常用中藥方劑與阿斯匹靈類藥物併用對鼷鼠肝臟及腎臟功能的影響

楊榮森
國立台灣大學
根據衛生署的報告，台灣每年洗腎病人已高達4萬人，而且每年以10%繼續增加，每年花健保費用約200億元，已超越國人肝病第一的記錄，據估計其中約有25%左右的病人可能與不適當的藥物濫用，密切關係。我們推測病人生病看西醫吃藥外，也可能同時看中醫吃中藥，或自己去藥房買科學中藥一起服用，由於中西藥併用，在體內產生的交互作用結果，可能增加或減小藥效，或甚產生意外的毒性，我們查詢相關文獻，發現這方面的研究報告很少，因此，研究中西藥的交互作用，乃當今重要課題之一，我們擬於本計劃中，研究常用的六種中藥方劑（小柴胡湯、半夏瀉心湯、龍膽瀉肝湯、歸脾湯、疏經活血湯及血府逐瘀湯）與阿斯匹靈類藥物（aspirin及acetaminophen，長期大量使用，具有肝腎毒性）併用後，試驗其對鼷鼠肝功能及腎功能之影響。肝功能的指標將測量血中GOT及GTP活性，並測血液及肝臟組織中一氧化氮（NO）及脂質過氧化物（LPO）產生量，另外測量肝臟組中ROS及粒腺體中Reductase及合成ATP的酵素Mg2+ATPase活性變化。而腎功能的指標則測試尿蛋白，血中BUN、Creatinine、NO、LOP及RBC Na+-K+-ATPase活性。最後檢測肝腎組織顯微變化及其NO、LPO及Na+-K+-ATPase活性。我們預期此研究結果將能闡明：（1）適當的的使用（適當劑量及期間），所選用的中藥方劑或許能降低阿斯匹靈類藥物的肝腎毒性。（2）不適當的使用（劑量大且頻繁使用），可能加強阿斯匹靈類藥物的肝腎性。我們希望藉此研究，獲得科學證據，揭發慎用傳統中藥方劑對常用西藥的副作用有預防或緩解的功效，對疾病醫療有其貢獻的角色。但相反的結果也可能發生，就是使用不當的中藥（六種方劑中的任何一種或更多），或不正確的劑量及使用期限的結果，將導致嚴重的肝腎功能的損傷，我們將精心設計此實驗，以期證實我們的推測。
關鍵字：六種中藥方劑；兩種阿斯匹靈類藥；併用；交互作用；肝毒性；腎毒性

Studies on the interactions between traditional Chinese Medicines and aspirin-like drugs on hepatic and renal functions of the mice

Yang Rong - Sen
National Taiwan University
According to the recent epidemiological studies, we were aware that the number of patients with renal dysfunction required hemolytic reached 40,000 ; These number were progressively increased by 10 % per yeas and pond 200×100000000 NT of health case insurance budget in Taiwan. Although the cares of renal dysfunction were not totally understood, some clinical observations auspicated that the drugs aloes woo possibly involved, especially the combined use of orthodox drugs with TCM (traditional Chinese medicine) However, the scientific evidence for these suspicion were few. Leis segment for us to expose this possibility involved in the increasing detrimental incidence of renal function in Taiwan. Therefore, we palmed to explore possibility that the combined use of the frequently used compounding TCNs including (Shiau China Hu Tang, Ban Shan Shen Shin Tang, Fun Dan Shen gon Tang, gue pie Tang Shu gen Hao Sheu Tang, Sheu Fu Tsu Iu Tang) with aspirin-like drugs (either aspirin or acetaminophen) which were known capable of inducing hepatic and seal dysfunction after long use of large closes. The hepatic functions of the mice were monitored by the change of GOT and GPT in fold. Production of NOx and lipid per oxidation in flood and liver tissues were also assayed before and after drug treatment.
關鍵字：TCMs；aspirin-like drugs；combination use；drug interaction；renal function；liver function；Na+K+ATPase；LPO