頁籤選單縮合
題名 | 過敏性鼻炎的中醫藥診治之研究=Research on Diagnosis and Treatment of Traditional Chinese Medicine (TCM) to Allergic Rhinitis |
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作者 | 林昭庚; |
期刊 | 行政院衛生署中醫藥年報 |
出版日期 | 19980500 |
卷期 | 16:1 1998.05[民87.05] |
頁次 | 頁79-98 |
分類號 | 413.52 |
語文 | chi |
關鍵詞 | 玉屏風散; 過敏性鼻炎; 組織胺; 間白素-4; Yu ping feng san; Allergic rhinitis; Histamine; Interleukin 4; IL-4; |
中文摘要 | 為了闡明中醫方藥玉屏風散對過敏性鼻炎的作用機轉,並於細胞免疫反應 中,研究玉屏風散及其組成黃耆、白朮、防風與晉耆在細胞激素網路上所扮演 之角色。於中國醫藥學院附設醫院篩選15位健康青年與成年人(平均年齡23.13 ±5.15歲)為研究對象。每位抽取30cc血液加入肝素(heparined-blood),進 行分離單核球(MNC)及中性白血球(PMN)之實驗;分別加入刺激物(對照組)及玉 屏風散組成相同(黃耆:白朮:防風)劑量不同比例二組,G組=1:1:1,J組 =3:1:1,及組成黃耆(正品)、白朮、防風與晉耆(非正品),各以五種濃度 (5ug/ml、10ug/ml、100ug/ml、250ug/ml、500ug/ml),共30組(實驗組)進行 實驗研究。故本實驗研究主題:過敏性鼻炎的中醫藥診治之研究(一),治療過 敏性鼻炎中醫方藥玉屏風散及其組成藥物與晉耆體外試驗 (In Vitro)對單核球 分泌間白素-4(interleukin-4、IL-4) 與中性白血球分泌組織胺(histamine)影響 之研究。實驗中以酵素結合免疫分析法(ELISA)測其濃度。將所得資料,使用 SAS統計軟體進行統計分析。 結果顯示:玉屏風散G組可以有效降低histamine(3.22±0.61ng/ml vs 1.33 ±0.46ng/ml;於濃度 100ug/ml 時p<0.05)、IL-4(18.43±5.18 pg/ml vs 10.61 ±0.52 pg/ml;於濃度 100 ug/ml 時 p<0.05)。玉屏風散J組亦能有效降低 IL- 4(18.43±5.18 pg/ml vs 6.57±0.97 pg/ml;於濃度500 ug/ml時 p<0.05)但會刺激 histamine 釋放(3.22±0.61 ng/ml vs 4.44±0.77 ng/ml;於濃度 250 ug/ml 時 p<0.05);若以濃度而言:玉屏風散G組於100 ug/ml具最佳抑制histamine、IL-4 作用。進一步分析,結果顯示:主要由其組成中防風扮演最重要的角色 (Dunnett's t test; p<0.05),黃耆反而增加histamine 的濃度(6.64±2.57 ng/ml vs 14.88±3.78 ng/ml;於濃度250 ug/ml時 p<0.05);此外我們亦探討佔臺灣市售 黃耆 90%以上市場之晉耆(非正品),得知晉耆於體外試驗整體作用最不明顯 (least significant difference ; p<0.05),因此我們認為玉屏風散於治療過敏 性鼻炎,主要是抑制histamine 和 IL-4的釋放;同時本研究亦為選擇真材實品 的重要性,提供了一項強而有力之佐證;至於玉屏風散組成中,防風含量比例較 高與黃耆含量比例較低組合之玉屏風散G組比J組更具抑制histamine及IL-4 作用,可當為臨床上治療過敏性鼻炎之指標。期望本實驗能為整合中西醫學建 立一可行的研究模式。 |
英文摘要 | In order to explain the function of Yu Ping Feng San(prescription of TCM) for treatment on allergic rhinitis and from the action of the role of Yu Ping Feng San and its composition of Huangpi, Baizhu, Fangfeng, and chingqi in the network of cytokine, Fifteen healthy youths and adults (average age, 23.13±5.15 years) were selected from the China Medical College Hospital for participation in this study, and each person is blooded 30cc to set in heparined-blood for test in mononuclear cell (MNC) and polymorphonuclear cell (PMN). Add in stimulator (comparison set) separately and five concentrations (5 ug/ml, 10 ug/ml, 100 ug/ml, 250 ug/ml, and 500 ug/ml)each of two different prescriptions of Yu Ping Feng San, each containing the same ingredients (Huangqi, Baizhu and Fangfeng) in different proportions and labeled G (1:1:1) and J (3:1:1), as well as the same five concentrations of the individual ingredients of Yu Ping Feng San, Huangqi (an authentic medicinal root used in traditional Chinese medicine), Baizhu, Fangfeng and Chingqi (a non-authentic substitute for Huangqi), totaling 30 samples (Experimental set) , for testing and studying. Therefore, the subject of this research: the study of TCM for treatment on allergic rhinitis (1) Prescription of TCM for allergic rhinitis Yu Ping Feng San and its composition and Chingqi In Vitro test to study on their effect on the secretion of interleukin-4 (IL-4) from mononuclear cells and the secretion of histamine from neutrophils, in the test, makes use of Enzyme-linked immunosorbent assay (ELISA) to get the concentration. From the data obtained, we use SAS statistic software for analysis. Results indicated that Yu Ping Feng San prescription G effectively reduced histamine levels (3.22±0.61 ng/ml vs 1.33±0.46 ng/ml, P<0.05 at concentrations of 100 ug/ml)as well as IL-4 levels (18.43±5.18 pg/ml vs 10.61±0.52 pg/ml, P<0.05 at concentrations of 100 ug/ml). Yu Ping Feng San prescription J also effectively reduced IL-4 levels (18.43±5.18 pg/ml vs 6.57±0.97 pg/ml, P<0.05 at concentrations of 500 ug/ml), however, histamine release increased (3.22±0.61 ng/ml vs 4.44±0.77 ng/ml, P< 0.05 at concentrations of 250 ug/ml). By concentration, Yu Ping Feng San prescription G presented the best inhibitive effect on histamine and IL-4 at the concentration of 100ug/ml. Further analysis showed that one component, Fangfeng, played a major role in inhibiting histamine and IL-4 (Dunnett's t test; P<0.05); Huangqi actually increased the concentration of histamine (6.64±2.57 ng/ml vs 14.88±3.78 ng/ml, P<0.05 at concentrations of 250 ug/ml). In addition, we also investigated the effects of Chingqi (a non-authentic substitute for Huangqi, now supplying over 90% of the Huangqi market in Taiwan). In vitro experiments demonstrated that Chingqi produced the least significant effect (LSD ; p<0.05). Therefore, we believe that Yu Ping Feng San improves conditions of allergic rhinitis mainly by inhibiting the release of histamine and IL-4. This study also provides substantial evidence to support the use of authentic ingredients in traditional Chinese medicine preparations. The fact that among the two prescriptions of Yu Ping Feng San, prescription G, which contained a higher proportion of Fangfeng and a lower proportion of Huangqi than prescription J, effected greater inhibition of histamine and IL-4, can be used as a clinical guide for the effective treatment of allergic rhinitis We hope this investigation will provide a useful research model for the integration of Chinese and western approaches to medicine. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。