半夏止呕及抗肿瘤临床与实验研究
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摘要
呕吐是恶性肿瘤患者放化疗期间常见的不良反应,特别是细胞毒性化疗药所致的呕吐发生率高,程度严重,往往给病人造成很大的痛苦,影响了生活质量,甚至引起机体水电解质平衡紊乱及酸碱中毒等问题。因此,抗呕吐治疗成为人们关注的热点。目前的抗呕吐药最常用的是5-HT_3受体阻断剂(如ondansetron,格拉斯琼等)及促胃肠动力药(如甲氧氯普胺,吗丁啉等),这些药物作用单一,价格昂贵,且有一定的毒副作用。为了进一步继承和发扬祖国医学传统,拓宽中药研究思路,本文立足我国资源优势,选取具有降逆止呕,消痞散结之中药半夏,借助我国首创的水貂呕吐模型,着重研究了其在止呕、抗肿瘤两方面的作用,旨在开发既能止呕又能抗肿瘤的新型止呕剂,并与甲氧氯普胺进行了对照,结果如下:
     1 姜半夏醇提物及姜半夏水煎剂两种剂型对抗顺铂(7.5ng·kg~(-1),ip)所致干呕和呕吐次数为54.5、63.5、8.0和10.0(P<0.01)。
     2 姜半夏醇提物在对抗阿朴吗啡(1.6mg·kg~(-1),sc)所致的呕吐实验中潜伏期延长,干呕呕吐次数分别为10.3及2.3(P<0.05)。
     3 生半夏在水貂引起的干呕和呕吐次数为78.3和13.3。
    
    第一章中文摘要
    4半夏水煎剂在肿瘤病人化疗组临床实验中,半夏+恩旦西酮组总有效率为
     91.4%,对照组总有效率为80.8%(P<0 .01)。
    5半夏水煎剂在肿瘤病人放疗组中,口服半夏组总有效率为78.6%单纯放疗组总
     有效率为76.0%(P>0.05)。
    6生半夏(xo,5,19·ml’l)对s;50,H22,及EAe荷瘤小鼠的肿瘤抑制率分别为5 7.5,
     犯.9,26%;24.7,30.9,35.1%和12.5,20.5,30.10,0。姜半夏(10,5,19·ml”)
     对5.5。,H22.及EAC荷瘤小鼠的肿瘤抑制率分别为63.1,47.4,57.70,0;36.3,32.4,
     38.4%和20.5,28.9,27.2%。
    7免疫组化法检测顺铂引起水貂肠道嗜铬细胞(EC)5一HT3释放情况,说明外周
     5一H几受体刺激腹部迷走神经传入纤维是顺铂引起呕吐的主要诱发因素。
     结论:中药半夏具有止呕,抗肿瘤等多方面作用,深入研究半夏止呕,抗肿
    瘤的机理,寻找有效化学成分,则有望开发出具有双重作用的抗呕吐新药,不仅
    可造福于广大肿瘤患者,还可有效地利用我国的中药资源优势,进一步推动中医
    药现代化的发展。
Chemotherapy and radiotherapy are associated with emesis as a common adverse reaction in the treatment of malignant tumor, the rate of emesis induced by cytotoxic drugs was very high. At present ,the commonly used antiemetic drugs are 5-HT3 receptor antagonist(such as ondansetron) and dopamine antigonist(such as metoclopramide), these drugs have have many side effects. In order to carry on the Chinese traditional medicine , having the aid of the new vomiting model in Minks, we study the actions of pinella tuber. The follows are the results:
    1 Ethanol extraction and water-decoction of pinellia tuber (processed with ginger inhibited the emesis induced by cisplatin (7.5mg-kg-1,ip),the number of emesis are 54.5; 63.5; 8.0 and 10.0 (p<0.01).
    2 Ethanol extraction of pinella tuber (processed with ginger) inhibited the emesis induced by apomorphine(1.6mg-kg-1,sc), the latency of vomit is prolonded, the number of retching and emesis are 10.3 and 2.3(p<0.05).
    3 Raw pinella can induce emesis in minks, the number of retching and emesis are 78.3 and 13.3.
    4 In the clinical experiment of Chemotherapy of tumor, The total effective rate was 91.4% in the pinellia tuber combination with ondansetron group and was 80.8% in contrast group(P<0.01).
    5 In the clinical experiment of radiotherapy of tumor, The total effective rate was 78.6% in the pinellia tuber and was 76% in mono-radiotherapy group(p>0.05).
    6 Inhibitory of pinellia tuber(10, 5, lg-ml-1)against implanted S180,H22 and EAC tumors in mice were 57.5, 32.9, 26%; 24.7, 30.9, 35.1% and 12.8, 20.5, 30.1% respectly compared with that in control groups .Inhibitory of pinellia processed with ginger (10, 5, 1g-ml-1) against implanted S180,H22 and EAC tumors in mice were 63.1, 47.4, 57.7%; 36.3, 32.4, 38.4% and 20.5, 28.9, 27.2%.
    
    
    7 In cisplatin group,the assay of distribution of 5-HT3 was performed by immunohitologic method,The result showed that 5-HT3 receptors stimulate abdominal vagal afferent neuros which may be an important mechanism involved in vomiting.
    The results suggested that pinellia tuber have many actions such as antiemetic and anti-neoplasia, studying the active chemical constituents and its mechanisms in pinellia tuber may be great value in screening new antiemetic and anti-neoplasia drugs.
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