臺灣博碩士論文加值系統

肝臟是人體重要的代謝器官，舉凡藥物、酒精等皆須經由肝臟代謝，任何能影響游離基的生成及抗氧化機制間的平衡，就會損傷肝細胞，最近的研究發現，不論是病毒性肝炎、酯肪肝、缺血或休克後的肝損傷等，自由基或過氧化脂質皆是誘發的原因或增惡的因子。因此具自由基清除作用的藥物，或抑制自由基產生的藥物，皆被期待成為肝病患者的治療或預防藥物。
本研究計劃目的，在探討肝病疾患常用中藥方劑的抗氧化活性。在十二種臨床常用的保肝中藥方劑中，研究它們清除超氧陰離子的活性，及抑制四氯化碳和氯化亞鐵引起肝細胞脂質過氧化的效力。我們發現十二種常用保肝中藥方劑中以茵陳蒿湯、大柴胡湯、龍膽瀉肝湯的抗氧化效用最為明顯。
另一方面，我們也探討茵陳蒿湯對急性肝損傷合併黃疸的病患，之全血超氧陰離子(O2o－)和過氧化氫(H2O2)的清除作用，並進一步探討其組成藥物茵陳蒿、梔子、大黃的抗氧化活性。結果發現，茵陳蒿湯水萃取物可以顯著地清除急性肝損傷患者全血中的超氧陰離子及過氧化氫，但以清除超氧陰離子的作用較明顯。此一研究結果也顯示茵陳蒿湯具有抑制白血球產生氧自由基的作用。另一方面，茵陳蒿湯的三種組成中藥大黃、茵陳蒿、梔子之水萃取物都具有清除由黃嘌呤/黃嘌呤氧化酵素產生之超氧陰離子的作用，並且能抑制氯化亞鐵誘發大白鼠肝細胞過氧化脂質的產生，三種中藥以大黃的作用最為顯著。由以上結果顯示，茵陳蒿湯能有效地清除急性肝損傷患者全血中之氧自由基，而三種組成中藥中又以大黃為最強的抗氧化劑。

Free radicals and lipid peroxide are related to the liver damage recently. They are thought to be the triggering or exerbating factors of viral hepatitis, fatty liver, post-ischemic or shock-induced liver injury. Those antioxidants with scavenging effect on free redicals are considered to be hepato- protective drugs. Many Chinese drugs used for liver disease have been found that their pharmacological effects are due to antioxidative activities. We selected twelve kinds of Chinese prescriptions and tested their scaverging effects of superoxide anion and the inhibitory activity on FeCl2. Also, we evaluated their suppressing effect on CCl4-induced lipid peroxidation of Wistar rats in vivo. Among the twelve prescriptions, Inchenhau-Tang, Tachaihu-Tang, and Rondansegan-Tang are found to have better antioxidative effects.
ICHT is mostly used in treatment of acute hepatitis with jaundice in ancient China. Therefore, we further investigated the scavenging effect of ICHT on the oxygen radicals, including superoxide anion(O2o－) and hydrogen peroxide(H2O2) in the whole blood of patients with acute hepatitis. Morever, we also investigated the anti-oxidative effect of Artemisiae Capillaris Herba(ACH), Gardeniae Fructus(GF), and Rhei Rhizoma(RR) which are composed of ICHT. The results show that the watery extract of ICHT significantly scavenged both superoxide anion and hydrogen peroxide in the whole blood of patients with acute hepatitis. The scavenging effect of ICHT on superoxide anion was greater than that on hydrogen peroxide. Furthermore, all of watery extracts of three composed herb drugs significantly scavenged superoxide anion produced by xanthine/xanthine oxidase, and markedly inhibited the production of lipid peroxidation from rat liver cells induced by FeCl2. Among them , RR had the strongest antioxidative effect. Those above results revealed that watery extract of ICHT can scavenge oxygen radicals in the whole blood of patients with acute hepatic injury. Among three composed herb drugs of ICHT, RR is a relative important antioxidant.

茵陳蒿湯之抗氧化作用的研究
----- 目 錄 -----
附圖目錄
附表目錄
中文摘要 7
第一章. 前 言 8
第二章. 文獻探討 11
第一節.中國醫學對黃疸的看法 11
一、 歷代醫家對黃疸的論述
二、黃疸的病因病機
三、黃疸的辨証論治
第二節.現代醫學對肝炎的看法 20
一、 肝炎的發展歷史
二、 黃疸型病毒性肝炎的臨床病程
三、 肝損傷的定義
第三節.歷代醫家對茵陳蒿湯的看法 30
一、 茵陳蒿湯的方劑組成
二、 歷代醫家對茵陳蒿湯的論述
第四節.茵陳、大黃、梔子的藥物作用 32
一、 茵陳
二、 大黃
三、 梔子
第五節.自由基理論 36
一、 自由基理論的歷史
二、 自由基對生物體的氧化損傷機制
三、 自由基的分類
四、 肝臟細胞損傷的機轉
第三章. 材料與方法 45
第一節. 中藥方劑製作 45
第二節. 實驗用藥 49
第三節. 實驗儀器 49
第四節. 實驗動物 49
第五節. 實驗方法 50
一、十二種保肝中藥方劑在試管內清除超氧陰離子(O2o－)
的活性實驗
二、十二種保肝中藥方劑在試管內抑制氯化亞鐵誘發
肝細胞脂質過氧化(lipid peroxidation)的實驗
三、 十二種中藥方劑抑制四氯化碳誘發大白鼠
急性肝損傷及肝細胞脂質過氧化的實驗
四、 茵陳蒿湯對肝損傷病患之全血中超氧陰離子
(O2o－)的影響
五、 茵陳蒿湯對肝損傷患者之全血中過氧化氫
(H2O2)的影響
六、茵陳蒿、梔子及大黃對超氧陰離子（O2o－）
的清除作用
七、 茵陳蒿、梔子及大黃對大白鼠肝細胞脂質過氧化
(lipid peroxidation)的清除作用
第六節、統計分析 59
第四章. 結 果 60
一、十二種保肝中藥方劑在試管內清除超氧陰離子(O2o－)
的活性實驗
二、十二種中藥方劑在試管內抑制FeCl2誘發肝細胞
脂質過氧化(lipid peroxidation)的實驗
三、十二種中藥方劑抑制四氯化碳誘發大白鼠急性肝損傷
及肝細胞脂質過氧化的實驗
四、茵陳蒿湯對肝損傷病患之全血中超氧陰離子
(O2o－)的影響
五、 茵陳蒿湯對肝損傷患者之全血中過氧化氫
(H2O2)的影響
六、 茵陳蒿、梔子及大黃對超氧陰離子（O2o－）
的清除作用
七、 茵陳蒿、梔子及大黃對大白鼠肝細胞脂質過氧化
(lipid peroxidation)的清除作用
第五章. 討 論 72
第一節、 十二種中藥方劑的抗氧化作用 73
第二節、 茵陳蒿湯清除自由基的作用 74
第六章. 結 論 79
第七章. 參考文獻 80
英文摘要 87
縮寫表 89
謝辭 90

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