| 摘要: | 本研究目的在探討傷寒論、金匱要略和溫病條辨治療黃疸的處方，對ANIT誘發大白鼠膽道性黃疸型肝炎，比較其退黃的作用、抗肝細胞損傷的療效，並以Jonker’s病理半定量分析，觀察比較各方劑對病理組織變化的改善情形。 結果顯示：（1）傷寒論治黃疸方劑，當劑量為1g/kg時，梔子柏皮湯具有抗肝細胞損傷、改善膽道阻塞的作用，療效最佳。當劑量達2g/kg時，麻黃連翹赤小豆湯與茵陳蒿湯皆有抗肝細胞損傷作用；但梔子柏皮湯非但無抗肝細胞損傷的效果反而產生肝毒性，甚或造成溶血，所以中藥最適劑量的研究應加以重視。（2）金匱要略治黃疸方劑，當劑量為1g/kg時，梔子大黃湯、茵陳五苓散及大黃硝石湯三者皆有抗肝細胞損傷及利膽退黃的作用，其中以大黃硝石湯療效最佳；而僅茵陳五苓散有改善膽道阻塞的作用。當劑量達2g/kg時，三者的療效較1g/kg時更佳，除了抗肝細胞損傷及利膽退黃的作用外，還有改善膽道阻塞的作用，其中仍以大黃硝石湯療效最佳。在病理組織學上，三者主要作用在減少白血球的浸潤，抑制對肝細胞的傷害，而達到保肝的作用。（3）溫病條辨治黃疸方劑，當劑量為1g/kg時，二金湯、杏仁石膏湯及連翹赤小豆飲皆有抗肝細胞損傷的作用，其中以連翹赤小豆飲療效最佳；此外，連翹赤小豆飲還有改善膽道阻塞的作用。在病理組織學上，主要作用在抗肝細胞發炎及減少白血球浸潤兩方面。當劑量達2g/kg時，二金湯僅有抗肝細胞損傷的作用；杏仁石膏湯有抗肝細胞損傷及利膽退黃的作用；而連翹赤小豆飲則有抗肝細胞損傷、利膽退黃及改善膽道阻塞的作用；整體而言，以連翹赤小豆飲的療效優於杏仁石膏湯及二金湯。在病理組織學上，杏仁石膏湯和連翹赤小豆飲的作用表現在在抗肝細胞發炎及改善組織壞死兩方面。; The purpose of the study is to deal with the prescriptions for curing Jaundice in Shan-Han-Lun, Jin-Gui-Yao-Lueh and Wen-Bing-Tian-Bian, comparing their choleretic and anti-liver damage effects, in treating ANIT-induced experimental cholangiolitic hepatitis of Jaundice in Rats, and, by means of Jonker’s pathologically semi-quantitative analysis to observe and compare how these prescriptions can make improvement in the model’s pathological lesion. The results demonstrate that: (1)in Shan-Han-Lun, when the dosage is 1g/kg, Zhi-Zi-Bo-Pi Tang(ZBT) has the best effect on improving liver cell damage and bile dust obstruction; when the dosage is 2g/kg, Ma-Huang-Lian-Qiao-Chi-Xiao-Dou Tang(MLT) and Yin-Chen-Hao Tang (YCT) have the effect of anti-liver damage, but ZBT cought make liver toxicity and hemolysis, therefore, the best dosage of the prescription is worth to research. (2)in Jin-Gui-Yao-Lueh, when the dosage is 1g/kg, Zhi-Zi-Da-Huang Tang(ZDT), Yin-Chen-Wu-Ling San(YWS) and Da-Huang-Xiao-Shi Tang(DXT) can make improvement of liver damage and choleretic effect, only the YWS can make improvement of bile dust obstruction; when the dosage is 2g/kg, the treatment effects of these prescriptions are better then the dosage is 1g/kg. Among these prescriptions, the best effect of treatment is DXT. Pathologically, the main protective effect of liver damage may because of attenuation of PMN infiltration to inhibit the liver damage. (3)in Wen-Bing-Tian-Bian, when the dosage is 1g/kg, Er-Jin Tang(EJT), Xing-Ren-Shi-Gao Tang(XST) and Lian-Qiao-Chi-Xiao-Dou Yin(LCY) can make improvement of liver damage, LCY has the best effect among three prescriptions and can make improvement of bile duct obstruction. Pathologically, the main effects are on attenuation of liver cell inflammation and PMN infiltration; when the dosage is 2g/kg, among these prescriptions, LCY has the best effect on improvement of liver damage, choleretic and bile duct obstruction. Pathologically, on the main protective effect of liver damage, XST and LCY can make improvement of liver cell inflammation and tissue necrosis. |
