TW201422230A - Pharmaceutical composition for preventing and treating liver fibrosis - Google Patents
Pharmaceutical composition for preventing and treating liver fibrosis Download PDFInfo
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本發明係有關一種用於預防及治療肝纖維化或非酒精性脂肪肝之醫藥組成物,包含50至90重量%之冬蟲夏草菌絲體及10至50重量%之黃耆。 The present invention relates to a pharmaceutical composition for preventing and treating liver fibrosis or nonalcoholic fatty liver, comprising 50 to 90% by weight of Cordyceps sinensis mycelium and 10 to 50% by weight of jaundice.
酒精、病毒或化學物質所引起之慢性肝損傷會使肝臟星狀細胞活化且分泌大量膠原蛋白等胞外基質,並使該等胞外基質過度沉積而造成肝纖維化。根據上述致病機制,治療肝纖維化之藥品開發主要係針對抑制胞外基質合成,或促進胞外基質降解等目標,但目前所發現之物質大多具有生物毒性,或會產生強烈的副作用,至今仍未發現在動物模式中有療效者。 Chronic liver damage caused by alcohol, viruses or chemicals can activate liver stellate cells and secrete a large amount of extracellular matrix such as collagen, and excessive deposition of these extracellular matrices can cause liver fibrosis. According to the above-mentioned pathogenic mechanism, the development of drugs for treating liver fibrosis mainly aims at inhibiting the synthesis of extracellular matrix or promoting the degradation of extracellular matrix, but most of the substances found so far are biologically toxic or may have strong side effects. No one has been found to be effective in animal models.
非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)為沒有攝取過量酒精病患之肝脂肪含量超過肝臟重量之5%以上,這些患者臨床上常伴隨肥胖、糖尿病、高血脂等疾病,而可能引發肝纖維化及肝硬化。目前對於非酒精性脂肪肝之治療係以減重、血糖及血脂之控制,但並無任何藥物被證明可有效治療非酒精性脂肪肝且進一步預防其進展為肝纖維化及肝硬化。 Nonalcoholic fatty liver disease (NAFLD) is a liver fat content of more than 5% of liver weight in patients who do not consume excessive alcohol. These patients are often accompanied by diseases such as obesity, diabetes, and hyperlipidemia. Liver fibrosis and cirrhosis. At present, the treatment of nonalcoholic fatty liver is controlled by weight loss, blood sugar and blood lipids, but no drug has been proven to be effective in treating nonalcoholic fatty liver disease and further preventing its progression to liver fibrosis and cirrhosis.
本發明之目的在於提供一種以中草藥作為預防及治療肝纖維化或非酒精性脂肪肝之醫藥組成物。本發明之醫藥組成物主要係包含50至90重量%之冬蟲夏草菌絲體及10至50重量%之黃耆。 It is an object of the present invention to provide a pharmaceutical composition for preventing and treating liver fibrosis or nonalcoholic fatty liver using Chinese herbal medicine. The pharmaceutical composition of the present invention mainly comprises 50 to 90% by weight of Cordyceps sinensis mycelium and 10 to 50% by weight of scutellaria.
冬蟲夏草(Cordyceps sinensis)為一種傳統中藥材,具有抗菌、消炎、解熱、鎮靜、促進血管擴張、平喘、抗心律不整、促進新陳代謝、抗老化、抗腫瘤及刺激免疫活性等功效。由於野生冬蟲夏草產量稀少且價格昂貴,本發明所採用之冬蟲夏草係由冬蟲夏草分離純化而得之菌絲體,其包含下列各菌種:中國被毛孢(Hirsutella sinensis)、中國擬青黴(Paecilomyces sinensis)、中國金孢黴(Chrysosporium sinensis)、蟲生簇孢(Sporothrix insectorum)、葡萄穗黴屬(Stachybotrys sp.)、中國彎頸黴(Tolypocladium sinensis)、蝙蝠蛾擬青霉(Paecilomyces hepiali)及蝙蝠蛾被毛孢(Hirsutella hepiali)等。 Cordyceps sinensis is a traditional Chinese herbal medicine with antibacterial, anti-inflammatory, antipyretic, sedative, vasodilating, anti-asthmatic, anti-arrhythmia, metabolism, anti-aging, anti-tumor and immune activity. Because the wild Cordyceps sinensis is sparsely produced and expensive, the Cordyceps sinensis used in the present invention is a mycelium obtained by separating and purifying Cordyceps sinensis, which comprises the following species: Hirsutella sinensis , Paecilomyces sinensis Chrysosporium sinensis , Sporothrix insectorum , Stachybotrys sp., Tolypocladium sinensis , Paecilomyces hepiali , and bat moth Spores ( Hirsutella hepiali ) and the like.
根據本發明之一較佳具體例,該冬蟲夏草菌絲體係為蝙蝠蛾擬青霉菌絲體(Paecilomyces hepiali Chen et Dai mycelia)經分離培養及發酵,所得之菌絲體再經冷凍或烘乾乾燥以製成粉末,以作為本發明醫藥組成物中主要成分之一。 According to a preferred embodiment of the present invention, the Cordyceps sinensis mycelium system is isolated, cultured and fermented by Paecilomyces hepiali Chen et Dai mycelia, and the obtained mycelium is frozen or dried. It is made into a powder as one of the main components in the pharmaceutical composition of the present invention.
黃耆(Astragalus membranaceus)之藥用部分為其根部,具有增強細胞免疫之功能。本發明係採用選自蒙古黃耆(Astragalus membranaceus(Fisch.)Bge.Var.mongholicus(Bge.)Hsiao)或膜莢黃耆(Astragalus membranaceus(Fisch.)Bge.)的乾燥根所製成之濃縮黃耆粉,以作為本發明醫藥組成物中另一主要成分,任何其他種類黃耆亦屬於本發明範疇。 The medicinal part of Astragalus membranaceus is its root and has the function of enhancing cellular immunity. The present invention is concentrated by using dried roots selected from the group consisting of Astragalus membranaceus (Fisch.) Bge. Var. mongholicus (Bge.) Hsiao or Astragalus membranaceus (Fisch.) Bge. Astragalus powder is the other major component of the pharmaceutical composition of the present invention, and any other type of xanthine is also within the scope of the present invention.
本發明醫藥組成物中可進一步包含大棗(Zizyphi Sativae)濃縮粉,及更進一步包含藥理學上可接受之賦形劑。該賦形劑係可選自磷酸鈣、葡萄糖酸鋅、硬脂酸鎂、二氧化矽及澱粉中之一或多者之組合。 The pharmaceutical composition of the present invention may further comprise a concentrated powder of Zizyphi Sativae , and further comprising a pharmaceutically acceptable excipient. The excipient can be selected from a combination of one or more of calcium phosphate, zinc gluconate, magnesium stearate, cerium oxide, and starch.
本發明之另一目的為提供一種用於製作預防及治療肝纖維化或非酒精性脂肪肝藥劑或保健食品之醫藥組成物,且該藥劑或保健食品可為膠囊、錠劑或散劑等口服製劑形式。 Another object of the present invention is to provide a pharmaceutical composition for preventing or treating liver fibrosis or nonalcoholic fatty liver medicine or health food, and the medicament or health food can be an oral preparation such as a capsule, a lozenge or a powder. form.
以下將藉由本發明之一較佳具體例詳細說明其實施方式,及其用於預防及治療肝纖維化或非酒精性脂肪肝所達到之優異功效。 Hereinafter, embodiments thereof will be described in detail by a preferred embodiment of the present invention, and their excellent effects for preventing and treating liver fibrosis or nonalcoholic fatty liver.
圖1為製備本發明蝙蝠蛾擬青霉菌絲體粉末之流程圖。 BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a flow chart for preparing a filamentous powder of Paecilomyces pallidum of the present invention.
圖2為TAA誘導肝纖維化試驗中於四種處理下所測得(A)三酸甘油酯、(B)膽固醇、(C)AST及(D)ALT含量,表中數據為平均值±SEM(n=12),標示不同字母表示差異顯著(p<0.05)。 Figure 2 shows the contents of (A) triglyceride, (B) cholesterol, (C) AST and (D) ALT measured under four treatments in the TAA-induced liver fibrosis test. The data in the table are mean ± SEM (n=12), indicating different letters indicates significant difference (p<0.05).
圖3為高油飼料誘導脂肪肝試驗中對照組與兩種劑量(557及2786毫克/公斤)處理下所測得小鼠體重變化。 Figure 3 is a graph showing changes in body weight of mice measured in the control group and two doses (557 and 2786 mg/kg) in a high-oil feed-induced fatty liver test.
圖4為高油飼料誘導脂肪肝試驗中於四種處理下所測得(A)AST及(B)ALT含量。 Figure 4 shows the (A) AST and (B) ALT levels measured under four treatments in a high oil feed induced fatty liver test.
圖5為高油飼料誘導脂肪肝試驗中於四種處理下所測得胰島素含量。 Figure 5 shows the insulin content measured under four treatments in a high oil feed induced fatty liver test.
圖6為高油飼料誘導脂肪肝試驗中於四種處理下所測得肝臟濕重。 Figure 6 is a graph showing the wet weight of the liver measured under four treatments in a high oil feed induced fatty liver test.
(製備本發明之醫藥組成物) (Preparation of the pharmaceutical composition of the present invention)
本發明之一較佳具體例所採用之冬蟲夏草菌絲體係為蝙蝠蛾擬青霉菌絲體粉末。該蝙蝠蛾擬青霉菌絲體粉末之製備係參照圖1之流程圖,該蝙蝠蛾擬青霉菌株係經培養及發酵,所得菌絲體再經冷凍或烘乾乾燥、研磨及過篩以製成粉末。另,黃耆係採用選自蒙古黃耆或膜莢黃耆的乾燥根所製成之市售黃耆濃縮粉末。此外,本發明之醫藥組成物更進一步包含大棗濃縮粉及藥理學上可接受之賦形劑,該賦形劑係可選自磷酸鈣、葡萄糖酸鋅、硬脂酸鎂、二氧化矽及澱粉中之一或多者之組合。上述組成物較佳係製成膠囊形式,其中所包含各成分及含量如下述:
本發明組成物之人體劑量(70公斤)係為3120毫克/日;大鼠口服劑量依據實驗動物與人體表面積比等效劑量換算比率計算,大鼠200公克與70公斤人體表面積比值為0.018,換算200公克大鼠劑量為56.16毫克/日。以下將以本發明組成物檢測對於預防及治療肝纖維化或非酒精性脂肪肝之功效。 The human dose (70 kg) of the composition of the present invention is 3120 mg/day; the oral dose of the rat is calculated according to the ratio of the equivalent surface dose of the experimental animal to the human body, and the ratio of the surface area of the human body of 200 g to 70 kg is 0.018. The dose of 200 grams of rats was 56.16 mg / day. The efficacy of the composition of the present invention for preventing and treating liver fibrosis or nonalcoholic fatty liver will be examined below.
(以硫代乙醯胺(TAA)誘導肝纖維化之保護作用) (protection of liver fibrosis induced by thioacetamide (TAA))
將5週齡雄性Wistar大鼠分成四組,分別處理如下:
TAA係以每星期三次注射100毫克/公斤,以誘發大鼠之肝纖維化症狀;及以每星期六次分別管灌各組之去離子水、一倍或五倍劑量之本發明組成物,持續八週。 TAA is administered with 100 mg/kg three times a week to induce liver fibrosis symptoms in rats; and the composition of the present invention is continuously administered with deionized water, one-time or five-fold doses of each group per Saturday. Eight weeks.
八週後採集血液測定各組大鼠血清中與肝傷害相關之生化指數與血脂,及測定肝組織之脂質含量、細胞激素、膠原蛋白、抗氧化酵素活性及過氧化代謝產物。結果分述如下: Eight weeks later, blood was collected to measure the biochemical index and blood lipids related to liver injury in the serum of each group, and the lipid content, cytokines, collagen, antioxidant enzyme activities and peroxidative metabolites of liver tissues were determined. The results are described as follows:
1. 血液生化值與肝臟脂質含量之影響 1. The effect of blood biochemical value and liver lipid content
如圖2A及圖2B所示,TAA處理會導致血脂(三酸甘油酯(TG)及膽固醇(TC))下降,而補充本發明組成物之個體血清中,TG及TC都顯著高於只以TAA處理之個體,TC甚至可恢復至控制組的水準;而肝臟脂質分析結果則顯示補充本發明組成物可有效減少肝臟脂肪之堆積(如表1所示)。 As shown in Fig. 2A and Fig. 2B, TAA treatment resulted in a decrease in blood lipids (triglyceride (TG) and cholesterol (TC)), and TG and TC were significantly higher in individual serum supplemented with the composition of the present invention. Individuals treated with TAA, TC can even return to the level of the control group; and liver lipid analysis results show that supplementation of the composition of the invention can effectively reduce the accumulation of liver fat (as shown in Table 1).
2. 肝臟抗氧化能力之影響 2. The effect of liver antioxidant capacity
測定各組之抗氧化成分與酵素活性,結果如表2所示。 The antioxidant components and enzyme activities of each group were measured, and the results are shown in Table 2.
結果顯示補充本發明組成物有顯著降低脂質過氧化產物丙二醛(melondialdehyde,MDA)、提高總抗氧化能力(trolox equivalent antioxidant capacity,TEAC)、及提高抗氧化酵素SOD、CAT、GPx之活性。 The results show that supplementing the composition of the present invention significantly reduces the lipid peroxidation products malondialdehyde (MDA), increases the total antioxidant capacity (TEAC), and increases the activity of antioxidant enzymes SOD, CAT, GPx.
3. 肝臟受損情形之影響 3. The impact of liver damage
丙胺酸轉胺酶(alanine transaminase,ALT)及天冬胺酸轉胺酶(aspartate transaminase,AST)係可作為肝臟損傷之指標,結果顯示補充本發明組成物可有效降低血液中ALT及AST(如圖2C及圖2D所示),且低劑量之組成物即展現降低ALT及AST之能力。 Alanine transaminase (ALT) and aspartate transaminase (AST) can be used as indicators of liver damage, and the results show that supplementing the composition of the present invention can effectively reduce ALT and AST in blood (such as 2C and 2D), and the low dose composition exhibits the ability to reduce ALT and AST.
腫瘤壞死因子-α(TNFα)及介白素-1β(IL1-β)係受損肝臟細胞分泌之細胞激素,會加劇細胞之傷害,引發強烈發炎反應。檢測結果如表3所示,顯示補充本發明組成物可有效降低TNFα與IL1-β之含量,表示減緩了肝臟損傷程度。此外,分析肝臟中膠原蛋白,補充本發明組成物亦可顯著降低肝臟中膠原蛋白之含量(表3)。 Tumor necrosis factor-α (TNFα) and interleukin-1β (IL1-β) are cytokines secreted by damaged liver cells, which can aggravate cell damage and cause a strong inflammatory response. The test results are shown in Table 3. It is shown that supplementing the composition of the present invention can effectively reduce the content of TNFα and IL1-β, indicating that the degree of liver damage is slowed down. In addition, analysis of collagen in the liver and supplementation of the composition of the present invention can also significantly reduce the amount of collagen in the liver (Table 3).
由上述以TAA誘導大鼠肝纖維化之模式中,證明本案之醫藥組成物可藉由改善肝臟中脂質代謝、減少脂肪堆積、提高抗氧化能力及減緩因TAA造成之肝損傷,且使用低劑量(正常試驗組)即可達到預期效果。 From the above-mentioned pattern of rat liver fibrosis induced by TAA, it was proved that the pharmaceutical composition of the present invention can improve lipid metabolism in the liver, reduce fat accumulation, improve antioxidant capacity, and alleviate liver damage caused by TAA, and use low dose. (normal test group) can achieve the desired results.
(以四氯化碳引發化學性肝損傷) (Initiation of chemical liver damage with carbon tetrachloride)
將Spraque-Dawley大鼠分為五組,分別處理如下:
以口服方式投藥六週,以每星期三次管餵1毫升/公斤之40%溶於橄欖油之四氯化碳;及每日管餵各組去離子水、一倍或十倍劑量之本發明組成物及水飛薊素。 Oral administration for six weeks, feeding 1 ml/kg of 40% carbon tetrachloride dissolved in olive oil three times a week; and daily feeding of each group of deionized water, one or ten times the dose of the invention Composition and silymarin.
1. 血液生化值及分析 1. Blood biochemical value and analysis
六週後採血檢驗下列表4中各項肝臟功能。結果顯示投予本發明組成物可降低AST、ALT及膽紅素,且增加血清白蛋白含量。 Six weeks later, blood tests were performed to examine the various liver functions in Table 4. The results show that administration of the composition of the present invention lowers AST, ALT and bilirubin and increases serum albumin content.
2. 抗氧化酵素與蛋白質濃度 2. Antioxidant enzymes and protein concentration
檢測肝臟組織中抗氧化分子麩胺基硫(GSH)、麩胺基硫過氧化酶(GSH-Px)、麩胺基硫還原酶(GSH-Rd)、超氧化歧化酶(SOD)及過 氧化氫酶(Catalase)之活性。結果如表5所示。 Detection of antioxidant molecules glutamine-based sulfur (GSH), glutamine-based thioperoxidase (GSH-Px), glutamine-based sulfur reductase (GSH-Rd), superoxide dismutase (SOD) and Activity of catalase (Catalase). The results are shown in Table 5.
結果顯示投予本發明組成物後測得GSH及GSH-Px增加至與正常對照組接近,Catalase及SOD甚至較投予水飛薊素之正對照組為高,蛋白質濃度亦為此相同趨勢。 The results showed that GSH and GSH-Px were increased to be close to the normal control group after administration of the composition of the present invention, and Catalase and SOD were even higher than the positive control group administered with silymarin, and the protein concentration was also the same.
3. 病理切片 3. Pathological section
四氯化碳造成之肝損傷由病理切片中可發現肝臟表面粗糙,但投予本發明組成物之大鼠肝組織顯示纖維化的現象輕微,肝小葉變形機率下降。 Liver damage caused by carbon tetrachloride was found to be rough on the surface of the liver by pathological sections, but the rat liver tissue to which the composition of the present invention was administered showed a slight phenomenon of fibrosis and a decreased rate of hepatic lobular deformation.
以Sirius red組織染色觀察膠原蛋白在肝組織之分布,以四氯化碳處理之負對照組於肝組織切片顯示膠原蛋白面積增加,且肝小葉有嚴重的肝纖維化。經定量分析結果如表6所示,顯示本發明組成物兩種劑量均使肝臟中膠原蛋白減少,具有保護肝臟之作用。 The distribution of collagen in liver tissue was observed by Sirius red tissue staining. The negative control group treated with carbon tetrachloride showed an increase in collagen area in liver tissue sections and severe liver fibrosis in hepatic lobules. The results of the quantitative analysis are shown in Table 6. It is shown that both doses of the composition of the present invention reduce collagen in the liver and have the effect of protecting the liver.
由上述以四氯化碳誘導大鼠肝損傷之模式中,證明本案之醫藥組成物可降低四氯化碳對大鼠肝指數之損傷、增加抗氧化酵素活性與蛋白質濃度,於病理切片及膠原蛋白含量上亦說明可降低肝臟纖維化之現象。 From the above model of inducing liver injury in rats by carbon tetrachloride, it was proved that the pharmaceutical composition of the present invention can reduce the damage of liver carbon index of rat carbon tetrachloride, increase the activity of antioxidant enzymes and protein concentration, in pathological sections and collagen. The protein content also indicates that the phenomenon of liver fibrosis can be reduced.
(高油飼料誘導脂肪肝之作用評估) (Evaluation of the role of high oil feed in inducing fatty liver)
以含60%以上熱量為油脂之高油飼料(D12492,Research Diets,USA)飼養6週齡之C57BL/6小鼠共18週,誘發小鼠肥胖;及以含10%熱量為油脂之正常飼料(D12450B,Research Diets,USA)飼養同週齡之C57BL/6小鼠作為對照組。 6-week-old C57BL/6 mice were fed with high-oil feed (D12492, Research Diets, USA) containing more than 60% of calories as oil for 18 weeks to induce obesity in mice; and normal feed containing 10% calories as oil (D12450B, Research Diets, USA) C57BL/6 mice of the same age were housed as a control group.
各組分別以每星期五次口服投予無菌水(10毫升/公斤)或本發明組成物(557毫克/公斤或2786毫克/公斤),連續十週。每週測量體重,十週後,採集血液測量血清AST、ALT及胰島素,並取下肝臟秤重。 Each group was orally administered with sterile water (10 ml/kg) or the composition of the present invention (557 mg/kg or 2786 mg/kg) every 10 weeks for ten consecutive weeks. Body weight was measured weekly, and after ten weeks, blood was collected to measure serum AST, ALT, and insulin, and the liver was weighed.
餵食正常飼料之空白組的小鼠體重於整個實驗過程中無明顯的變化;餵食高油飼料之對照組的小鼠體重統計上明顯高於空白組。本發 明組成物557毫克/公斤劑量相較於對照組,並無明顯差異;而以高劑量2786毫克/公斤劑量口服的小鼠體重從第22天開始下降;第36天至57天可明顯觀察到小鼠之體重減輕(圖3)。 The body weight of the mice in the blank group fed the normal diet did not change significantly throughout the experiment; the mice in the control group fed the high oil diet were statistically significantly higher than the blank group. This hair The composition of 557 mg/kg of the composition was not significantly different from the control group; the weight of the mice orally administered at the high dose of 2786 mg/kg decreased from the 22nd day; the 36th to 57th days were clearly observed. The weight loss of the mice (Fig. 3).
本發明組成物以高劑量2786毫克/公斤口服八週後,相較於對照組(174±46.7U/L)係降低血清AST值(73±6.6U/L)約58%,尤其是明顯降低血清ALT值(9±3.7U/L)約84%(對照組為56±13.2U/L,p<0.05)(圖4A及圖4B),具有統計上的差異。 After the oral administration of the high dose of 2786 mg / kg for eight weeks, the composition of the present invention reduced the serum AST value (73 ± 6.6 U / L) by about 58%, especially the significant decrease compared with the control group (174 ± 46.7 U / L). Serum ALT values (9 ± 3.7 U / L) were about 84% (control group was 56 ± 13.2 U / L, p < 0.05) (Figure 4A and Figure 4B), with statistical differences.
餵食高油飼料小鼠之胰島素(9.69±2.04ng/ml)係高於餵食正常飼料(3.55±0.65ng/ml)2.7倍,然,以本發明組成物557毫克/公斤或2786毫克/公斤兩種劑量口服,相較於對照組(9.69±2.04ng/dl),可分別增加24%及36%胰島素含量(12.00±1.83ng/dl及13.17±2.31ng/dl)(圖5)。根據文獻記載,分泌胰島素係有助於肝臟功能的保護作用。 The insulin (9.69±2.04 ng/ml) fed to the high-oil feed mice was 2.7 times higher than the normal feed (3.55±0.65 ng/ml), and the composition of the present invention was 557 mg/kg or 2786 mg/kg. Oral doses were increased by 24% and 36% insulin (12.00 ± 1.83 ng / dl and 13.17 ± 2.31 ng / dl), respectively, compared to the control group (9.69 ± 2.04 ng / dl) (Figure 5). According to the literature, the secretion of insulin contributes to the protective function of liver function.
餵食高油飼料之小鼠肝臟濕重係高於空白組。本發明組成物557毫克/公斤劑量口服十週後,小鼠的肝臟濕重相較於對照組,在統計上無明顯的差異。然而,以本發明組成物2786毫克/公斤劑量口服8週,小鼠的肝臟濕重相較於對照組約減少29%(1.16±0.1克vs.對照組1.64±0.1克)(圖6)。 The liver wet weight of mice fed high oil diet was higher than that of the blank group. After 10 weeks of oral administration of the composition of the present invention at a dose of 557 mg/kg, the liver wet weight of the mice was statistically indistinguishable from that of the control group. However, oral administration of the composition of the present invention at a dose of 2786 mg/kg for 8 weeks reduced the liver wet weight of the mice by about 29% (1.16 ± 0.1 g vs. 1.64 ± 0.1 g of the control group) compared with the control group (Fig. 6).
本發明係參照較佳具體例及圖式說明如上,其並非用於限制本發明。熟悉本技藝者對上述具體例之內容所作各種修改、省略及變化均屬本發明之範圍。 The present invention has been described above with reference to preferred embodiments and drawings, which are not intended to limit the invention. Various modifications, omissions and changes to the details of the specific embodiments described above are the scope of the invention.
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