牛蒡複方飲對幽門螺旋桿菌感染之影響

Effects of burdock complex extract on Helicobacter pylori infection

黃舒郁(Shu-yu Huang)

指導教授 ： 王進崑

中山醫學大學/健康管理學院/營養學研究所/碩士(2015年)

摘要

幽門螺旋桿菌 (Helicobacter pylori) 已被證實是造成胃炎、胃潰瘍、十二指腸潰瘍等消化性潰瘍的重要病因之一，在台灣有55%的人感染幽門螺旋桿菌，多數感染者都是無症狀的帶原者，約有10-20%的感染者會產生胃部病狀，約1-2%的病人會進展成胃癌，其嚴重程度不可忽視。臨床治療多是以三合一或四合一的藥物治療為主，包含了抗生素、制酸劑或黏膜保護劑，但伴隨著噁心、嘔吐、上腹疼痛及腹瀉等副作用，降低病人對藥物的依從性，且研究指出，幽門螺旋桿菌株對抗生素會產生抗藥性，降低治療之成功率。近來許多研究探討植物或食物促進健康、改善疾病症狀甚至治療病因。本試驗使用之牛蒡複方飲含牛蒡、當歸、紫草以及芝麻油，多用於中藥或食物食用為主，目前有許多研究證實有抑菌、抗氧化及抗發炎等功效，但對幽門螺旋桿菌之影響探討甚少，故本研究以人體試驗，探討牛蒡複方飲改善幽門螺旋感染之功效，並以細胞實驗為輔，了解牛蒡複方飲是否可抑制幽門螺旋桿菌或是抑制其附著。人體試驗以招募幽門螺旋桿菌感染但無病症的感染者，以碳13尿素呼吸測試數值 (C13-urea breath test, UBT) 大於10‰之感染者為主要納案條件，隨機分成試驗組和安慰劑組，並比較兩組在服用試驗飲品前後(0周、4周、8周)及追蹤期(10周)之UBT、發炎指標、抗氧化數值之變化。試驗組給予飲品4周後，UBT數值顯著減少並持續至追蹤期，而安慰劑組並無差異，發炎指標除腫瘤壞死因子(tumor necrosis factor α, TNF-α)於各期逐漸減少至追蹤期有顯著減少外，其餘指標並無變化，抗氧化數值也皆有顯著改善。利用人類胃上皮細胞株AGS細胞進行細胞實驗，將AGS細胞與幽門螺旋桿菌共同培養，再給予牛蒡複方飲之萃取物，發現牛蒡萃取物無法抑制H. pylori生長，但能有效抑制H. pylori附著於AGS細胞之效果。由本研究可知，牛蒡複方飲可透過抑制H. pylori附著，幫助人體改善H. pylori之感染，並提升其抗氧化能力。

關鍵字

牛蒡 ； 幽門螺旋桿菌 ； 碳13尿素呼吸測試

並列摘要

Helicobacter pylori infection is the major cause of chronic gastritis, gastric ulcer and gastric malignancy formation. In Taiwan, the prevalence of H. pylori approximately 55% most of H. pylori-positive patients is nonsymptomatic, but they had 10-20% risk to develop gastric diseases and 1-2% to develop gastric cancer which are unignored seriously problem. In clinically, the major treatment of H. pylori is triple or quadruple therapies which combine two antibiotics with either a bismuth compound or an antacid agents (proton pump inhibitor, PPI). However, the treatments cause several side effects, such as nausea, vomiting, diarrhea and abdominal pain that might lead poor medication adherence. Also, many studies suggest that some strains of H. pylori could mutate to resist antibiotic that reduced eradication rate. Recently, many studies investigated natural materials or food which could improve health, reduce disease symptom and even cure disease. In this study, burdock complex constituted by burdock (Arctium lappa), angelica (Angelica sinensis), gromwell (Lithospermum erythrorhizon) and sesame (Sesamum indicum) oil, which are commonly used in Chinese medicine. Many researches indicated all of four materials have antimicrobial, antioxidant and anti-inflammary effects. However, the inhibitory and preventive effects of these herbs on H. pylori remain unknown. The aim of this study is to investigate the inhibition of H. pylori infection by the supplement of burdock complex in clinical trial and determine whether burdock complex could inhibit H. pylori proliferation or adhesion in cell model. In clinical trial, we recruited H. pylori-positive subjects whose C13-urea breath test (UBT) value higher than 10‰, but they were nonsymptomatic. The H. pylori positive subjects (n = 36) were recruited and randomly divided into experimental and placebo groups. Burdock or placebo was taken for 8 weeks and 2 weeks of follow-up period after administration. The UBT value, antioxidant capacity, and inflammatory markers were analyzed and compared at the initial, 4th, 8th and 10th weeks. UBT value was significantly decreased in experimental group compared with base line, and no significant difference in placebo group. Moreover, as inflammatory markers, only tumor necrosis factor α (TNF-α) was decreased and had significant difference in 10th weeks. Also, antioxidant activity and total phenolics levels were increased after consuming 8 weeks of burdock complex. In cell model, the AGS cell was co-cultured with H. pylori then treated burdock complex extract, we found out the burdock complex extract could not inhibit H. pylori proliferation but inhibit adhesion of H. pylori to AGS cell. Burdock complex could improve H. pylori infection by inhibiting H. pylori adhesion on gastric epithelial cell and increase antioxidant capacity.

並列關鍵字

burdock ； Helicobacter pylori ； C13-urea breath test

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