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162 «“√ “√°“√·æ∑¬å·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ° ªï∑’Ë 10 ©∫—∫∑’Ë 3°—𬓬π-∏—𫓧¡ 2555

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àߺ≈„Àâπ—°«‘®—¬„πÀ≈“¬ “¢“«‘™“»÷°…“‡æ◊ËÕÀ“·À≈àß ‡æ‘Ë¡¢÷ÈπÕ¬à“ß√«¥‡√Á« “√∑ÿ쑬¿Ÿ¡‘®“°æ◊™ (second-
¢Õ߬“™π‘¥„À¡à‡æ◊ËÕ„™â√—°…“‚√§ “√μâ“π‡™◊ÈÕ ary metabolites) ®÷ßÕ“®‡ªìπ·À≈àߢÕß “√∑’Ë¡’
·∫§∑’‡√’¬®“°æ◊™π—∫‡ªìπÕ’°·À≈àßÀπ÷Ëß∑’Ë¡’°“√»÷°…“ ª√– ‘∑∏‘º≈¥’„π°“√√—°…“°“√μ‘¥‡™◊ÈÕ·∫∫∑’Ë„™â√à«¡°—π
·≈–æ—≤π“Õ¬à“ß°«â“ߢ«“ß ‡π◊ËÕß®“°„π∏√√¡™“μ‘æ∫ (combination therapy) ‡æ◊ËÕ‡æ‘Ë¡ª√– ‘∑∏‘º≈¢Õ߬“

«à“æ◊™¡’°“√μ‘¥‡™◊ÈÕπâÕ¬´÷Ë߇ªìπ ‘Ëß∫àß™’ȉ¥â¥’∂÷ß°≈‰° ≈¥°“√¥◊ÈÕ¬“ ·≈–‡æ‘Ë¡∑“߇≈◊Õ°„π°“√√—°…“„π‚√§
°“√æ—≤π“°“√ªÑÕß°—πμ—«∑’Ë¥’¢Õßæ◊™ æ◊™º≈‘μ “√∑’Ë¡’ μ‘¥‡™◊ÈÕ
‚¡‡≈°ÿ≈¢π“¥‡≈Á°∑’Ë¡’§«“¡ “¡“√∂°“√μâ“π‡™◊ÈÕ‚√§ °“√æ‘®“√≥“ªØ‘°‘√‘¬“√–À«à“ß “√≈¥°“√¥◊ÈÕ¬“
‡√’¬°«à“ çphytoalexinsé ª√–°Õ∫¥â«¬ “√À≈“¬ ·≈–¬“ “¡“√∂∑”‰¥â 4 «‘∏’ §◊Õ checkerboard as-

°≈ÿࡉ¥â·°à terpenoids, glycosteroids, flavonoids, say, time kill assay, Epsilometer test (E-test),
·≈– polyphenols ·μà “√¥—ß°≈à“«¡’§«“¡ “¡“√∂ ·≈– isobole method ´÷Ëß·μà≈–«‘∏’®–¡’¢âÕ¥’·≈–¢âÕ

„π°“√¬—∫¬—Èß®ÿ≈‘π∑√’¬å‰¥âπâÕ¬‡¡◊ËÕ‡ª√’¬∫‡∑’¬∫°—∫¬“ ‡ ’¬·μ°μà“ß°—π checkerboard assay ‡ªìπ«‘∏’∑’Ë
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ªØ‘™’«π–∑’˺≈‘μ‰¥â®“°·∫§∑’‡√’¬À√◊Õ‡™◊ÈÕ√“ ·μà„π ∑”‰¥âßà“¬·≈–‡ªìπ∑’Ëπ‘¬¡ ·μà‡ªìπ‡æ’¬ß«‘∏’‡∫◊ÈÕßμâπ„π
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ªï §.». 2000 Stermitz ·≈–§≥– æ∫§«“¡ °“√ª√–‡¡‘πªØ‘°‘√‘¬“‡∑à“π—Èπ ‚¥¬°“√·ª≈º≈®–„™â§à“
“¡“√∂„π°“√∑”ß“π√à«¡°—π (combination action) fractional inhibitory concentration index (FIC

·≈–°“√‡ √‘¡ƒ∑∏‘Ï´÷Ëß°—π·≈–°—π (synergistic effect) index) ‚¥¬§à“¥—ß°≈à“«À“®“° Ÿμ√ FIC index = FIC
¢Õß “√∑’Ë·¬°‰¥â®“°æ◊™ Berberis fremontii °“√ ¢Õß “√™π‘¥∑’Ë 1 + FIC ¢Õß “√™π‘¥∑’Ë 2 ´÷Ëß§à“ FIC

»÷°…“¥—ß°≈à“«∑¥ Õ∫°“√∑”ß“π√à«¡°—π¢Õß ber- ¢Õß “√·μà≈–™π‘¥§”π«≥®“° —¥ à«π¢Õß§à“§«“¡
berine ·≈– 5'-methoxyhydnocarpin D ‚¥¬ ‡¢â¡¢âπμË” ÿ¥∑’Ë “¡“√∂¬—∫¬—Èß°“√‡®√‘≠¢Õß·∫§∑’‡√’¬
berberine ‡ªìπ “√ hydrophobic alkaloid ∑’Ë¡’ (MIC) ¢Õß “√°àÕπ·≈–À≈—ß„™â√à«¡°—π À“°§à“ FIC
°≈‰°„π°“√ÕÕ°ƒ∑∏‘Ϭ—∫¬—Èß·∫§∑’‡√’¬‚¥¬√∫°«π index ≤ 0.5 ·ª≈º≈‡ªìπ‡ √‘¡ƒ∑∏‘Ï (Synergistic

°“√ —߇§√“–Àå·≈–°“√∑”ß“π¢Õß DNA ·μଗ߉¡à interaction) §à“ FIC index > 0.5 ·μà ≤ 4 ·ª≈º≈
“¡“√∂„™â “√¥—ß°≈à“«„π°“√∑”≈“¬·∫§∑’‡√’¬‰¥â ‡ªìπ‰¡à¡’°“√‡ª≈’ˬπ·ª≈ß (Indifferentt interaction)

‡π◊ËÕß®“° “√¥—ß°≈à“«∂Ÿ°¢—∫ÕÕ°‚¥¬ multidrug re- §à“ FIC index > 4 ·ª≈º≈‡ªìπμâ“πƒ∑∏‘Ï°—π (an-
sistance pump (MDR pump) ¢Õß·∫§∑’‡√’¬ tagonistic interactions) °“√®–„™â«‘∏’π’È„π°“√
·μà‡¡◊ËÕ∑”ß“π√à«¡°—∫ “√Õ’°™π‘¥Àπ÷Ëß §◊Õ 5'- ª√–‡¡‘ππ—È𮔇ªìπμâÕß∑√“∫§à“ MIC ¢Õ߬“·≈– “√
methoxyhydnocarpin D ´÷Ëß·¬°‰¥â®“°æ◊™™π‘¥π’È ≈¥°“√¥◊ÈÕ¬“μàÕ·∫§∑’‡√’¬∑¥ Õ∫π—ÈπÊ «‘∏’ time kill

·≈– “¡“√∂¬—∫¬—Èß MDR pump ‰¥â °“√∑”ß“π√à«¡ assay ‡ªìπÕ’°Àπ÷Ëß«‘∏’∑’ˉ¥â√—∫§«“¡π‘¬¡„π°“√𔉪
°—π¢Õß “√∑—Èß Õß™π‘¥ àߺ≈„À⇰‘¥°“√¬—∫¬—Èß°“√ ª√–‡¡‘πªØ‘°‘√‘¬“√–À«à“߬“·≈– “√≈¥°“√¥◊ÈÕ¬“
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‡®√‘≠¢Õß·∫§∑’‡√’¬ ®“°·π«§‘¥¥—ß°≈à“« àߺ≈„Àâ ·≈–¬—߇ªìπ«‘∏’∑’Ë “¡“√∂ª√–‡¡‘𧫓¡ “¡“√∂„π°“√
¡’°“√æ—≤π“ berberine ‡™◊ËÕ¡°—∫ INF55 ´÷Ë߇ªìπ ¶à“·∫§∑’‡√’¬¢Õ߬“ “√≈¥°“√¥◊ÈÕ¬“ ·≈–°“√„™â
“√¬—∫¬—Èß MDR pump æ∫«à“ “√π’È “¡“√∂¬—∫¬—Èß ·∫∫√à«¡°—π¢Õ߬“·≈– “√≈¥°“√¥◊ÈÕ¬“ ‚¥¬¡’À≈—°
·∫§∑’‡√’¬‰¥â¥’·≈–æ∫°“√ – ¡¢Õß “√¿“¬„π‡´≈≈å °“√§◊Õ∑¥ Õ∫§«“¡ “¡“√∂„π¬—∫¬—ÈßÀ√◊Õ¶à“