臺灣博碩士論文加值系統

本實驗的目的在評估黃耆對門脈壓力及全身血液動力效應之影響。造型採用部份門靜脈結紮法(partial portal vein ligation, PVL)，誘導大白鼠產生門脈高壓狀態；將門脈高壓鼠隨機分為四組分別接受生理食鹽水、propranolol（10 mg/kg）、低劑量黃耆粗萃取物（0.1 g/kg）及高劑量黃耆粗萃取物（1 g/kg），觀察給藥前後門脈壓力、平均動脈壓，及心跳速率的變化。結果依序以多變量變異數分析、單變量區集化二因子變異數分析及Duncan事後比較分別比較門脈壓力、平均動脈壓及心跳速率在不同治療組下，不同時間點作用的差異。
本研究之結果顯示：低劑量黃耆對門脈壓力、平均動脈壓無顯著影響，但有提升心跳速率之作用。高劑量黃耆對門脈壓力、平均動脈壓之作用為先上升後再下降至略低於給藥前之基準值，在心跳速率方面亦有提升之作用，與propranolol降低門脈壓力、平均動脈壓，及心跳速率之作用不同。
根據實驗結果，我們建議臨床上肝硬化病人服用大量黃耆時應更審慎評估。

The purpose of this study was to investigate the hemodynamic effects of of Huang-qi in anesthetized portal hypertensive rats. Portal hypertension was induced by partial portal vein ligation in Sprague-Dawley rats. The portal hypertensive rats were randomly divided into four groups to receive normal saline, propranolol（10mg/kg）, low dose crew extract of Huang-qi（0.1 g/kg）, and high dose crew extract of Huang-qi（1 g/kg）, respectively. The changes of portal vein pressure（PVP）, mean arterial pressure（MAP）and heart rate（HR）were observed. Statistical comparison was performed using the multivariate analysis of variance, general linear model’s procedure, and Duncan’s multiple comparison.
Infusion of low dose of Huang-qi increased HR, but showed no influence on PVP and MAP. Infusion of high dose of Huang-qi first induced elevation of PVP and MAP, and then followed by reduction slightly from baseline. HR was also increased in this group. The effects of Huang-qi are different from those of propranolol.
Our results suggest that the patients with liver cirrhosis should be more careful when taking high dose of Huang-qi.

第一章 前言
第二章 文獻探討
第一節 現代醫學對門脈高壓之探討
壹、肝門靜脈系統之解剖構造與生理特性
貳、門脈高壓之定義與致病因素
參、門脈高壓之併發症
肆、門脈高壓之病理生理機轉
一、門脈高壓的致病機轉：血管阻力與血流量
二、血管阻力增加
（一）肝硬化時肝內血管阻力
（二）側枝循環內之阻力
三、內臟血管擴張與門脈血流增加
四、週邊血管擴張與高動能體循環狀態
（一）週邊血管擴張
（二）血漿容積增加
五、門脈高壓之血液動力學特徵
伍、門脈高壓之臨床治療
一、降低血管阻力之藥物
（一）增加肝內NO含量的藥物
（二）α─腎上腺素受體阻斷劑
（三）腎素─血管收縮素系統之阻斷劑
二、降低內臟血流量之藥物
（一）非選擇性β受體阻斷劑
（二）血管加壓素與其異構物
（三）對於血漿容積增加的處理
三、混合性療法
第二節　中醫學對門脈高壓之研究
壹、病名的研究
貳、鼓脹證候之敘述
參、鼓脹之病因病機研究
肆、鼓脹之辨證要點
一、分清寒熱
二、分清虛實
三、分辨氣、血、水三者的主次
伍、鼓脹之論治要點
第三節　黃耆之簡介
壹、中醫學關於黃耆之論述
貳、黃耆之現代藥理研究
一、正性肌力作用
二、降壓作用
三、擴張血管及對微循環的影響
四、保肝作用
五、利尿作用
參、黃耆在鼓脹治療中所扮演之角色
第四節　實驗動物模型
壹、部分門靜脈結紮模型
貳、四氯化碳誘導肝硬化模型
參、總膽道結紮模型
第三章 材料與方法
第一節 實驗材料
壹、儀器設備
貳、化學試劑與藥品
參、藥物基源與藥物製備
肆、實驗動物
第二節 實驗方法
壹、門脈高壓動物模型─部分門靜脈結紮模型
貳、門脈壓及血壓、心跳之測量
參、藥物試驗
肆、計算與統計分析
一、參數計算方式
二、統計分析方法
第四章 結果
第一節 實驗記錄
第二節各治療組對於門脈壓、平均動脈壓、及心跳速率在不同時間點影響之比較
壹、門脈壓、平均動脈壓及心跳速率三變量在治療及時間上的變化
貳、治療、時間分別對門脈壓、平均動脈壓、及心跳速率的影響
一、門脈壓（PVP）
二、平均動脈壓（MAP）
三、心跳速率（HR）
參、Duncan事後比較
一、各治療組給藥前後PVP之變化
二、各治療組給藥前後MAP之變化
三、各治療組給藥前後HR之變化
第五章 討論
壹、實驗模型之選擇與限制
一、實驗模型之選擇
二、實驗模型之限制
貳、實驗藥物製備與使用
參、黃耆對門脈壓力及全身血液動力效應之探討
肆、未來展望
第六章 結論與建議
參考文獻
英文摘要

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