Thursday, September 16, 2010

黃芩湯

美國科學家發現,以芍藥、甘草、大棗和黃芩為原料制成的中藥黃芩湯,伴隨化療藥物的使用,有助於減輕結腸和直腸癌患者接受化療時產生的副作用,如惡心、嘔吐、腹瀉,胃痙攣和體重減輕。

美國耶魯大學的藥學家鄭永齊和PhytoCeutica, Inc.的科學家等人研制出實驗室配方名為PHY906的中藥,借鑒有1800年歷史的中藥古方黃芩湯,使用四種植物芍藥、甘草、大棗和黃芩的提取物制成一種中藥。黃芩湯在中國用來治療諸如腹瀉、惡心和嘔吐等腸道疾病的一種古老的藥方。

他們對患有癌症的小鼠進行了化療,化療藥物Irinotecan阻斷了參與DNA複製的酵素,雖然縮小了腫瘤,但也造成了小鼠腸道內膜的大面積的破壞。使用PHY906給患腸道癌的小鼠進行治療,發現腫瘤更迅速地縮小且沒有發生體重減輕,數日後發現受損的腸道內膜復原。PHY906還阻斷了炎症細胞向腸道的遷徙並減輕了炎症反應,和炎症有關的基因Cox2、NF-κB和iNOS的表現量也下降。這種效應看來是由PHY906的多種作用所引起的。

鄭永齊指出,用化約主義的方法來治療由癌症化療或復雜疾病所引發的多種副作用可能是不夠的。這些結果提示,傳統的中藥可能是一些藥物研發者的一種學習對象,因為有些藥物研發者渴望測試各種藥物的複方,他們希望複方藥物的效果會比任何單方藥物效果更好。

鄭永齊表示,這是結合中西醫來治療癌症的方法,而PHY906單獨使用不能縮小腫瘤。他們已經進行了小規模的臨床測試,測試結果看來很有希望。但他建議病患不應自己嘗試,此藥研制仍處於初期階段,而且許多聲稱是黃芩湯的草藥產品可能含有有害或無效的替代物。

原學術論文:

Sci Transl Med 18 August 2010:

Vol. 2, Issue 45, p. 45ra59
DOI: 10.1126/scitranslmed.3001270


Research Article
The Four-Herb Chinese Medicine PHY906 Reduces Chemotherapy-Induced Gastrointestinal Toxicity


Wing Lam1, Scott Bussom1, Fulan Guan1, Zaoli Jiang1,2, Wei Zhang1, Elizabeth A. Gullen1, Shwu-Huey Liu2 and Yung-Chi Cheng1,*


1Yale University School of Medicine, New Haven, CT 06520, USA.
2PhytoCeutica Inc., New Haven, CT 06511, USA.

Abstract
PHY906, a four-herb Chinese medicine formula first described 1800 years ago, decreases gastrointestinal toxicity induced by the chemotherapeutic drug CPT-11 (irinotecan), as shown in a phase I/II clinical study. Similarly, in a murine colon 38 allograft model, PHY906 increased the antitumor activity of CPT-11 while decreasing animal weight loss caused by CPT-11. Here, we have further examined the effect of PHY906 on the intestinal toxicity caused by CPT-11 in mice. PHY906 did not protect against the initial DNA damage and apoptosis triggered by CPT-11 in the intestine, but by 4 days after CPT-11 treatment, PHY906 had restored the intestinal epithelium by promoting the regeneration of intestinal progenitor or stem cells and several Wnt signaling components. PHY906 also potentiated Wnt3a activity in human embryonic kidney–293 cells. Furthermore, PHY906 exhibited anti-inflammatory effects in mice by decreasing the infiltration of neutrophils or macrophages, tumor necrosis factor–α expression in the intestine, and proinflammatory cytokine concentrations in plasma. Chemical constituents of PHY906 potently inhibited nuclear factor κB, cyclooxygenase-2, and inducible nitric oxide synthase. Our results show that the herbal medicine PHY906 can counteract the toxicity of CPT-11 via several mechanisms that act simultaneously.



黃芩湯
【製法用量】

黃芩9克 白芍6克 甘草6克 大棗4枚

【功效】
清熱止痢,和中止痛。

【主治】
痢疾或腹瀉、症見發熱不惡寒,肛門灼熱,瀉下粘穢,腹痛、口苦、舌紅苔薄黃、脈弦數。

【方義】
本方原治太陽與少陽合病,自下利者,乃以少陽受邪為主,少陽的火鬱之邪內迫陽明,下趨大腸所致。病位在少陽故治宜和解之。方中有黃芩、清熱止利”神農本草經”謂其「主腸澼泄痢」,芍藥和營止痛”神農本草經”謂其「主邪氣腹痛」,甘草、大棗和中養脾。諸藥合用,以清裡熱為主,裡熱清則利可止,身熱可除。

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