臺灣博碩士論文加值系統

異位性皮膚炎（atopic dermatitis; AD）屬於慢性、復發性、炎症性並伴隨著強烈搔抓、潮紅病灶的皮膚疾病。它是一種皮膚的過度免疫，主要由於炎症細胞受到各種過敏反應的活化所造成。黃柏是一種常用的傳統中草藥，近年來有越來越多的相關研究指出，黃柏具有一定的抑制細胞免疫反應和抗炎性作用，常常作為治療異位性皮膚炎的重要的藥物成分之一。本實驗之目的為評估黃柏對於誘導異位性皮膚炎大鼠之治療效用，並針對三種不同的給藥劑量進行治療效力差異性的比較。
實驗動物為25只雄性、七周齡之Sprague Dawley品系大鼠，利用化學性半抗原（haptens）：2,4-二硝基氯苯（2,4-dinitrochlorobenzene; DNCB）試劑，一周兩次塗抹於大鼠背頸部皮膚，以達到誘導異位性皮膚炎的狀態，並維持誘導處置至實驗結束，共六周。誘導成功後，操作組按體重分別給予150 mg/kg，300 mg/kg，600 mg/kg的順天堂黃柏濃縮散灌胃治療，每週兩次，持續四周，四周後進行大鼠犧牲。本實驗進行評估的項目包括：皮膚炎臨床狀態評分、皮膚鏡觀察、血清總IgE抗體力價、皮膚組織切片H&E（Hematoxylin-Eosin）染色下之表皮厚度及炎症細胞之浸潤情形、皮膚組織切片TB（Toluidine Blue）染色下肥大細胞之浸潤情形。
結果顯示，黃柏治療的組別在表皮厚度與炎症細胞浸潤計數的部分，與陽性控制組相比，三組皆有不同程度的下降（P<0.05）；在肥大細胞浸潤計數的部分，與陽性控制組相比，三組皆有下降的趨勢，但僅中等劑量組和高等劑量組有顯著性差異（P<0.05）；在皮膚炎臨床狀態評分數值上，與陽性控制組相比，治療組皆有顯著性下降（P<0.05），但在組內比較上，低等劑量組的皮膚炎臨床狀態評分數值在治療前後數值雖有下降，差異卻不顯著；在IgE 數值上，與陽性控制組相比，三組皆有下降的趨勢，但僅中等劑量組和高等劑量組有顯著性差異（P<0.05）。體重改變在黃柏治療的組別與陽性控制組之間，不存在顯著性差異（P>0.05）。實驗過程中亦無產生其他明顯異常或副作用。
本實驗結果顯示黃柏的治療可以減輕異位性皮膚炎的病程變化、調節免疫系統並緩解皮膚發炎的情形，並且治療效果隨著藥物劑量的增加而變得更好。
中草藥治療異位性皮膚炎本身具有副作用少、安全性高等優點，在證明黃柏治療異位性皮膚炎的效果後，期許未來可以更多加應用在獸醫臨床治療的領域中。

Atopic Dermatitis (AD) is a kind of skin disease, because of excessive immunity of skin mainly due to the activation of inflammatory cells by all kinds of allergic reactions. Huang Bo, which contain Cortex Phellodendri as the main ingredients, has the ability of immunosuppression and anti-inflammatory, which could inhibit the growth of a variety of bacteria. The aim of this study is to evaluate the effect of Huang Bo in treating rats suffered from AD, and compare the difference between the effects of three doses Huang Bo.
A total of 25 7-week-old male SD rats, were treated with chemical haptens (2, 4-dinitrochlorobenzene; DNCB) on the bank to induce AD for a total of six weeks. After successfully induced AD, the rats of treatment groups were given 150 mg/kg, 300 mg/kg, 600 mg/kg of Huang Bo by i.g. for 4 weeks. The evaluating projects in this experiment contain Dermatitis Score, serum total Ig E levels and skin histological characteristics including epidermis thickness, infiltration of inflammatory cells, and the infiltration of mast cell infiltration.
As aresult, compared with the positive control group, there was a decrease of the degree of epidermal thickness and inflammatory cell infiltration in the treatment of Huang Bo. The mast cell infiltration count decreased in the three groups compared with the positive control group. Treatment with Huang Bo can significantly decrease the Dermatitis Score. In the IgE values, there was a decreasing trend in the three treatment groups compared with the positive control group. No other significant abnormalities or side effects were observed during the course of the experiment.
The results of this study support that being treated with Huang Bo can reduce the course of atopic dermatitis changes, regulate the immune system and relieve skin inflammation, and the treatment effect becomes better as dose increasing.

誌謝 1
摘要 i
Abstract iii
第一章 緒言 1
第二章 文獻探討 4
第一節 異位性皮膚炎 4
一、 異位性皮膚炎之定義 4
二、 異位性皮膚炎之病因及致病機制 5
三、 犬、貓異位性皮膚炎於臨床上傳統治療方式 7
四、 誘導異位性皮膚炎之實驗動物模型 11
五、 異位性皮膚炎改善效力之評估 15
第二節 黃柏 20
一、 中醫上對異位性皮膚炎病因的看法 20
二、 黃柏的化學成分 20
三、 黃柏的藥理作用 23
四、 黃柏對小鼠 DTH 及其體內幾種細胞因數的影響 29
第三章 材料與方法 31
第一節 實驗動物 31
第二節 實驗材料 31
一、 實驗藥物與試劑 31
二、 實驗儀器與設備 32
三、 其他 33
第三節 實驗設計 33
一、 實驗分組 33
二、 藥物劑量的選擇 34
三、 建立異位元性皮膚炎模型 35
四、 異位性皮膚炎改善效力之評估 36
第四節 資料分析 40
第四章 結果 42
第一節 臨床狀態觀察 42
第二節 血清總IgE抗體力價檢測 43
第三節 皮膚狀態觀察與皮膚炎臨床狀態評分 45
第四節 皮膚組織切片H&E染色下皮膚厚度觀察 47
第五節 皮膚組織切片H&E染色下炎症細胞之浸潤情形 48
第六節 皮膚組織切片TB染色下肥大細胞之浸潤情形 49
第五章 討論 50
第一節 誘導效果評估 50
第二節 治療評估-血清總IgE抗體力價檢測 51
第三節 治療評估-皮膚炎臨床狀態評分 53
第四節 治療評估-皮膚厚度、皮膚組織切片H&E及TB染色 55
一、 皮膚組織切片 H&E 染色下皮膚厚度 55
二、 皮膚組織切片H&E染色下炎症細胞之浸潤 56
三、 皮膚組織切片TB染色下肥大細胞之浸潤 56
第六章 結論 58
參考文獻 60
附錄圖表 74

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