芭樂心葉水萃物主成份(gallic acid, quercetin, EGCG, and rutin)合併臨床用藥及控制飲食應用於治療慢性腎臟疾症之完整療效探討

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 健康照護學院 > 物理治療學系暨復健科學碩士班 > 研究計畫 > Item 310903500/44210

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题名:	芭樂心葉水萃物主成份(gallic acid, quercetin, EGCG, and rutin)合併臨床用藥及控制飲食應用於治療慢性腎臟疾症之完整療效探討
作者:	陳冠州;彭瓊琦(Chiung-Chi Peng)
贡献者:	健康照護學院物理治療學系;中國附醫醫學研究部
关键词:	慢性腎臟疾症;動物模式;營養因子;臨床藥物;日常飲食 Chronic Kidney Disease (CKD);Animal model;Nutritional facts;Medicines clinically applied;Daily diets
日期:	2011-07-31
上传时间:	2012-06-13 09:23:42 (UTC+8)
摘要:	慢性腎臟疾病(Chronic Kidney Disease) (CKD)常發生於高血壓及高血酯病患並引發慢性腎功能改變，且大多數的CKD最後都會進展到末期腎臟疾病(End-Stage Renal Disease， ESRD)。近來，中草藥治療被當做是慢性腎臟疾病的輔助療法，其中牽涉到免疫抑制及抗氧化機制。在我們的初步研究中(NSC- 98-2320-B-038-024)(圖三，四)，我們以皮下注射Doxorubicin 8.5 mg/kg 成功地誘發SD大白鼠之CKD，並在之後以gallic acid (GA) 70mg/kg/day 治療，治療後顯示其血中膽固醇，尿素氮，肌?酸擴清率，氧化壓力及纖維化因子皆有明顯之改善，而H&E 染色顯示GA 可有效地壓抑腎炎，減少腎壞死和類澱粉沉澱。根據上述的結果，我們提出三年計畫案，於第一年，我們將應用芭樂心葉水萃物中之四種主成份(gallic acid, quercetin, EGCG, and rutin; GQER) 來執行 CKD SD 大白鼠之輔助療法。於第二年，臨床藥物將個別合併GQER 來進一步檢視合併治療之效果。於第三年，我們將依據前兩年的結果來執行營養因子對合併治療產生進一步影響之實驗，並特別著重在鹽分及/或膽固醇之控制。由此可觀察在不同比例之鹽分及/或膽固醇含量下，日常家庭飲食對CKD治療的影響程度。總之，從我們的研究成果，我們將發現臨床藥物合併輔助療法及營養因子對CKD治療之影響，並將其應用於門診病患。另外，我們也將進一步探討上述治療方式之分子作用機轉。 Chronic kidney disease (CKD) is often found in patients associated with hypertension, hyperlipidemia and obstructive uropathy. Factors attributing to CKD include Glomerulonephritide, infectious inflammation, obesity, genetic disorder and autoimmune diseases. A large majority of CKD may progress to a final stage called the End-Stage Renal Disease (ESRD). Generally, the therapeutic strategy is aiming at slowing down the progression of CKD and preventing the possible complications. Recently, complementary & alternative medicine (CAM) has attracted much attention of many clinical physicians. Previously, we performed a preliminary study (NSC- 98-2320-B-038-024)( Figures 3 & 4), in which we successfully induced CKD in SD rat model by s.c. Doxorubicin 8.5 mg/kg and treated the rat CKD by feeding gallic acid (GA)-containing diet at GA 70mg/kg/day. The CKD rats showed a huge improvement in serum cholesterol (Ch), triglyceride, BUN, creatinine clearance (CCr), oxidative stress and pro-fibrotic factors (IL-6, PDGF), H&E stain revealed GA effectively attenuated nephritis, renal necrosis and amyloidosis. Based on these results, we submit this Three-Year Project. In the first year, the four main constituents in extract of Psidium guajava L. (PE) (gallic acid, quercetin, EGCG, and rutin; GQER) will be straightforwardly used to perform the CAM on CKD rats. In the second year, different medicines clinically applied (MCA) will be used in combination with the GQER (GQER plus MCA), respectively, to see the therapeutic effect of these combined therapy. Based on the results, in the third year we will carry out the experiment of GQER plus MCA when further affected by nutritional facts (NF) especially with respect to the salt (ST) and/or cholesterol (Ch) levels. In this way we will be able to examine the effect of plain CAM in the first year using pure GQER. In the second year, we will examine the effect of CAM plus MCA. And in the third year the effect of CAM plus MCA plus NF of daily diets containing ST+/-Ch in different proportions will be conducted to see to what extent the effect of daily family diet may affect the therapy of CKD. To summarize, from our achievement we will be able to find the effect of different combination of routine clinical therapy/with CAM/plus NF, the treatment course usually applied to a CKD-affiliated OPD patient. Besides, the molecular action mechanisms of GQER with these formulations will be also extensively investigated.
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