Page 21 - วารสารกรมการแพทย์แผนไทยฯ ปีที่ 10 ฉบับที่ 3

Journal of Thai Traditional & Alternative Medicine Vol. 10 No. 3 September-December 2012 171

‡ª≈’ˬπ·ª≈ß°“√· ¥ßÕÕ°¢Õß gene ∑’Ë àߺ≈μàÕº≈‘μ “√ diterpenes ®“° Lycopus europaeus “¡“√∂

MDRp (¢) ¬—∫¬—Èß°√–∫«π°“√ √â“ß‚ª√μ’π∑’ˇªìπ ‡æ‘Ë¡ª√– ‘∑∏‘º≈„Àâ°—∫ tetracycline ·≈– erythro-
Õߧåª√–°Õ∫¢Õß MDRp (§) ¬—∫¬—Èß°“√¢—∫ “√ÕÕ° mycin „π°“√¬—∫¬—Èß S. aureus “¬æ—π∏ÿå∑’Ë¡’°“√
∫√‘‡«≥ OM (ß) ∑”≈“¬·À≈àßæ≈—ßß“π (®) √â“ß “√ · ¥ßÕÕ°¢Õß multidrug efflux pump ™π‘¥ Tet
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™π‘¥Õ◊Ëπ¡“·¬àß®—∫°—∫ MDRp ·∑π¬“ªØ‘™’«π– (©) (K) ·≈– Msr (A) “√ 2,6-dimethyl-4-
‡ª≈’ˬπ‚§√ß √â“ߢÕ߬“ªØ‘™’«π–‡æ◊ËÕ‰¡à„Àâ®—∫°—∫ phenylpyridine-3,5-dicarboxylic acid diethyl
MDRp °“√»÷°…“ “√®“°æ◊™‡æ◊ËÕ„™â„π°“√¬—∫¬—Èß ester ®“° Jatropha elliptica “¡“√∂¬—∫¬—Èß°“√
MDRp (efflux pump inhibitor; EPI) æ∫«à“°”≈—ß ∑”ß“π¢Õß NorA „π NorA resistant S. aureus

‡æ‘Ë¡¡“°¢÷Èπ„πªí®®ÿ∫—π (μ“√“ß∑’Ë 3) °“√»÷°…“ à«π àߺ≈„π·∫§∑’‡√’¬¥—ß°≈à“«¡’§«“¡‰«μàÕ ciproflo-
„À≠à∑”°“√∑¥≈Õß„π√–¥—∫À≈Õ¥∑¥≈Õß·≈–¡ÿàß xacin, norfloxacin ·≈– pefloxacin ‡æ‘Ë¡¡“°
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‡πâπ°“√æ—≤π“ EPI ”À√—∫·∫§∑’‡√’¬·°√¡∫«° ¢÷Èπ μ—«Õ¬à“߇À≈à“π’È· ¥ß„Àâ‡ÀÁπ‡ªìπÕ¬à“ߥ’«à“ “√
·≈–ªí®®ÿ∫—π¬—߉¡à¡’√“¬ß“π°“√∑¥≈Õß„™â„π —μ«å ®“°æ◊™ ‡ªìπ·À≈àß ”§—≠„π°“√«‘®—¬‡æ◊ËÕæ—≤𓇪ìπ
∑¥≈ÕßÀ√◊Õ„π¡πÿ…¬å “√≈¥°“√¥◊ÈÕ¬“
5'-methoxyhydnocarpin-D (5ûMHC-D) „π·∫§∑’‡√’¬·°√¡≈∫®–¡’‡¬◊ËÕÀÿâ¡¥â“ππÕ°

‡ªìπ “√®“°æ◊™°≈ÿà¡ Berberis ™π‘¥·√°∑’Ëπ—°«‘®—¬ ºπ—߇´≈≈å (outer membrane; OM) Õ’°™—Èπ ‚¥¬¡’
„À⧫“¡ π„®»÷°…“§ÿ≥ ¡∫—μ‘„π°“√‡ªìπ EPI Õߧåª√–°Õ∫ ”§—≠§◊Õ lipopolysaccharide (LPS)

‡π◊ËÕß®“° “¡“√∂‡æ‘Ë¡°“√ – ¡¢Õß berberine √â“ß ¿“«–¥â“ππÕ°ºπ—߇´≈≈凪ìπ hydrophilic
¿“¬„π‡´≈≈å S. aureus ∑”„Àâ berberine “¡“√∂ surface ∑”Àπâ“∑’ˇªìπ·π«ªÑÕß°—π∑“ß∏√√¡™“쑧—¥
ÕÕ°ƒ∑∏‘Ϭ—∫¬—Èß·∫§∑’‡√’¬‰¥â ·≈–‡¡◊ËÕ∑¥ Õ∫μàÕ‚¥¬ ‡≈◊Õ°‰¡à„Àâ “√°≈ÿà¡∑’ˇªìπ hydrophobic ºà“π‡¢â“¡“
„™â¬“ªØ‘™’«π– æ∫«à“ 5ûMHC-D “¡“√∂≈¥°“√¥◊ÈÕ ‰¥â (√Ÿª∑’Ë 2¢) πÕ°®“°π’È¥â“ππÕ°ºπ—߇´≈≈å ¬—ß

μàÕ¬“ ciprofloxacin ¢Õß S. aureus, E. coli ·≈– ª√–°Õ∫¥â«¬‚ª√μ’π´÷Ëߪ√–°Õ∫°—π‡ªìπ™àÕß∑“ߺà“π
P. aeruginosa ‰¥â πÕ°®“°π’Ȭ—ß¡’√“¬ß“π¢Õß “√ ‡¢â“ÕÕ°¢Õß “√ (outer membrane protein; OMP)

pheophorbide a ´÷Ëß·¬°‰¥â®“°æ◊™°≈ÿࡇ¥’¬«°—ππ’È ‡™àπ porin §«“¡ ¡¥ÿ≈¢Õß OM π—Èπ‡°‘¥®“°°“√
¡’§«“¡ “¡“√∂„π°“√‡ªìπ EPI ‰¥â‡™àπ‡¥’¬«°—∫ √—°…“ ¡¥ÿ≈¢Õ߉ÕÕÕπ√–À«à“ß LPS ·≈– OMP
5ûMHC-D “√°≈ÿà¡ polyphenols ‡ªìπÕ’°°≈ÿà¡∑’ˉ¥â ß“π«‘®—¬™’È„Àâ‡ÀÁπ«à“°“√√∫°«π ¡¥ÿ≈¢Õ߉ÕÕÕππ’È®–
√—∫§«“¡ π„®»÷°…“§ÿ≥ ¡∫—μ‘„π°“√‡ªìπ EPI àߺ≈μàÕ§«“¡‰«¢Õß·∫§∑’‡√’¬μàÕ “√À≈“¬™π‘¥
48
Roccaro ·≈–§≥– (2004) æ∫«à“ EGCg “¡“√∂ °“√„™â EDTA √∫°«π‰ÕÕÕπ∫π OM ¢Õß P.
¬—∫¬—Èß°“√∑”ß“π¢Õß Tet (K) ·≈–‡æ‘Ë¡§«“¡‰«¢Õß aeruginosa ™à«¬≈¥°“√¥◊ÈÕ¢Õß·∫§∑’‡√’¬π’ÈμàÕ¬“
MRSA μàÕ¬“ tetracycline À√◊Õ ellagic acid ∑’Ë À≈“¬™π‘¥ ‡™àπ ampicillin, chloramphenicol,

“¡“√∂æ∫„πæ◊™À≈“¬™π‘¥ ·¡â‰¡à¡’ƒ∑∏‘Ï¶à“‡™◊ÈÕ oxytetracycline, streptomycin, oxacillin, ·≈–
63-65
·∫§∑’‡√’¬·μà¡’§«“¡ “¡“√∂„π°“√‡ªìπ “√≈¥°“√ cefamandole ‡ªìπμâπ §ÿ≥ ¡∫—쑇™àπ‡¥’¬«°—π
23
¥◊ÈÕ¬“¢Õß MDR A. baumannii μàÕ¬“À≈“¬™π‘¥ π’Èæ∫„π “√®“°æ◊™ ‡™àπ essential oils (thymol ·≈–