八味地黃丸改善代謝症候群效用之探討

傳統中藥以複方著稱，除各味藥各有其特有功效外，更有「君臣佐使」原則，利用不同用藥之間形成烘托、互補的功能而產生更好的療效。目前世界各國代謝症候群盛行率持續上升中，已成為重要的公共衛生議題。新的預防和治療代謝症候群策略是必須同時針對肥胖、高血壓、糖尿病及心血管疾病等一起進行整合性的治療。然而目前在市面上的西藥，大部份只能針對單一症狀進行診治，對於代謝症候群的諸多症狀，難以達到全面性的改善功效，而八味地黃丸中的部分單味草藥在過去的研究上，被發現具有改善血糖或血脂異常的潛力，甚至具改善胰島素阻抗的效用，因此本實驗擬測試八味地黃丸改善以胰島素阻抗為主要致病機轉的代謝症候群的功效性。實驗設計將雄性SD大鼠先分為2大組，分別為基礎組(B)及高果糖餵飼組，其中基礎組餵飼一般商業飼料，高果糖組則餵食60%果糖的配方飼料誘發大鼠產生代謝症候群現象。誘發成功之大鼠再依序分為控制組(C)、低劑量實驗組1g/kg (L)及高劑量實驗組2g/kg (H)。實驗為期10週。實驗期間收集禁食血漿測量血漿葡萄糖、三酸甘油酯、總膽固醇、胰島素等數值，並收集檢體測定胰島素訊息傳遞相關蛋白之磷酸化活性表現量，亦測量體重、腹部脂肪及血壓。結果顯示C組之血壓、三酸甘油酯、膽固醇、低密度脂蛋白膽固醇濃度、肝臟三酸甘油酯濃度及腹部脂肪皆顯著高於B組。而胰島素敏感性則顯著低於B組。相較於C組，L組具有改善血壓、三酸甘油酯、膽固醇及胰島素阻抗之作用，並增加高密度脂蛋白膽固醇比例。H組則可改善腹部肥胖、高血壓、高三酸甘油酯血症、高膽固醇血症及低密度脂蛋白過高之現象。本實驗同時發現，八味地黃丸可藉由增加胰島素受體基質-1、Akt與葡萄糖轉位蛋白Ⅳ的蛋白質表現量與活性來達到改善胰島素阻抗之效果。綜合以上結果顯示八味地黃丸具有改善代謝症候群之效用。

關鍵字

代謝症候群；高果糖飲食；八味地黃丸；胰島素阻抗

並列摘要

Traditional Chinese medical approach always deals with any disease with an integral view by using a special combination of different herbs. Each herb has its unique effect as well as balances the side effect from others and reaches to a holistic effect. Since metabolic syndrome (MS) includes obesity, hypertension, hyperglycemia and hyperlipidemia, the prevention and treatment of MS may be more effective by using the traditional Chinese approach, which takes advantage of complementary features among different herbs to yield a better result. In the past, some herbs used in Ba Wei Di Huang Wan (BW) have been found to improve blood glucose, dyslipidemia and even insulin resistance (IR). Therefore, in this study we tested the improving effect of BW on MS whose underlying pathophysiology may be related to IR. In our study, male Sprague-Dawley (SD) rats were divided into two groups, the basal (B) group, fed with normal chow diet, and the high-fructose group, fed with 60% fructose diet to induce MS. Then, the MS rats were further divided into the control group (C), low-dose (1g/kg) group (L) and the high-dose (2g/kg) group (H). The study was last for 10 weeks. Biochemical parameters related to fasting plasma glucose, triglyceride, total cholesterol, insulin and the activity and expression of insulin signaling pathway related proteins were measured. Body weight, abdominal fat mass and blood pressure were also determined. Results of our study showed that group C had significant increases in plasma triglyceride, cholesterol, LDL-C, hepatic triglyceride and systolic blood pressure as compared to group B. Insulin sensitivity of rats in group C was lower than group B. Compared with the group C, low dose BW ameliorated hypertension, hypertriglyceridemia, hypercholesterolemia and IR, and increased HDL/TC ratio in group L. In group H, high dose BW ameliorated abdominal obesity, hypertension, hypertriglyceridemia, hypercholesterolemia, IR and LDL/TC ratio. We also found that supplementation of BW ameliorated IR by enhancing the expression and activity of insulin signaling pathway related proteins, including insulin receptor substrate-1, Akt and GLUT 4. These findings indicate that BW supplementation is effective for improving MS.

並列關鍵字

insulin resistance ； metabolic syndrome ； high fructose diet ； Ba Wei Di Huang Wan

參考文獻

許勝發 (2002). 六味地黃丸降血糖作用之研究. 國立成功大學藥理學研究所碩士論文.

Alberti, K.G., and Zimmet, P.Z. (1998). Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15, 539-553.

Attie, A.D., and Scherer, P.E. (2009). Adipocyte metabolism and obesity. J Lipid Res 50 Suppl, S395-399.

Bai, Y., S. Zhang, K. S. Kim, J. K. Lee, and K. H. Kim (1996). Obese gene expression alters the ability of 30A5 preadipocytes to respond to lipogenic hormones. J. Biol. Chem. 271, 13939-13924.

Balkau, B., and Charles, M.A. (1999). Comment on the provisional report from the WHO consultation. European Group for the Study of Insulin Resistance (EGIR). Diabet Med 16, 442-443.

國際替代計量

八味地黃丸改善代謝症候群效用之探討

未授權

主題瀏覽