婦女在更年期或產後服用中藥製劑對體內總代謝體之影響
陳燕惠
台灣大學醫學院藥學系
總目的：中藥無論是單方或複方，都是一個繁雜的含多種純化物的組成物。原料藥材基原的正確性、產品的安全性、一致性等都會影響中藥製劑的有效性。至於中藥在體內的作用機制之研究則難度更高，除了品質難以掌控外，有效成分的篩選，指標成分的追蹤，對體內的靶位(target)的確認及可能造成的影響等都有待解決。本計劃將引入代謝體學(metabolomics)的觀念，利用偵測總體代謝物的圖譜，以體內總體代謝物的表現作為指標，來驗證加味逍遙散、酸棗仁湯、通肝生乳湯、生化湯等婦科、產科常用的中藥方劑介入後對體內總體代謝物影響的證據以及與臨床上的徵狀改善的相關性。第一年目的：偵測更年期婦女使用加味逍遙散或酸棗仁湯治療睡眠障礙時體內總體代謝物之變化，來驗證加味逍遙散及酸棗仁湯等方劑對人體代謝的總體影響，在相同病症及治療目的下有無異同處?實施方法：1.以多中心方式，在中醫門診針對有睡眠障礙之更年期婦女群，分別給予加味逍 遙散或酸棗仁湯治療。2.收集(1)睡眠障礙(控制組) (2)使用加味逍遙散(使用前/後) (3)使用酸棗仁湯(使 用前/後)之更年期婦女之血液做為檢體。每組預計各收30名。3.以LC/MS/MS偵測檢體中之總代謝物。4.以MarkerView軟體分析中藥介入，對體內總體代謝之影響及臨床效益的相關性。第二年目的：針對產後婦女，使用通肝生乳湯來改善乳汁不足或奶漲現象；以及服用產後生化湯治療產後腹痛及惡露，偵測其體內總體代謝物之變化，驗證這些方劑對人體代謝的總體影響，在使用中藥方介入後有無改變？實施方法：1.以多中心方式,在中醫門診針對產後婦女有乳汁不足或奶漲之現象，給予通肝生乳湯；另收集經評估產後可使用生化湯者。2.收集(1)控制組 (2) 乳汁不足或奶漲組使用通肝生乳湯 (使用前/後) (3)有腹痛及惡露組使用生化湯(使用前/後)之產後婦女之血液做為檢體。每組預計各收30名。3.以LC/MS/MS偵測檢體中之總代謝物。4.以MarkerView軟體分析中藥介入,對體內總體代謝之影響及臨床效益的相關性。
關鍵字：加味逍遙散、酸棗仁湯、總代謝體學、更年期、產後
The influence of Chinese medicine on metabolomics in menopausal or postpartum women
Yen-Hui Chen
National Taiwan University
Goal: Traditional Chinese herbal medicine, no matter mono-therapy or poly-pharmacy, is composed of complicated chemical constituents. Many confounding factors influence activity of Chinese herbs, including the origin of the herbs, safety of the products and consistency between batches. Study of the effectiveness and mechanism of Chinese herbs in vivo is much more challengeable due to unresolved problems of product quality control, screen of effective principles, monitor of the marker constituents and the targets for site of action. In this project, we will introduce the concept of metabolomics to detect total metabolites spectra as the biomarkers of Chinese herbs intervention. Correlation will be analyzed between changes in total metabolites and clinical improvements when menopausal women receive Jia Wei Xiao Yao San Extract or Suan Tsao Jen Tang, and postpartum women receive Tong gan Sheng Ru Tang or Sheng Hua Tang. First year Purpose: Total metabolites spectra of Jia Wei Xiao Yao San Extract or Suan Tsao Jen Tang will be detected in menopausal women suffering from insomnia. The influences of the Chinese medicine on in vivo total metabolism will be analyzed. Methods: 1. A multicenter, 3-arm, randomized trial will be performed in menopausal women with insomnia. 2. Collect blood samples of three groups (1) insomnia control (2) Jia Wei Xiao
關鍵字：Jia Wei Xiao Yao San Extract ; Suan Tsao Jen Tang; Tong gan Sheng Ru Tang ; Sheng Hua Tang
