Science and Technology Program of Tianjin, Grant Numbers: 20ZYJDJC00120 and 21ZYJDJC00080.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

  1. , , , , , , . Simultaneous quantification of polymethoxylated flavones and coumarins in Fructus aurantii and Fructus aurantii immaturus using HPLC-ESI-MS/MS. Pharm. Biomed. Anal.. 2012;10:0456-0463.
    [Google Scholar]
  2. , , , , , , , , , , . Protective effect of berberine on aconite–induced myocardial injury and the associated mechanisms. Mol. Med. Rep.. 2018;18:4468-4476.
    [Google Scholar]
  3. , , , . Inheritance and innovation of traditional Chinese medicine from the development of Xinsuning capsule. Chin. Traditional Patent Med.. 2018;40:1875-1877.
    [Google Scholar]
  4. , , . Evolution of orbitrap mass spectrometry instrumentation. Annu. Rev. Anal. Chem.. 2015;8:61-80.
    [Google Scholar]
  5. , , , . Qualitative and quantitative analysis on chemical constituents from Curculigo orchioides using ultra high-performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry. J. Pharm. Biomed. Anal.. 2015;102:236-245.
    [Google Scholar]
  6. , , . Further progress in predicting life-threatening arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy. J. Am. Coll. Cardiol.. 2016;68:2551-2553.
    [Google Scholar]
  7. , , . Evaluation of antioxidative and anti-inflammatory potential of hesperidin and naringin on the rat air pouch model of inflammation. Inflamm. Res.. 2011;60:483-491.
    [Google Scholar]
  8. Li, Y., Du, Z., 2015. Overview on method and strategy of therapeutic material basisin traditional Chinese medicine by multidisciplinary approach.Zhongguo Zhongyao Zazhi. 40, 1644–1648.
  9. Li, Y., Wang, J., Li, X., Ma, X., Li, Z., 2019. Mechanism of bradyarrhythmia and Current Traditional Chinese and Western Medicine Treatment. Med. Rev. 25, 3221-3226+3231.
  10. , , , , , , . Q-Marker: A New Concept for Quality Control of Chinese Medicine Products. Chin. Herbal Med.. 2016;47:1443-1457.
    [Google Scholar]
  11. , . Developmentof Q-marker theory, methods and strategies, and research to improve the level of science and technology of Chinese medicine. Acta Pharm. Sin.. 2019;54:185-186.
    [Google Scholar]
  12. Liu, D., Cao, G., Si, X., Chen, Q., Sun, H., 2017. Summary of the research on anti-arrhythmia of the alkaloids from Coptidis Rhizoma. Shandong J. Traditional Chin. Med., 36, 164-166+171.
  13. , , , . Qualitative and quantitative analysis of major constituents from Dazhu Hongjingtian capsule by UPLC/Q-TOF-MS/MS combined with UPLC/QQQ-MS/MS. Biomed. Chromatogr.. 2017;31:1-10.
    [Google Scholar]
  14. , , , . The effects of paeonol on the electrophysiological properties of cardiac ventricular myocytes. Eur. J. Pharmacol.. 2006;545:87-92.
    [Google Scholar]
  15. , , , , , . Glycyrrhiza glabra protects from myocardial ischemia-reperfusion injury by improving hemodynamic, biochemical, histopathological and ventricular function. Exp. Toxicol. Pathol.. 2013;65:219-227.
    [Google Scholar]
  16. , , . Arrhythmia-Induced Cardiomyopathy. Dtsch Arztebl Int.. 2018;115:335-341.
    [Google Scholar]
  17. , . On the research progress of antiarrhythmic effects of traditional Chinese medicines. China Modern Med. Appl.. 2017;11:194-195.
    [Google Scholar]
  18. , , , , , , , , , , , , . Rapid identificationof chemical compositions in callicarpa kwangtungensisChun byultrahigh-performance liquid chromatography with Q Exactive hybrid quadrupole orbitrap highresolution accurate mass spectrometry. J. Sep. Sci.. 2020;43:2487-2494.
    [Google Scholar]
  19. , , . Research progress of antiarrhythmic Chinese medicines acting on ion channels of cardiomyocytes. Chin. J. Integr. Med. Cardio-/Cerebrovasc. Dis.. 2017;15:1057-1059.
    [Google Scholar]
  20. , , , , . Xinsuning capsule for the treatment of premature ventricualr contraction: a multicenter randomised clinical trial. The Lancet.. 2017;390:61.
    [Google Scholar]

Appendix A

Supplementary data

Supplementary data to this article can be found online at https://doi.org/10.1016/j.arabjc.2022.103825.

Appendix A

Supplementary data

The following are the Supplementary data to this article:

Supplementary Data 1

Supplementary Data 1

Show Sections