臺灣博碩士論文加值系統

補中益氣湯是中醫用於輔助肝癌治療的主要方劑之一。本研究之目的在於探討補中益氣湯對於肝癌患者周邊血液單核細胞分泌腫瘤壞死因子-a及顆粒球株落刺激因子的影響。期望能漸次了解補中益氣湯對肝癌患者免疫系統的作用。本研究是以肝癌患者20位與非肝癌者12位為研究對象，從周邊血液分離出單核細胞後，分別加入不同濃度之補中益氣湯作測試培養。
結果顯示當補中益氣湯濃度增達125 mg/ml時，不論肝癌患者組與非肝癌者組，對於刺激單核細胞分泌腫瘤壞死因子-a 與顆粒球株落刺激因子皆有明顯增加的影響。在濃度625 mg/ml以上，刺激非肝癌者單核細胞分泌顆粒球株落刺激因子的增加量明顯高於肝癌患者，此結果可能顯示肝癌患者免疫反應雖較低下，但補中益氣湯可以透過調節顆粒球株落刺激因子之分泌來加強其免疫作用，只是尚無法提昇至非肝癌者的反應程度。而在刺激單核細胞分泌腫瘤壞死因子-a的增加方面，則肝癌患者與非肝癌者間沒有明顯差異。在一定的濃度範圍內，對於刺激單核細胞分泌腫瘤壞死因子-a 與顆粒球株落刺激因子的增加量會隨著補中益氣湯的濃度而有所增加。但在濃度達到3,125 mg/ml時，對於刺激單核細胞分泌腫瘤壞死因子-a增加的量有顯著降低。而當補中益氣湯增到濃度3,125 mg/ml經16小時培養後，對單核細胞並沒有明顯毒殺作用。因此較高濃度補中益氣湯造成腫瘤壞死因子-a 分泌增加量的下降，其原因尚值得進一步的研究與探討。
本研究可以了解補中益氣湯對於肝癌患者免疫系統的作用，有部份機轉是透過對於細胞激素如腫瘤壞死因子-a、顆粒球株落刺激因子等分泌的調節而發揮作用。並且在增加到高濃度時，不致於會有過度反應的情況產生。另外補中益氣湯對於刺激單核細胞分泌干擾素-g與轉型生長因子b1，並沒有明顯影響。

Bu-zhong-yi-qi-tang (BZYQT) is the kind of popular traditional Chinese medicine, and has been used for the treatment of hepatocellular carcinoma (HCC). At present, we still do not know the effects of BZYQT on the immune system very well.
The present in vitro study demonstrated that BZYQT is capable of increasing tumor necrosis factor-a (TNF-a) and granulocyte colony-stimulating-factor (G-CSF) produced by peripheral blood mononuclear cells (PBMC). The production levels of G-CSF by PBMC of health volunteers were higher than those of patients with HCC when more than 625 mg/ml of BZYQT was added. The reason may be due to the impaired immunologic reactivity in patients with HCC. When adding high concentration 3125 mg/ml of BZYQT to the cultured PBMC, the increment of cytokines production decreased although there were no obvious changes in the number of metabolic active PBMC.
Further studies are required to clarify this finding. By the way, BZYQT could not influence interferon-g or transforming growth factor b1 produced by PBMC. TNF-a and G-CSF are known to play important roles in the biological defense mechanism. Administration of BZYQT may, therefore, be beneficial for patients with HCC because it can induce these cytokines.