Indomethacin 與平胃散相互作用之探討

非類固醇止痛藥 Indomethacin 具有良好解熱、止痛、抗發炎的效果，是許多關節炎的病人常用的藥物，但在臨床上常因引起胃潰瘍的副作用，使病患在服用時須與制酸劑一起使用，效果卻不明顯。本研究目的是利用中藥治療胃腸疾病之平胃散與 Indomethacin 合併使用後，探討是否可以降低其副作用且不影響療效。利用Indomethacin 誘導胃黏膜細胞損傷及大鼠胃潰瘍，再合併使用平胃散，體外實驗結果顯示： 0.625~2.5mg / ml 的平胃散具有劑量依存性抑制 0.5 mM Indomethacin 誘導胃黏膜細胞毒性。體內實驗結果：餵服 200 mg / kg 之平胃散可減緩 40 mg/ kg Indomethacin 所誘導之大鼠胃潰瘍。再以 1% 鹿角菜膠誘發老鼠足掌腫脹中，評估平胃散與Indomethacin 合併之抗發炎作用，結果顯示：平胃散 200 mg / kg 未影響 Indomethacin 之抗發炎作用且可延長其作用時間。最後，檢測 Indomethacin 與平胃散合併後， Indomethacin 的血中濃度的變化，結果顯示： 200 mg / kg 平胃散合併使用時， Indomethacin 之血中濃度亦不會被影響。根據上述結果，平胃散可降低Indomethacin 誘導之胃潰瘍副作用，且不影響 Indomethacin 之原有抗發炎功效及血中濃度。此結果可做為中、西藥整合治療之參考。

關鍵字

平胃散； Indomethacin ；胃潰瘍；抗發炎

並列摘要

Indomethacin is one of the commonly used non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of arthritis. However,gastric ulcer is a common side effect of this drug. The purpose of this study was to investigate the effect of combined administration of indomethacin with Ping-wei san (PWS), a commonly used traditional Chinese medicine for the treatment of gastrointestinal disease, on reducing the side effects of indomethacin without affecting its efficacy. Indomethacin (0.5 mM) was used to induce gastric mucosal cell injury and gastric ulcer. Co-administration of PWS (0.625 ~ 2.5 mg / ml) resulted in a dose-dependent inhibition of indomethacin-induced gastric mucosal cell toxicity. PWS (200 mg / kg) could also reduce the indomethacin (40 mg / kg)-induced gastric ulcer in in vivo experiment. PWS (200 mg / kg) also augmented the anti-inflammatory effect of indomethacin in 1% carrageen-induced foot swelling in rat. Finally, pharmacokinetic study revealed that PWS co-treatment did not influence plasma level of indomethacin. Based on the above results, co-treatment with PWS reduced the occurrence of indomethacin-induced gastric ulcers without affecting the anti-inflammatory effect and the plasma concentration of indomethacin This result demonstrated an useful integration therapy of western and Chinese medicine.

並列關鍵字

Ping-wei San ； Indomethacin ； Gastric ulcer ； Anti-inflammation

參考文獻

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國際替代計量

Indomethacin 與平胃散相互作用之探討

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