中藥對腦缺氧的預防與治療效果

Therapeutic and Preventative Effects of Chinese-- Herb Medicines on Cerebrovascular Ischemia

腦血管老化會導致腦中風，腦中風是國人第二大死因，是老年人最常見的疾病之一。利用核磁共振攝影，可快速診斷是否有腦中風引起之腦組織缺血，腦細胞老化會引起腦梗塞，治療腦中風方面，西醫仍無有效藥物可供使用。中醫治腦方劑流傳已久，用以治療腦中風，但仍無科學化的證據顯示的確有療效。本研究目的即在探討這些中醫治腦方劑，是否具保護缺血腦組織之作用。本研究採大白鼠大腦皮質缺血動物模式來測試中藥方劑之療效。使用大白鼠重約450 公克，利用chloral hydrate（400mg/kg）腹腔注射麻醉，再利用顯微手術，把雙側頸動脈及右側中大腦動脈結紮，60分鐘後再放開，使大腦皮質血管恢復流通。48小時後，大白鼠再次麻醉，取腦作2%的triphenyl tetrazollium chloride （TTC）染色，梗塞皮質區則呈白色。第一階段：以十五種不同的治腦方劑逐一測試其對缺血性損傷之療效。實驗結果，初步發現有急性腦缺血的保護作用的這幾種治腦方劑為牛黃丸、育生丸、小續命湯、黃耆五物湯、參附湯 （腦梗塞體積mean±SEMmm3分別為牛黃丸152.3±21.0；育生丸115±10.4；小續命湯137.6±30.8；黃耆五物湯94.4±29.3與對照組203±9.03）。再進一步探討其對於急性腦缺氧的治療效果。以這五種中藥方劑繼續進行動物實驗，研究其對於腦缺血治療效果，結果發現參附湯與育生丸兩種中藥方劑對於急性腦缺氧者有顯著治療效果

Abstract: Aging and degeneration of brain blood vessels can lead to stroke, which has been the leading cause of death in Taiwan, especially with the elderly population. NMR(Nuclear Magnetic Resonance) imaging is an effective method of early diagnosis of stroke caused by brain tissue ischemia or the aging of brain cells which lead to vessel occlusion. However, there is not any drug proven to be clinically effective in the protection of the ischemic brain. Many Chinese herbs have been used for treating stroke for thousands of years. But none has been proven scientifically to be effective. The purpose of this study was to test scientifically in stroke animals with 15 Chinese herbs which have been considered effective Chinese medicines for treating stroke patients, so that we could find out some potentially useful Chinese herbs for clinical use in stroke patients. Sprague－Dawly rats weighing 450g were used. In the first stage, these animals were divided into 16 groups. Each group of animals were fed for 3 days with one kind of Chinese herb medicine chosen from lists of the more frequently and effectively used by Chinese herb medical doctors for treating stroke patients. The control group was fed with saline. Thereafter, the animals were anesthetized and subjected with a transient occlusion of the carotids and the right middle cerebral arteries for 1 hour. The brains of these animals were perfused with saline and stained for 30 minutes with 2% TTC 48 hours after brain reperfusion. Our results showed that the brain infarction volume of the control animals was 203＋－9.03mm3(mean ±SEM). The mean infarction volumes of the groups treated with the 15 herb medicines were listed in Table 1 and figured in Figure 1. Among the 15 treatment groups, five had significant lower infarction volume than the control. Niu Huang Wan (牛黃丸) 152.3±21.0; Yu Sheng Wan (育生丸) 115±10.4; Xiao Xu Ming Tang (小續命湯) 137.6±30.8; Huang Qi Wu Wu Tang (黃耆五物湯) 94.4±29.3; and Shen Fu Tang（參附湯）203±9.03: were effective in prevention of ischemic brain injury. In the second stage, those animals were divided into 6 groups. Five groups of animals underwent ligation procedures and the other one as control. Five ligation groups were fed for 2 days with one kind of 5 effective Chinese herb medicines demonstrated in the first stage of the experiment and the control group fed with normal saline. The results of the second stage showed that two groups had significant lower infarction volume than the control group. The mean infarction volumes of the groups treated with the five herb medicines were listed in Table 2 and figured in Figure 2. In conclusion, Shen Fu Tang (參附湯 ) 134 ±12.5, Yu Sheng Wan (育生丸) 118±16.4 deserved further investigation for clinically treating ischemic brain injury.