| 摘要: | 隨著現代女性的晚婚及遲育，治療不孕症的比例日漸增高，在女性不孕症患者中，以排卵異常最為常見。現今醫學中，治療不孕症除了求助於西醫外，尚有許多人藉由服用中藥調養身體。在古籍紀載中，四物湯被稱為是婦人眾疾之總司，多以四物湯為基底，治療女性之疾病，但鮮少提及四物湯及不孕症之關係，因此本研究藉由給予卵泡發育不全之婦人四物湯，觀察其服用後症狀之改變，並進一步探討四物湯保護卵巢之療效。
在化學品質分析中發現，四物湯及其樣品中，以四物湯缺當歸，含有最多的多酚類化合物(11.46±0.04 μg/g)，其次為四物湯缺熟地者(10.66±0.01 μg/g)，而在醣類化合物中，以四物湯缺熟地者為最(119.37±20.12 μg/g)。在指標成分阿魏酸及沒食子酸含量中，也以四物湯缺熟地含量最高(0.718±0.001, 1.125±0.001 μg/g)。其次，藉由給與卵泡發育不全之婦人服用四物湯三個月，並檢測期間生化數值之變化，其結果顯示：服用四物湯後，受試者之LH/FSH比值小於1，且雄性激素下降到正常值中，月經週期會回到正常。由此結果，繼而探討其保護卵巢之療效。藉由給予MCF-7細胞含雄性激素(testosterone)之樣品，測試四物湯是否可以促進MCF-7細胞中芳香環酶(aromatase)之活性表現，在雌激素(estradiol)及西方點墨的結果表示，四物湯缺少熟地黃者會使芳香環酶的活性減低，而缺少芍藥者，則會使芳香環酶的活性變高。而另一方面，文獻指出氧化壓力會造成排卵異常及不孕的情形，在DPPH及MDA抗氧化能力試驗中，又以四物湯缺熟地黃者有最高的抗氧化能力。
綜合以上結果，四物湯在以補血為主要療效時，組成以熟地黃為君；但若以抗氧化為主要指標時，則以含較多酚類化合物之芍藥為君；而在促進芳香環酶之活性時，以熟地黃為主。我們可以依不同的情況，去進行一個處方的比例更改，以達到最好的療效。
Nowadays, female infertility rate is gradually increased because of the late marriage and childbirth. Evidence showed female infertility may be caused by old age, anovulation and abnormal hormone. Besides the western medical assistances, people will also use traditional Chinese medicine (TCM) to solve this problem. Si-Wu Tang (SWT), a traditional Chinese formula, is commonly used for treating female disease, such as relief of menstrual discomfort, climacteric syndrome, and other related diseases. The TCM doctors usually applied SWT to treat the patients with ovarian follicular maldevelopment (OFM). Goal of this study is to explore whether SWT can reduce the OFM-related syndrome and discuss whether the possible mechanisms are through its antioxidant and aromatase activity.
In the chemical analysis of different SWT-modified formulas, SWT removed Angelica sinensis was richer in total polyphenols (11.46±0.04 μg/g) than the others. However, SWT removed Rehmannia glutinosa had the richest content in polysaccharide content (119.37±20.12 μg/g), ferulic acid (0.718±0.001 μg/g) and gallic acid (1.125±0.001 μg/g). After taking SWT for 3 months, the patients’ OFM symptoms were recovered, including the decreasing testosterone level, normalizing LH/FSH ratio (<1) and recovering menstrual cycle. In the testosterone-induced MCF-7 cell model, SWT removed Ligusticum chuanxiong Hortorum would increase the aromatase protein expression and estradiol content. However, SWT removed Rehmannia glutinosa displayed the opposite effects. Refer to the antioxidant activity, SWT removed Paeonia lactiflora would loss the anti-oxidation effect, but would enhance in the SWT removed Rehmannia glutinosa.
Structure of TCM is sovereign, minister, assistant and courier. Our results displayed that the Paeonia lactiflora in SWT with strongest antioxidant effects acts as sovereign. The Rehmannia glutinosa Libosch in SWT acts as an aromatase promoter. In summary, the ratio of SWT composition could be altered by driving different functions. |
