Page 46 - วารสารกรมการแพทย์แผนไทยฯ ปีที่ 14 ฉบับที่ 3

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§«“¡ª≈Õ¥¿—¬„π°“√„™â ª√–°Õ∫‰ª¥â«¬ chrysin, vitexin, isovitexin,
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®“°°“√»÷°…“∑“ߧ≈‘π‘°¢ÕߺŸâªÉ«¬·≈– orientin ·≈– isoorientin °“√»÷°…“ in vitro
Õ“ “ ¡—§√®”π«π 1,054 √“¬ æ∫º≈¢â“߇§’¬ßμàÕ „π ¡ÕßÀπŸ·√∑ ‚¥¬„™â RRA ¢Õß GABAA recep-
√–∫∫¬àÕ¬Õ“À“√ ·≈–¡’Õ“°“√ÕàÕπ‡æ≈’¬ ·μà‰¡à tor antagonist æ∫«à“ passion flower ÕÕ°ƒ∑∏‘Ï

æ∫§«“¡‡ªìπæ‘…μàÕμ—∫„πºŸâªÉ«¬∑—ÈßÀ¡¥∑’Ë∑”°“√ ‰ª·¬àß®—∫°—∫μ—«√—∫¥—ß°≈à“« ‚¥¬¡’§à“ IC50 ‡∑à“°—∫ 101
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»÷°…“ º≈‘μ¿—≥±å∑’Ë¡’ à«πº ¡¢Õß Kava ∂Ÿ° μg/ml ·≈–‡¡◊ËÕ„™â Flumazenil ´÷Ëß¡’§«“¡®”‡æ“–
∂Õ¥ÕÕ°®“°μ≈“¥¬ÿ‚√ª·≈–Õ‡¡√‘°“μ—Èß·μàªï 2002 ‡®“–®ß Ÿß∑’Ë∫√‘‡«≥ benzodiazepine site ¢Õß
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‡π◊ËÕß®“°μ√«®æ∫§«“¡‡ªìπæ‘…μàÕμ—∫„πºŸâ∫√‘‚¿§ GABAA receptor æ∫§à“ IC50 ‡∑à“°—∫ 944 μg/ml
Õ¬à“߉√°Áμ“¡ ªí®®—¬∑’Ë¡’§«“¡‡°’ˬ«¢âÕß°—∫°“√‡°‘¥ ·≈–‡¡◊ËÕ„™â specific antagonist ¢Õßμ—«√—∫ GABAB

§«“¡‡ªìπæ‘…μàÕμ—∫π—Èπ ‡°‘¥¢÷Èπ‰¥â®“°‡Õπ‰´¡åμ—∫„π æ∫ IC50 ‡∑à“°—∫ 31 mg/ml ¢≥–∑’Ë EC50 ¢Õß
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°√–∫«π°“√¢Õß CYP450 ‰¡à “¡“√∂‡¡μ“∫Õ‰≈´å GABA uptake ‡∑à“°—∫ 95.7 μg/ml πÕ°®“°π’È
kavalactones ∑’ˉ¥â¡“®“° à«π¢Õß„∫ÕàÕπ·≈– ¬—ßæ∫«à“ “√ °—¥ passion flower ¥â«¬«‘∏’ Oregonûs

≈”μâπ∑’Ë‚º≈àæâπ¥‘π‰¥â πÕ°®“°π’È°“√ °—¥¥â«¬μ—«∑” Wild Harvest (OWH) ‡æ‘Ë¡ GABA current „π
≈–≈“¬Õ–´‘‚μπ·≈–‡Õ∑“πÕ≈π—Èπ‰¡à‡ªìπ∑’ˬա√—∫ ¡Õß à«π hippocampus ¢ÕßÀπŸ·√∑ „π°“√
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„π°√–∫«π°“√º≈‘μ ‘Ëß∫√‘‚¿§ ª√–¡“≥ 79% ¢Õß »÷°…“∑“ß √’√«‘∑¬“‰øøÑ“
ª√–™“°√º‘«¢“«æ∫§«“¡º‘¥ª°μ‘¢Õ߇Õπ‰´¡å 4.2.1 °“√»÷°…“ƒ∑∏‘ϧ≈“¬°—ß«≈∫π EPM
CYP2D6 ´÷Ëß àߺ≈„Àâ°“√‡¡μ“∫Õ‰≈´å¬“∫“ß™π‘¥™â“≈ß ÀπŸ‡¡“ å∑’ˉ¥â√—∫ “√ °—¥ passion flower ¥â«¬
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¡“° „π§π‡Õ‡™’¬æ∫‡æ’¬ß 1% ®÷ßÕ“®‡ªìπ‡Àμÿ ‡Õ∑“πÕ≈„™â‡«≈“Õ¬Ÿà„π¥â“π‡ªî¥‡æ‘Ë¡¡“°¢÷ÈπÕ¬à“ß¡’
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∑’ˉ¡àæ∫§«“¡‡ªìπæ‘…μàÕμ—∫¢ÕߺŸâ∫√‘‚¿§∑’ˇªìπ§π π—¬ ”§—≠∑“ß ∂‘μ‘ „π¢≥–∑’Ë°“√ °—¥„π·∫∫¢Õß

‡Õ‡™’¬·ª´‘øî§ °“√°¥°“√∑”ß“π¢Õß CYP450s ¢Õß OWH ∑’ËÀπŸ‡¡“ 剥â√—∫ 100 mg „ππÈ”¥◊Ë¡‡ªìπ‡«≈“ 1
kava àߺ≈„Àâ therapeutic window Õ¬Ÿà„π™à«ß·§∫ —ª¥“Àå æ∫«à“ ÀπŸ‡¡“ å· ¥ßÕ“°“√«‘μ°°—ß«≈‡æ‘Ë¡¢÷Èπ
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°“√π”‡Õ“¬“™π‘¥Õ◊Ëπ¡“„™â√à«¡°—∫ kava „π°“√ ‚¥¬„™â‡«≈“Õ¬Ÿà„π¥â“π‡ªî¥≈¥≈ß πÕ°®“°π’È°“√
√—°…“‚√§«‘μ°°—ß«≈π—Èπ ¬—ß‰¡àæ∫√“¬ß“πÕ—πμ√°‘√‘¬“ ∑¥≈Õß„πÀπŸ‡¡“ å ‚¥¬©’¥ “√ flumazenil „Àâ —μ«å
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(drug interaction) WHO ·π–π”„Àℙ⠓√ °—¥ ∑¥≈Õß°àÕπ‰¥â√—∫ “√ °—¥ passion flower (PI)
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kava ¥â«¬μ—«∑”≈–≈“¬πÈ”‡æ◊ËÕ§«“¡ª≈Õ¥¿—¬ ·≈–∑”°“√∑¥ Õ∫æƒμ‘°√√¡¥â«¬ EPM æ∫«à“ PI
4.2 Passiflora incarnate (passion flower) ‰¡à “¡“√∂ÕÕ°ƒ∑∏‘ϧ≈“¬°—ß«≈„π —μ«å∑¥≈Õߥ—ß-
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‡ªìπ ¡ÿπ‰æ√∑’ˉ¥â√—∫°“√®¥∫—π∑÷°μ—Èß·μàªï 1938 °≈à“«‰¥â “√ °—¥ passion flower ¥â«¬πÈ”·≈–
‚¥¬¡’ƒ∑∏‘ϧ≈“¬°—ß«≈ ≈¥§«“¡°√–«π°√–«“¬ ≈¥ πÈ”º ¡·Õ≈°ÕŒÕ≈å 400 mg/kg · ¥ßƒ∑∏‘ϧ≈“¬

Õ“°“√∑âÕߺŸ°-∑âÕßÕ◊¥ ≈¥°“√μ‘¥‡™◊ÈÕ √—°…“‚√§ °—ß«≈„π DLB ¥â«¬°“√‡æ‘Ë¡‡«≈“∑’ËÀπŸ‡¡“ åÕ¬Ÿà„π
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πÕπ‰¡àÀ≈—∫ √—°…“‚√§Œ’ ∑’‡√’¬ ·≈–‚√§ª√– “∑ ¥â“π «à“߇¡◊ËÕ‡ª√’¬∫‡∑’¬∫°—∫°≈ÿࡧ«∫§ÿ¡
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™π‘¥ÕàÕπ‡æ≈’¬ßà“¬ (neurasthenia) Flavonoids 4.2.2 °“√»÷°…“ƒ∑∏‘ϧ≈“¬°—ß«≈∑“ß
‡ªìπ°≈ÿà¡ “√ ”§—≠ÕÕ°ƒ∑∏‘Ï„π°“√§≈“¬°—ß«≈ §≈‘π‘° „π°≈ÿà¡Õ“ “ ¡—§√ª°μ‘°àÕπ°“√„À⬓™“∑’Ë