- 學位論文
鹿茸、西洋蔘、黃芩、甘草及麻杏甘石湯
Studies of Chinese Medicines on Asthma I Cervi Parvum Cornu, Panacis Quinquefolii Radix, Scutellariae Radix, Glycyrrhizae Radix and Ma-Xin-Gan-Shi Tang
摘要
氣喘病的發生，與呼吸道炎性介質如組織胺(histamine)、白三烯C4(leucotriene C4,LTC4)之釋出及細胞素如interleukin 4(IL-4)、gamma interferon(IFN-γ)之參與有密切關係，在病理變化上呼吸道有炎性反應，造成上皮穿透性增加。故本研究探討中藥對氣喘的作用，分為兩部分評估：第一部分進行鹿茸(Cervus nippon Temminck)和西洋參(Panax quinquefolium Linne)封臨床小兒氣喘之輔助療效及免疫學變化之評估，選擇臨床氣喘病童共33名（服用鹿茸者20名，服用西洋參者13名），在不停用西藥治療下，配佐中藥之輔助治療，在服用中藥前後，進行免疫學變化之評估，探討病人血中histamine、LTC4、IL-4、IFN-γ、IgE等免疫因子之變化，並分別以細胞刺激劑(mitogen)、塵蹣(mite)抽取物為刺激劑，探討其作用於單核細胞(mononuclear cell，MNC)產生之非特異性及特異性免疫反應的變化。結果以鹿茸在各種免疫因子變化之評估上，對氣喘的改善作用較西洋參為佳。 第二部分針對氣喘發生時炎性反應所致的呼吸道上皮穿透性增加的現象，先建立氣管組織保護作用的生物活性測定模式，再探討氣喘急性發作時，上述臨床評估有效之中藥-鹿茸，和其他中醫常用治療氣喘之中藥方劑-六味地黃丸、麻杏甘石湯及其中藥方所含的單一活性成分-baicalin、glycyrrhizicacid、amygdalin，能否降低氣管穿透性而具保護機制進行研究。發現以鹿茸、麻杏甘石湯和麻杏甘石湯少杏仁，對氣管保護作用為佳。
並列摘要
Allergen-induced asthmatic response is induced by the influx ot inflammatory mediators (e.g. histamine, LTC4) into peribronchial tissues. Recently, asthma, T cell activation in asthma has been proposed, is associated with effect of cytokines (e.g. IL-4 、 IFN-γ). Increased airway epithelial permeability is observed in the pathology of asthma. Therefore, studies of Chinese medicines on asthma were separated into two parts to discuss: first. Pilose Deerhorn (Cervus nippon Temminck) and American Ginseng (Panax quinquefolium Linne) were investigated in an open clinical trial of asthmatic patients. Thirty-three asthmatics were recruited from the allergic clinics and they were treated with both conventional antiasthmatic drugs (e.g. aminophylline, β2 - agonist and prednisolone) and one of these two Chinese medicines. The immunologic effects of these two Chinese medicines on asthma before and after herbal drugs therapy were evaluated, including the measurement of inflammatory mediators (histamine, LTC4) production by polymorphonuclear cells and inflammatory cytokines (IL-4, IFN-γ) production by mononuclear cells. The change of nonspecific and specific immunologic effects in response to mitogen and mite extract was also detected, respectively. These results showed that Pilose Deerhorn was better than American Ginseng on improvement effect of asthma. The second part of this project was following to understand protective machanism of Pilose Deerhorn on tracheal epithelia in the cell membrane. We firstly established tracheal permeability model of aerosolized-ovalbumin sensitized guinea pigs by measuring transepi- thelial resistance and 14C flux amount. The results showed that after applied Pilose Deerhorn had decreasing tracheal permeability compared to non-treated sensitized guinea pigs. In addition, this model was also used to assess protective effect of other clinical Chinese prescriptions (e.g. Liu-Wei-Di-Huang Wan and Ma-Xin-Gan-Shi Tang) and pure components of herbal drugs (e.g. baicalin 、 glycyrrhizic acid and amygdalin) on tracheal permeability. These results concluded that pilose Deerhorn, Ma-Xin-Gan-Shi Tang and Ma-Xin-Gan-Shi Tang without Armeniacae semen had more protective effect on tracheal permeability.