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    題名: 香砂六君子湯對太平洋紫杉醇誘導副作用之輔助治療作用探討
    The Chemopreventive Effects of Xiang Sha Liu Jun Zi Tangon Paclitaxel-Induced Side Effects
    作者: 李芳瑜
    Li, Fang-Yu
    貢獻者: 王靜瓊
    關鍵詞: 香砂六君子湯;太平洋紫杉醇;化學療法;輔助治療
    Xiang Sha Liu Jun Zi Tang;Paclitaxel;Chemotherapy;Complementary and Alternative Medicine
    日期: 2015-07-27
    上傳時間: 2020-08-31 11:41:07 (UTC+8)
    摘要: 利用健保資料庫分析,使用paclitaxel(太平洋紫杉醇)治療乳癌之患者,高達81.5%曾至中醫門診接受治療,晚期乳癌患者接受傳統中藥的輔助治療之全死因死亡率(All-cause mortality)與非傳統中藥使用者相比,顯著下降,其中最常被使用的方劑之一為香砂六君子湯,故本論文將利用基礎實驗探討臨床上paclitaxel併用香砂六君子湯的意義。首先分析香砂六君子湯之植物化學成分,發現香砂六君子湯富含多酚、單寧、皂苷、粗多糖總含量。繼而探討香砂六君子湯作為paclitael輔助治療製劑之功效,結果顯示,香砂六君子湯可抑制paclitaxel引起之Balb/c小鼠白血球低下作用,並可改善paclitaxel所引起的Wistar大鼠機械性疼痛敏感,並顯著抑制大鼠脊柱Lambar 4-Lambar 6(L4-L6)的c-fos蛋白表現。再利用背根神經節細胞(DRG)的生長,探討香砂六君子湯改善paclitaxel引起之疼痛敏感之機轉,發現香砂六君子湯對DRG細胞不具毒性,且可改善paclitaxel所引起之軸突長度縮短程度,因此推測paclitaxel合併使用香砂六君子湯治療,可改善paclitaxel引起的白血球低下及疼痛敏感作用。此外利用體內、外P-388D1抗癌模式,評估paclitaxel和香砂六君子湯之合併治療作用,在P-388D1細胞毒性實驗中發現,paclitaxel及香砂六君子湯的IC50分別為11.34 ± 0.33 μM與 2.98±0.81 mg/ml,顯示香砂六君子湯對P-388D1細胞不具抗癌作用,且合併paclitaxel後細胞毒性未顯著增強;體內P-388D1-CD2F1擔癌鼠試驗結果顯示,paclitaxel併用香砂六君子湯治療的小鼠存活天數長於單獨使用paclitaxel組別,但統計上無顯著差異。因此推測香砂六君子湯主要作用不是增強paclitaxel抑制癌細胞生長,而是藉由改善paclitaxel引起的副作用,如:白血球低下及疼痛敏感,使臨床上提高了化療病人的生活品質,繼而延長了存活率。
    A study of the Taiwan National Health Insurance data base revealed that 81.5% of advance breast cancer patients who were treated with paclitaxel and in concurrence were receiving Traditional Chinese Medicine (TCM) treatment have shown reduced mortality rate as compared to the non-TCM user patients. According to NHI records, the most popular TCM prescribed for patients suffering from advance breast cancer is Xiang Sha Liu Jun Zi Tang (XSLJZT). Xiang Sha Liu Jun Zi Tang was found to enhance the WBC level and promoted leukocyte rebound in paclitaxel-induced leucopenia in mice. XSLJZT can also reduce paclitaxel-induced mechanical pain and inhibit c-fos protein expression in L4-L6 of Wistar rats. To further explore the mechanism behind the reduction of mechanical pain, we cultured DRG cells and found that XSLJZT can protect axons of DRG cells from paclitaxel induced toxicity. On the other hand, XSLJZT does not interfere with the anti-cancer activity of paclitaxel and have been found to slightly prolong survival rate in mice. Finally, compositional analysis of XSLJZT revealed to contain highest total content of polyphenols, tannins, saponins, polysaccharides this is maybe the reason for the chemoprotective properties of XSLJZT against paclitaxel-induced side effects.
    描述: 碩士
    指導教授:王靜瓊
    委員:張恒鴻
    委員:彭汪嘉康
    資料類型: thesis
    顯示於類別:[生藥學研究所] 博碩士論文

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