臺灣博碩士論文加值系統

類風濕性關節炎在傳統中國醫學中屬痹症、歷節、痛風之範疇，數千年來，對此證候之病因、病機、治療累積了許多寶貴的經驗。本研究選用上中下通用痛風丸(TFW)出自金朝朱丹溪所著丹溪心法痛風篇，為一將各種辨證加以綜合所設之方劑，臨床醫師常用於治療各類風濕病。利用佐劑性關節炎作為類風濕性關節炎的動物模型進行實驗研究，關節炎評估包括關節腫脹度、關節組織病理檢查；血液檢查包括albumin、ESR；此外，痛風丸對於角叉菜膠或組織胺誘發足蹠浮腫、鎮痛作用、微血管通透性之影響，急性毒性試驗亦在研究之內以探討TFW之相關作用及機轉。結果顯示：TFW無論對角叉菜膠足蹠急性炎症或佐劑性關節炎之慢性炎症皆有明顯之抗浮腫作用，TFW(2g/kg)抗角叉菜膠足蹠浮腫效果與Indometh- acin(5mg/kg)相當。由其發生作用時間，提示其作用可能與抑制發炎化學介質如組織胺、serotonin、Kinins、前列腺素及白三烯類皆有關。抗佐劑性關節炎，TFW 2g/kg 優於Indomethacin 5mg/kg，但關節組織病理發現痛風丸及 Indomethacin 皆具減輕關節滑膜炎之作用兩者無顯著差異。TFW及Indomethacin對ESR、albumin皆無影響。皮膚視窗法發現TFW(1g/kg)能抑制組織胺引起之微血管滲透性增加，此與其抑制組織胺所致急性浮腫相符。 TFW (0.5;1;2g/kg)對醋酸扭體及TFW(2g/kg) 對熱板致痛皆具顯著鎮痛作用。
由以上結果顯示，上中下通用痛風丸有其一定的抗炎止痛效果，且在有效劑量下未有明顯毒性，可望在抗炎鎮痛方面提供另一選擇。至於TFW對佐劑性關節炎之作用在免疫學上之影響則有待進一步研究。

Shanq-Jong-Shiah-Tong-Yonq-Tonq-Feng-Wan (TFW) is a traditional Chinese herbal remedy having heat- clearing, cold-warming, dampness transforming, hemodynamic, and analgesia effects. It has been used by traditional Chinese physicians for the treatment of rheumatic disorders. However, the scientic studies and pharmacologic mechanism of this well-tried recipe for rheumatoid arthritis is still unknown. Adjuvant-induced arthritis was used in this study as a animal model of rheumatoid arthritis, foot edema was measured by Plethysmeter, histopathology was examed, ESR and serum albumin was checked also. Additionally, carrageen-induced hindpaw edema (CIE), plasmaextravasation induced by inflammatory materials (histamine, 5-HT, bradykin, PGE2) in skin-window method, histamine-induced hind paw edema, acetic acid induced writhing pain, and hot plate pain model, were included in this study. Foot edema of AIA could be suppressed by TFW (1g, 2g/kg) significantly during the whole course. However, Indomethacin was only effective in first stage. THese finding partially supported by pathological picture, because Indomethacin was as effective as TFW. TFW (2g/kg) and Indomethacin (5mg/kg) both suppressed CIE to the same degree. The methanism of TFW in the CIE suppression by whole course might be related to overall histamine, 5-HT, kinins, prostagladin E2, leukotrenes. TFW could suppress the extravasation induced by histamine. This finding was supported by its suppressing histamine-induced hindpaw edema. The analgesic effects of TFW was proved by wirthing reponse ans hot plate method. Accordingly, TFW has definite antirheumatic and analgesic effects, no apparent acute toxicity was noted under effective dosage. It may become a alternate choice in antirheumatoidal drugs. However, the mathanism of TFW on immunologic aspects need to be further investigated.