课件：胆汁淤积症的诊断治疗PPT课件.ppt

Effect of fibre, antispasmodics, and peppermint oil in the treatment of IBS: systematic review and meta-analysis BMJ 2008;337:a2313 IBS in Australian general practice Australian Family Physician 2006;35( 11):840 薄荷素油的钙通道阻滞研究 ——膜片钳技术 膜片钳技术运用微玻管电极（膜片电极或膜片吸管）来测量多种通道电流,其测量值可达到皮安级(pA,10-12A)。采用膜片钳技术， Hawthorn 发现薄荷油可有效地松弛离体的胃肠道平滑肌组织(oddi)，其机理是： ①薄荷素油中主要成分薄荷醇有效的降低电压依赖L型钙通道结合键，抑制神经元的去极化导致Ca2+离子的摄取减少 ②能有效地阻滞Ca2+离子进入细胞 ③发现薄荷油抑制电压依赖型Ca2+离子电流，与薄荷油的浓度呈现剂量依赖关系 薄荷素油调节Oddi括约肌的药理研究 Journal of Ethnopharmacology 2010; 130 :433–436 Antispasmodic effect of Mentha piperita essential oil on tracheal smooth muscle of rats A choleretic action has traditionally been ascribed to peppermint oil,in keeping with the occasional use of menthol in the treatment of gallstones (Leuschner et al., 1988). Increases in bile production of 1.3–2.4-fold were recorded (Mans and Pentz,1987) after oral doses of 0.1–1.0 g/kg in male rats. Trabace et al. (1993) found dose- and time-dependent choleretic effects of peppermint oil and menthol in anesthetized rats and used theseas standards for testing other essential oils. The mechanism of action underlying the observed choleretic activity of menthol or other constituents of peppermint oil is not clearly understood, but may result from the marked biliary output of metabolized menthol (Mans and Pentz,1987). Effects of peppermint oil on total bile secretion in rats （n=10） Group Bile Secretion (ml) Increase in bile secretion（%） Before drug 30 min 60 min 120 min PO 0.24±0.05 0.32±0.08** 0.64±0.07** 0.94±0.07** 33.3**## Saline 0.25±0.07 0.22±0.06 0.45±0.09 0.66±0.08 -12 UDCA 0.27±0.05 0.29±0.06** 0.57±0.08* 0.85±0.1* 7.4 原料（胆固醇+LDL） ①（LDLR） 胆酸 CYP8B1 ② 替代途径 27-羟胆固醇 3?，7?-二羟-5-胆固醇酸 7?-羟-3-酮-4-胆烷酸 3?，7?-二羟-5?-胆烷酸 鹅脱氧胆酸 3?HSD CYP27A1，CYP7B1 3?，7?-二羟-5?-胆烷酸 经典途径 3?，7?，12?-三羟-5?-胆烷酸 7?-4-胆固醇烯-3-酮 7?-羟胆固醇 胆固醇 CYP7A1 3?HSD ③FXR ①原材料摄入环节 LDLR ②胆酸合成关键蛋白 CYP7A1 CYP27A1 ③胆酸转运关键蛋白 FXR 通过上调胆酸合成关健基因的表达，促进胆汁合成 1 1 1 关键蛋白 1、细胞培养及药物处理….. HepG2细胞常规维持培养在含5%小牛