中藥五苓散對復發型草酸鈣結石患者之前瞻性研究; Prospective study of Wu-Ling-San Formula prophylaxis against recurrent calcium oxalate nephrolithiasis

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(1)ύ୯ᙴᛰεᏢύՋᙴ่ӝࣴ‫܌ز‬ᅺγፕЎ ጓဦǺ. GIIM-96-9507. ࡰ Ꮴ ௲ ௤ Ǻ ഋ ‫ ؙ‬ӓ! ௲௤. ፕЎᚒҞ. ύᛰϖऴණჹൺวࠠ૛ለ่້ҡ஻‫ޣ‬ϐ߻ᘳ‫زࣴ܄‬ Prospective study of Wu-Ling-San Formula prophylaxis against recurrent calcium oxalate nephrolithiasis. ࣴ‫ز‬ғǺ݅‫ػ‬ቼ. ύ๮҇୯ΐΜΎԃϤДΒΜΎВ.

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(4) ύЎᄔा ύ୯ᙴᛰεᏢύՋᙴ่ӝᙴᏢࣴ‫܌ز‬ ࣴ‫ز‬ғ : ݅‫ػ‬ቼ ࡰᏤ௲௤ : ഋ‫ؙ‬ӓ ௲௤ ߻‫ق‬Ǻύ୯ᙴᛰεᏢഋ‫ؙ‬ӓ௲௤ϐࣴ‫ز‬᛾ჴǴϖऴණ‫ܭ‬ᡏѦჴᡍϷ୏‫ނ‬၂ᡍϐ ύǴ‫ޑ‬ዴԖ‫ڋ׭‬૛ለ่້඲‫׎‬ԋǵᏉ໣‫ک‬ԋߏϐфਏǶҁჴᡍϐҞ‫ޑ‬ջࣁᔈҔύ ᛰϖऴණǴࣴ‫ځز‬ჹ‫ܭ‬ൺวࠠ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾Ϸ‫ڋ׭‬Ӣηϐቹៜǹа ය‫פ‬р΃ୋբҔեЪԖਏϐБ‫ٰݤ‬Ⴃ่ٛҡϐൺวǶ ჴᡍБ‫ݤ‬Ǻ ჴᡍಔ΋ 5 ΓǴϖऴණ 2g ‫؂‬ВΟԛ໭ࡕܺҔǴӅܺҔ΋ঁДǴ٠ӭ സНᆢ࡭‫؂‬Вֿໆ>2000ccǶჹྣಔ 5 ΓǴ๏ϒӼኃᏊ 2g ‫؂‬ВΟԛ໭ࡕܺҔǴӅ ܺҔ΋ঁДǴ٠ӭസНᆢ࡭‫؂‬Вֿໆ>2000ccǶᢀჸ‫ܺځ‬ᛰ߻Ϸܺᛰࡕ΋ঁДϐ Ոనᔠࢗǵֿనᔠࢗǵဎ೽ X ӀϷ๝᠌ຬॣ‫ݢ‬ᔠࢗϐᡂϯǴࢂցԖཥғԋϐ่ ҡϷ‫ܭ‬Ոనᆶֿనύࢂց཮ౢғᡂϯǶ಍ीϩ‫݋‬ճҔ SPSS ೬ᡏ຾Չ t-test ಍ीǴ p ॶ<0.05 ᇡࣁ‫ܭ‬಍ीᏢ΢‫ڀ‬Ԗᡉ๱ϐৡ౦Ƕ ่݀Ǻ10 ՏੰΓύǴ‫ ܄ت‬7 Տ(70%)Ǵζ‫܄‬ΟՏ(30%)Ƕѳ֡ԃស 50.7 ྃ(40 Կ 59 ྃ) Ƕჴᡍಔ 5 ΓϐֿໆᡂϯࣁǴܺҔ߻ 2260²434 డϲ/ϺǴܺҔࡕ 2580²526 డϲ/Ϻ(ᡂϯԭϩК 14.1%)Ƕჹྣಔ 5 ΓϐֿໆᡂϯࣁǴܺҔ߻ 2660²844 డϲ/ ϺǴܺҔࡕ 2660²850 డϲ/Ϻ(ᡂϯԭϩК-0.1%)Ƕ‫ٿ‬ಔКၨว౜ύᛰϖऴණ‫ޑ‬ዴ ૈቚу่ҡੰ஻ϐ௨ֿໆ(t ᔠ‫ۓ‬Ǵp ॶλ‫ ܭ‬0.05)ǴԶቚу௨ֿໆჹ่ҡϐႣٛ‫ڀ‬ Ԗ҅य़ϐշ੻Ƕќ΃Бय़Ǵύᛰϖऴණ٠คဉगၰ‫ڈ‬ᐟੱ‫܈ރ‬ႝှ፦Ѩᑽϐ௃‫ݩ‬ วғǹՈమύႝှ፦ǵ‫ط‬Ϸ๝фૈࡰኧ٠คܴᡉϐᡂϯǶ ่ፕǺύᛰϖऴණёૈࣁ΃ୋբҔեЪԖਏϐύᛰёᔈҔ‫ܭ‬Ⴃ่ٛҡϐൺวȄᆶ ᖏ‫׉‬΢தᔈҔ‫่ܭ‬ҡϐᘗᘔለႇણ҃Кၨว౜Ǵύᛰϖऴණ٠คဉगၰ‫ڈ‬ᐟੱ‫ރ‬ วғǹᆶᖏ‫׉‬΢தᔈҔ‫่ܭ‬ҡϐճֿᏊКၨว౜Ǵύᛰϖऴණ٠คႝှ፦Ѩᑽϐ ௃‫ݩ‬วғǶ٬Ҕύᛰϖऴණёа٬૛ለ่້ҡੰ஻ϐֿໆቚу٠ႴᓰੰΓӭസН.

(5) аቚуֿໆǶ‫܌‬аჹ‫ܭ‬ሡߏයܺҔ่ҡႣٛᛰ‫ޑނ‬ൺวࠠ૛ለ่້ҡ஻‫ޣ‬Զ‫ق‬Ǵ ҁБ፾ӝբࣁᢀჸߏයܺҔႣٛਏ݀‫ޑ‬ύᛰБᏊǶ ᜢᗖຒǺ૛ለ້ǹֿၡ่ҡǹ໺಍ύᛰǹϖऴණǹ๝่ҡ.

(6) Ҟ. ᒵ. ಃ΋ക ߻‫……………………………………ق‬.1 ಃΒക Ў᝘௖૸……………………………...2 ಃΟക ‫׷‬਑ᆶБ‫…………………………ݤ‬...5 ಃѤക ่݀…………………………………...7 ಃϖക ૸ፕ…………………………………..8 ಃϤക. ่ፕ………………………………….11. კ߄…………………………………………….12 ୖԵЎ᝘……………………………………….14 मЎᄔा……………………………………….16 Γᡏ၂ᡍीჄቩਡЎҹ……………………….18 ࣴ‫ز‬ीฝቩਡЎҹ…………………………….51 ࣴ‫ز‬ीฝයύൔ֋…………………………….72 բ‫ޣ‬ᙁᐕ……………………………………….78 ᖴຒ…………………………………………….80.

(7) ಃ΋കʳ ߻‫ق‬ Urinary stone disease affects 9.6% of the total population in Taiwan, which includes 4.3% of females and 14.5% of males [1]. The recurrent rate ranges from 35% within 5 years and after first treatment to 74% within 10 years [2]. A number of medical treatments have been reported to prevent the recurrence of urinary stone, including encouraging patients to take more fluid, nutrient supplements and diet control [3]. In recent years, the most popular medication for preventing calcium oxalate nephrolithiasis is potassium citrate [4, 5, 6, 7] Potassium citrate effectively reduces the recurrence rate of calcium oxalate nephrolithiasis [4, 5]. However, potassium citrate has tendency to irritate gastric mucosa, and this problem can limit patient acceptability. In published clinical trials of potassium citrate, incidence of gastrointestinal adverse incidence ranged from 9 to 17% [6, 7]. On the other hand, medicinal herbs are widely accepted by many people in Taiwan and in Chinese societies elsewhere. We previously reported that WLS effectively inhibited the process of calcium oxalate nucleation, crystallization and aggregation in vitro and in vivo [8, 9]. These findings inspired us to clarify the nephrolithiasis prevention effects of WLS in a clinical trail. In this study, we examined the efficacy of Wu-Ling-San formula (WLS) prophylaxis for preventing recurrent calcium oxalate nephrolithiasis. We analyzed the changes in urine output, body weight and biochemical parameters of urine and serum. We are trying to find out a lower side effect drug for calcium oxalate nephrolithiasis prevention. 1.

(8) ಃΒകʳ Ў᝘௖૸ ֿၡ่ҡࢂ໻ԛ‫ֿܭ‬ၡགࢉǴಃΒத‫ֿࣽݜޑـ‬੯ੰǴՠ‫ځ‬ԋӢ ‫ޑ‬ፄᚇǵ‫ݯ‬ᕍ‫֚ޑ‬ᜤǵᙴᕍԋҁ‫޸ޑ‬຤Ǵࠅᇻε‫ֿܭ‬ၡགࢉǶᏵߥӺ ՗ीǴѠ᡼Ӧ୔Ԗ5Կ10ʝ‫ޑ‬Γම࿶ᑡ஻‫่ڙ҅܈‬ҡϐधǶԖ΋ъа ΢‫ੰޑ‬Γ‫ܭ‬5Կ10ԃ໔཮ൺวǶ‫؂‬ԃ15ʘൺว౗Ƕൺว౗ӧΎԃϣଯ ၲ60% [1]ǶӧѠ᡼่ҡϐ౰Չ౗ऊ9.6%(‫܄ت‬ऊ14.5%Ϸζ‫܄‬ऊ4.3%) [1]Ƕவᙴᕍၗྍ‫ޑ‬ᢀᗺٰ࣮ǴѠ᡼Ӧ୔ऊԖ2301࿤ΓαǴࠅԖຬၸ 130Ѡ࿗ҡᐒǹΨ൩ࢂᇥǴѳ֡‫؂‬ԭ࿤ΓαᏱԖ6Ѡ࿗ҡᐒǶ‫؂‬ԃ޸຤ ‫ܭ‬࿗ҡ‫ޑ‬ԋҁຬၸ΋ሹऍߎǴऊ՞଼ߥᕴᚐ‫ޑ‬4% [8]ǶࣁΑ෧Ͽᙴᕍ ԋҁϐ޸຤Ǵ‫܌‬а‫ॺך‬Ѹ໪൨‫פ‬р΃ঁԖਏԶёՉ‫ޑ‬Б‫ٰݤ‬Ⴃ่ٛҡ ϐൺวǶᗨฅҞ߻ςԖදၹᔈҔ‫ܭ‬Ⴃ่ٛҡϐᛰ‫ࣁނ‬ᘗᘔለႇણ҃Ǵ ՠࢂ‫ځ‬ϝԖ9%-17%Їଆဉगၰό፾ϐёૈ‫[܄‬4]Ƕ. ֿၡ่ҡ‫ܭ‬ύᙴ‫ڂ‬ᝤ૶ၩ΢ᆀϐࣁϙҡరϙ‫܈‬ϙࣳరϙˎʳ ‫ੱځ‬ ‫ރ‬хࡴΑֿύԖҡǵှֿੵภǵֿύԖՈ‫܈‬ቃਗ਼ဈภǶӧύᙴ‫ڂ‬ᝤ૶ ၩύǴԖ೚ӭБᏊё‫ݯ‬ᕍֿၡ่ҡǴ‫ځ‬ύхࡴΑϖऴණǶϖऴණനԐ ૶ၩ‫ܭ‬ՋϡΟШइҗ஭Ҹඳ‫܌‬ጓቪϐϙ໾ൣፕϙǴ‫ځ‬చЎࣁʳ Ϙύ॥ ว዗Ǵʳ ϤΎВόှԶྠǴԖ߄္᛾Ǵ෰ట໯НǴНΕ߾ӗ‫ޣ‬Ǵʳ ӜГ Н଍ʳ Ǵʳ ϖऴණЬϐǶ໾ൣԠрԶ෰‫ޣ‬ǴϖऴණЬϐϙϘ໾ൣፕϙύ ૶ၩ‫ځ‬ಔԋࣁϙ፜ऴΜΖሏȐѐҜȑ!ᐛᘞ΋‫ٿ‬Ϥሏ!қҀ!ΜΖሏ!ἐ 2.

(9) ऴΜΖሏ!ਦ݄ъ‫ٿ‬ȐѐҜȑϙǶԶനԐ૶ၩϖऴණᔈҔ‫ݯܭ‬ᕍֿၡ ่ҡࣁՋϡΜϤШइҗЦޭ୸ጓቪϐ”ຓ‫ྗݯ‬ᛣ”[8, 9]Ƕ. ϖऴණ‫ܭ‬ύᙴϐᔈҔ΢ࣁ੃НဍϐᏊǴᖐΥНྒྷϣଶ‫܌‬ठНဍ‫ي‬ ख़ǵλߡόճǴࣣё٬ҔǴᖏ‫׉‬΢Ҕ‫ܭ‬གߵԖ༾዗ǵα෰ǵ੾ཀྵǵλ ߡόճ฻Ǵჹ‫࡚ܭ‬ᄌ‫܄‬๝‫ݹ‬ǵ‫ݹط‬ǵᆮા‫ݹ‬ǵ࡚‫܄‬ဉग‫ݹ‬ǵНᘞǵН ဍ‫܈‬ဎ೽Ћೌࡕ௨ֿ֚ᜤ֡Ԗਏ [24, 25]Ƕӧ౜жᛰ౛ᏢБय़Ǵϖऴ ණ‫ڀ‬ԖճֿϷ‫ל‬๵բҔǶճֿբҔёߦ຾‫ֿݜ‬ၰ่ҡ௨рǴ‫ځ‬ύ፜ ऴǵἐऴǵқҀǵᐛᘞ֡ԖճֿբҔǶԶਦ݄ᙖ‫ׯ‬๓ՈనൻᕉǴЀ‫ځ‬ ࢂ๝᠌ՈనൻᕉǴуமճֿբҔ [24, 25]ǶЪ‫ל‬๵բҔё‫ڋ׭‬གࢉ‫܄‬ ่ҡ‫׎‬ԋǴ‫ځ‬ύਦ݄ჹࢬՉ‫܄‬གߵੰࢥǵ‫ݹޤ‬ౚ๵ǵฟ੯ఎ๵ǵεဉ ఎ๵฻Ԗ‫׭‬๵բҔǴ፜ऴᎇගనჹߎ໳Յဟ๻ౚ๵ǵεဉఎ๵Ԗ‫ڋ׭‬ բҔǶќѦਦ݄ǵᐛᘞჹဉगѳྖԼԖှยբҔǴёᔅշᒡֿᆅѳྖ Լ‫ܫ‬᚞Ǵߦ຾‫ֿݜ‬ၰ่ҡ௨р [24, 25]Ƕ ӧύ୯ᙴᛰεᏢഋ‫ؙ‬ӓ௲௤ϐࣴ‫ز‬ΨࡰрǴϖऴණ‫ܭ‬ᡏѦ၂ᡍϐ ύǴ‫ܭ‬όӕᐚࡋ6.25ǵ12.5ǵ25‫ ک‬50 mg/mlΠё‫ڋ׭‬344ǵ387ǵ543 Ϸ943%‫ޑ‬૛ለ่້඲ਡϐ‫׎‬ԋǴՠࢂჹ่඲ਡϐԋߏ٠ค‫ڋ׭‬ϐբ ҔǶӧќ΋Бय़Ǵϖऴණ‫ܭ‬12.5ǵ25‫ک‬50 mg/ml‫ޑ‬ᐚࡋϐΠǴё‫ڋ׭‬ 74.24ǵ75.05‫ک‬92.49%‫ޑ‬૛ለ่້඲ϐᏉ໣բҔǹࡺӧᡏѦ၂ᡍ‫่ޑ‬ ፕࣁϖऴණ‫ޑ‬ዴԖ‫ڋ׭‬૛ለ่້඲‫׎‬ԋ‫ک‬Ꮙ໣ϐфਏǴ‫܈‬೚ჹ‫ܭ‬૛ለ 3.

(10) ่້ҡϐႣٛԖ‫ځ‬фਏ [9]Ƕӧഋ‫ؙ‬ӓ௲௤ϐ୏‫ނ‬ჴᡍύΨຓჴǴӧ ΌΒᎇᗯ१εқႵᇨว๝ϣ૛ለ่້ҡϐኳಔύ;ӧ໯ҔΌΒᎇН‫ޑ‬ εႵ๝᠌ಔᙃϪТёว౜๝λᆅϐઇᚯǵཞ໾Ϸว‫ݹ‬ϸᔈǶԶϖऴණ ᗯ१ಔǴ‫ځ‬๝ϣ่඲ϐ௃‫ܴ߾ݩ‬ᡉ෧ᇸǶа่඲؈ᑈࡰኧٰ߄ҢǴե ᐚࡋϖऴණಔ (375 mg/kg )Кჹྣಔࡰኧёவ1.40फ़Կ0.46ǹଯᐚࡋ ϖऴණಔ (1,125 mg/kg )Кჹྣಔࡰኧёவ1.40फ़Կ0.45ǶᕴᢀٰᇥǴ ϖऴණёԖਏ‫ڋ׭‬ჴᡍ୏‫ނ‬๝᠌ϐ૛ለ่້඲Ϸ่ҡϐ‫׎‬ԋ(pॶ฻ ‫ܭ‬0.035) [8]Ƕ Ӣֿၡ่ҡࢂ΋ଯൺว౗ϐ੯ੰǴӵคϷਔϐ፾྽ೀ౛Ǵᇸ߾ੵ ภǵՈֿǴख़߾Їଆ௳Ոੱǵ๝૰ᆃ฻‫ٳ‬วੱǴჹ‫ܭ‬ᙴᕍϷ‫཮ޗ‬ԋҁ ๱ჴࣁ΃؈ख़ϐॄᏼǹҁჴᡍϐҞ‫ޑ‬ջࣁᔈҔύᛰϖऴණǴࣴ‫ځز‬ჹ ‫ܭ‬ൺวࠠ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾Ϸ‫ڋ׭‬Ӣηϐቹៜǹаය‫פ‬р΃ ୋբҔեЪԖਏϐБ‫ٰݤ‬Ⴃ่ٛҡϐൺวǴа೷ᅽቶεϐ่ҡੰ஻ ဂǶ. 4.

(11) ಃΟക ‫׷‬਑ᆶБ‫ݤ‬ Preparation of Wu-Ling-San Formula Extracts The formula of Wu-Ling-San (WLS) consists of five herbs including Rhizoma alismatis, Poria cocos Wolf, Polyporus umbellatus Fries, Rhizoma Atractylodis Macrocephalae and Ramulus Cinnamomi Cassiae; the weight of each is in a ratio of 4:3:3:3:2. The fine powder formula used in this study was provided by the Koda pharmaceutical company (Taichung, Taiwan). Aqueous extracts of WLS formula were prepared by putting 100g of formula into a bottle containing 500ml distilled water; the solution was then heated for 15 min in an autoclave at 121°C. Then resulting jellies-like product was dissolved in distilled water to a final volume of 750 ml and stored at 4°C for 7 days. Next, the solution was centrifuged at 1,500 rpm for 10 min. The concentration of the extract was measured by weighing 1 ml of the supernatant which had been dried in a 60°C oven for 1 day (82 mg/ml). Finally, the crude drugs (6, 4.5, 4.5, 4.5 and 3 gm respectively) were concentrated to 4gm net weight (crude drug:net drug=5.625:1). The placebo was made with starch and caramel, the appearance of which was similar to WLS formula. The packing of the placebo and the WLS formula were identical. Study Protocol This experimental protocol was approved by the Institutional Review Board of Show Chwan Memorial Hospital (IRB, SCMH No: 960202). This was a prospective pilot study that evaluated the WLS formula effect on 10 patients with recurrent calcium oxalate nephrolithiasis. The patients with malignant tumor with bony metastasis, hyperthyroidism, psychosis, 5.

(12) renal tubular acidosis, anatomical abnormalities, chronic urinary tract infection, osteoporosis, gout, chronic diarrhea or pregnancy were excluded. The patients were randomized divided into two groups. The medication group took 2 gm Wu-Ling-San formula three times daily for 1 month. The control group took 2 gm placebo formula three times daily for 1 month. The patients were asked to drink enough fluid to urinate at least 2 L daily during the study period. At entry before treatment a 24-hr urine sample was collected from every patient, who was kept on a random diet, for measurement of calcium, uric acid, PH and total urine volume. A venous serum sample was collected for calcium, phosphorus, creatinin, sodium, GOT, GPT, potassium and urine acid. At the beginning and 1 month later, image follow-up a single KUB film and renal ultrasonography was taken in all patients. We calculate the sum of the long-axis diameter of the largest stone and stone numbers for further statistical analysis. The long-axis diameter of the largest stone, less than 1 cm stone get 1 point, 1-2 cm stone get 2 point, larger than 2cm stone get 3 point. About the stone numbers, 1 or less 1 stone get 1 point, two stones get 2 point and more than 2 stones get 3 point. Statistical analysis was performed using the Student’s t-test, p<0.05 was considered statistically significant.. 6.

(13) ಃѤക ่݀ A total of 10 patients were enrolled, of whom 7 (70%) were men and 3 (30%) were women. All the patients completed the study. The mean age was 50.7 years (range 40 to 59). The patients reported a lifetime total of 3 to 6 (average 4.2) stone episodes. The patients had undergone 2 to 3 (average 2.5) stone procedures. There were no differences in baseline data between the two groups, including age, male/female ratio, stone severity index, urolithiasis procedures and BMI (Table 1). The baseline urine output level was 2260±434 ml/day in Wu-Ling-San formula (WLS) group and 2660±844 ml/day in placebo group. After treatment with Wu-Ling-San formula group, the mean urine output level increased to 2580r526ml/day (percentage of change, 14.1%). With placebo therapy, the mean decreased slightly to 2660r850ml/day (percentage of change, -0.1%). Comparing the two groups, WLS group significantly increased the urine output (student t-test, p<0.05). No patient complained of side effects,. including. fatigue,. dizziness,. impotence,. musculoskeletal. symptoms, or gastrointestinal disturbance. The serum liver function, renal function, electrolyte and urinary parameters were found to have no significant change in both groups (Table 2). No significant differences in urine calcium, urine pH value, serum calcium or phosphorous at the beginning of the study were noted between the groups.. 7.

(14) ಃϖക ૸ፕ Many traditional Chinese medicine (TCM) are used to treat urolithiasis, Wu-Ling-San (WLS) is one of those [10, 11, 12]. To the best of our knowledge, the possible mechanism of WLS used in antilithic remains unclear. Some studies have suggested that macromolecules may be involved in the antilithic mechanism of WLS [8]. One of the components of WLS, Alisma orientalis, has been shown to inhibit the stone formation process [13, 14]. Yin et al. reported that Alisma inhibited the growth and aggregation of CaOx crystals in vitro and the renal calcium content decreased in Alisma treated rats [15]. In addition, Suzuki et al also reported that Alisma orientalis (also named as Takusha) strongly suppressed crystal formation, growth and aggregation of CaOx crystals in vitro[16]. Furthermore, several studies have shown that this herb significantly. decreased. the. formation. of. CaOx. deposits,. and. downregulated the expression of inter-alpha-trypsin inhibitor and bikunin [17]. Yashimura et al in another in vitro study also noted that WLS significantly inhibited CaOx crystallization in human urine [18]. Liu et al reported that in reducing CaOx crystals, WLS also suppressed the development of hydroxylapatite renal calcinosis in rats fed on a high phosphorus diet [19]. Our previous study already concluded that WLS effectively inhibits the process of CaOx nucleation, crystallization and aggregation in vitro and in vivo [8, 9]. All of these reports suggest that WLS may be a useful drug for preventing renal stones. WLS is a TCM formula mainly used for treatment of uremia, dropsy, nephrosis and to promote urination. The formula for WLS was first 8.

(15) recorded in the book “Shang Han Lun” (Treatise of Cold-induced Disorders) written by Zhong-Jing Zhang. The original indications for WLS were symptoms of headache, fever, voiding difficulty, irritability, strong thirst with vomiting immediately after drinking and a floating pulse [8]. Treating urinary stone disease by WLS was recorded in the book written by Ken-Tang Wang entitled “Zheng Zhi Zhun Sheng” (standards of patterns and treatment) during the Ming Dynasty (later sixteenth century). Since that time, the WLS formula has been used as a usual prescription for treating urinary difficulties and febrile diseases because of its diuretic properties [20]. This study is the Wu-Ling-San (WLS) clinical trail for calcium oxalate stone prevention. The baseline urine output level was 2260±434 ml/day in Wu-Ling-San formula (WLS) group and 2660±844 ml/day in placebo group. After treatment with Wu-Ling-San formula group, the mean urine output level increased to 2580r526ml/day (percentage of change, 14.1%). With placebo therapy, the mean decreased slightly to 2660.0r850ml/day (percentage of change, -0.1%). Comparing both groups, WLS group significantly increased the urine output (student t-test, p<0.05). The results of this study have confirmed that Wu-Ling-San Formula is effective in increasing urine output in recurrent calcium oxalate stone formers.. Hydration and increase of urine output are effective methods. in stone prevention [21]. Other popular stone prevention drugs, like Potassium Citrate, have a number of side effects like gastrointestinal disturbances, and it may be improved if diluted in a large glass of water [4, 22]. Loop agents such as the thiazides, may induce hypokalemic, hypochloremic, metabolic 9.

(16) alkalosis and it may be treated with potassium chloride replacement. Thiazide diuretics also have been linked to glucose intolerance, which may be an effect of hypokalemia rather than the diuretic itself. Thiazides may lead to hyponatremia which may cause permanent neurologic damage [23]. In the contrast, Wu-Ling-san did not have any of the side effects like gastrointestinal adverse, electrolyte imbalance or malaise in our series. An interesting finding from our study was the overall good compliance with the instruction to urinate 2 L daily. All the patients met the goal, including WLS group and placebo group. That may be because we educated the patients about the WLS possible antilithic mechanism and the diuretic effect. One should drink enough fluid to urinate at least 2 L daily during the study period for reaching the best effect of WLS. In view of cost-effect, the Wu-Ling-San formula cost was only 10.2 USD/month. The potassium citrate cost was 40.9 USD/month. The limitation of this study is that we did not examine the oxalate and citrate levels in urine. The significance of the study is also limited due to the small number of subjects included.. 10.

(17) ಃϤകʳ. ่ፕ. Traditional Chinese herb medicine (Wu-Ling-San Formula) is a promising adjunct to surgical and medical management of kidney stones. It might be better accepted by patients, when compared with potassium citrate, because of the lower gastrointestinal disturbance. However, in the case of Wu-Ling-San Formula versus hydration group, the urinary parameters did not improve with Wu-Ling-San Formula. Active therapy with Wu-Ling-San Formula did have a positive effect on the urine volume without electrolyte imbalance. Patients need ongoing education and encouragement to meet the goals of urinary output, and treatment with Wu-Ling-San Formula might help patients reach these goals.. 11.

(18) კ߄ Table 1. Patient’s data of the study. Wu-ling-san group. Men(n). 4. Placebo group. P value. 3 1.000. Women(n). 1. 2. Mean age (years). 49.8r3.8. 51.60r7.89. 0.548. Urolithiasis. 2.60r0.55. 2.40r0.55. 0.690. Stone severity index. 3.80r1.10. 3.40r0.55. 0.421. BMI. 26.31r3.01. 26.28r3.01. 1.000. procedure. BMI: body mass index. 12.

(19) Table 2. Urinary parameters at baseline and after treatment with Wu-ling-san formula and placebo Wu-ling-san group pretreatment. Placebo group. Post-treatment. %of. pretreatment. Post-reatment. change. %of change. 2260r434*. 2580r526*. 14.1r9.1̺. 2660r844. 2660.0r850. -0.1r3.4̺. Serum GOT. 23.0r4.2. 23.8r5.2. 3.5r13.4. 18.8r1.8. 18.2r2.2. -3.2r7.1. Serum GPT. 25.2r2.2. 26.6r3.8. 6.4r18.9. 20.2r4.1. 20.4r5.0. 0.3r10.6. Serum K. 4.26r0.40. 4.30r0.24. 1.8r13.4. 4.04r0.18. 3.96r0.27. -02.0r4.5. Serum CL. 105.2r1.3. 104.2r2.4. -1.0r1.8. 105.4r2.2. 105.0r2.3. -0.4r1.4. Serum Ca. 8.96r0.37. 9.16r0.67. 2.3r7.8. 250.5r43.5. 269.1r60.9. -1.7r2.3. Serum P. 2.82r0.56. 3.12r0.27. 13.2r17.4. 3.02r0.93. 2.80r0.68. -5.6r7.8. Urine Ca. 288.4r170.9. 351.4r192.4. 63.2r117.0. 250.5r43.5. 269.1r60.9. 7.3r14.9. Urine UA. 685.6r372.2. 823.2r148.0. 61.7r117.0. 753.1r252.2. 744.3r272.5. -2.2r10.1. Urine Cr. 59.9r23.9. 71.6r24.3. 70.9r180.0. 57.3r16.6. 58.2r15.1. 2.6r5.8. Urine PH. 6.80r0.45. 6.60r0.55. -2.9r6.4. 6.00r0.771. 6.40r0.55. 8.0r17.9. Urine Ccr. 98.8r28.4. 112.2r34.1. 25.6r67.1. 97.1r17.7. 100.2r14.6. 3.8r5.3. Stone severity. 3.8r1.1. 3.4r0.9. -9.0r12.5. 3.4r0.5. 3.2r0.4. Urine volume(ml/day). index. Data presented as mean ̈́SD *p<0.05 versus pretreatment ̺ % of change between groups < 0.05 (Student t test). 13. -5.0r11.2.

(20) ୖԵЎ᝘ 1. Lee YH, Huang WC, Tsai JY, Lu CM, Chen WC, Lee MH, Hsu HS, Huang JK and Chang LS. Epidemiological studies on the prevalence of upper urinary calculi in Taiwan. Urol Int 2002; 68: 172-177. 2. Uribarri J, Man S and Carroll JH. The first kidney stone. Ann Int Med 1989; 111: 1006–1009. 3. Lewandowski S and Rodgers AL. Idiopathic calcium oxalate urolithiasis: risk factors and conservative treatment. Clin Chim Acta 2004; 45: 17–34. 4. Whalley NA, Meyers AM, Martins M and Margolius LP. Long-term effects of potassium citrate therapy on the formation of new stones in groups of recurrent stone formers with hypocitraturia. Brit J Urol 1996; 78: 10-14. 5. Hofbauer J, Hobarth K, Szabo N and Marberger M. Alkali citrate prophylaxis in idiopathic recurrent calcium oxalate urolithiasis: a prospective randomized study. Brit J Urol 1994; 73: 362-365. 6. Ettinger BC, Pak Y, Citron JT, Thomas C, dams-Huet B and Vangessel A. Potassium-magnesium citrate is an effective prophylaxis against recurrent calcium oxalate nephrolithiasis. J Urol 1997; 158: 2069–2073. 7. Barcelo P, Wuhl O, Servitge E, Rousaud A and Pak CY. Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J Urol 1993; 150: 1761-1764. 8. Tsai CH, Chen YC, Chen LD, Pan TC, Ho CY, Lai MT, Tsai FJ and Chen WC. A traditional Chinese herbal antilithic formula, Wulingsan, effectively prevents the renal deposition of calcium oxalate crystal in ethylene glycol-fed rats. Urol Res 2008; 36:17-24. 9. Chen YC, Ho CY, Chen LD, Hsu SF and Chen WC. Wu-Ling-San formula inhibits the crystallization of calcium oxalate in vitro. Am J Chin Med 2007; 35:533–541. 10. Das I, Gupta SK and Ansari SA. In vitro inhibition and dissolution of calcium oxalate by edible plant Trianthema monogyna and pulse Macrotyloma uniXorum extracts. J Cryst Growth 2005; 273:546–554. 11. Freitas A, Gohel MD and Wong SP. Chinese herbal medicines and there efficacy in treating renal stones. Urol Res 2006; 34:365–372. 12. Freitas AM, Schor N and Boim MA. The effect of Phyllanthus niruri on urinary inhibitors of calcium oxalate crystallization and other factors associated with renal stone formation. BJU Int 2002; 89: 829-834. 13. Cao ZG, Liu JH and Zhou SW. The effect of the active constituents of Alisma orientalis on renal stone formation and bikunin expression in rat urolithiasis 14.

(21) model. Matl Med J China 2004; 84:1276–1279. 14. Yasui T, Fujita K and Sato M. The effect of takusha, a kampo medicine, on renal stone formation and osteopontin expression in a rat urolithiasis model. Urol Res 1999; 27:194–199. 15. Yin CP, Liu JH and Zhang YS. Effects of Alisma orientalis Juzep on calcium oxalate crystallization in vitro and calcium oxalate renal stone in rats. Acta Univ Med Tongji 1997; 26:99–101. 16. Suzuki K, Kawamura K and Tsugawa R. Formation and growth inhibition of calcium oxalate crystals by Takusha (Alismati rhizoma). Scanning Microsc 1999; 13:183–189. 17. Cao ZG, Liu JH and Zhou SW. Effect of alisma orientalis extract on renal stone formation and the expression of inter-alphatrypsin inhibitor in rat urolithiasis model. Chin J Exp Surg. 2004; 21:295–297. 18. Yashimura K, Miake O and Okuyama A. Effect of chorei-to and gorei-san on calcium oxalate crystallization in human urine. Hinyokika Kiyo 1998; 44:13–16. 19. Liu QL, Sato S and Kishikawa T. Effectiveness of a traditional Chinese medicine, Wulingsan, in suppressing the development of nephrocalcinosis induced by a high phosphorus diet in young rats. Med Electron Microsc 2001; 34: 103–114. 20. Chen YH, Tsai FJ and Chen WC. Phytotherapies for urolithiasis. Research Signpost. 2008:17-38. 21. Patrick Y, Walsh C, Alan B and Retik .Campbell's urology. 8th ed 2002: 3230-3260. 22. Koff SG, Paquette EL, Cullen J, Gancarczyk KK, Tucciarone PR and Schenkman NS. Comparison between lemonade and potassium citrate and impact on urine pH and 24-hour urine parameters in patients with kidney stone formation. Urology 2007; 69:1013-1016. 23. Greenberg A. Diuretic complications. Am J Med Sci 2000; 319:10-24. 24. ࣥࡲ‫؟‬ΕࣥࡲؓΕࣥན൐ Κխᢐᢐ෻ᖂ ഏ‫م‬ᒳ᤟塢 (‫ )ק؀‬1995Κ228-229 25. ᝔ࣔ‫ޘ‬Κֱᕪᖂ ഏ‫م‬խഏ᠔ᢐઔߒࢬ (‫ )ק؀‬1999: 201-202. 15.

(22) मЎᄔा Objectives: Wu-Ling-San formula has been proved to have a preventive effect on the treatment of calcium oxalate nephrolithiasis both in vitro and in vivo. In this study, we examined the efficacy of Wu-Ling-San formula prophylaxis for preventing recurrent calcium oxalate nephrolithiasis. Methods: This was a prospective clinical study that evaluated the 24-hour urine parameters of 10 patients with kidney stones. All patients with a history of recurrent calcium oxalate nephrolithiasis who were aged 40 to 59 years old. The patients were asked to drink enough fluid to urinate at least 2 L daily during the study period. A 24-hour urine collection was performed to establish the baseline levels of multiple urinary parameters before taking the medicine. The patients were randomized divided into two groups. The medication group took 2 gm Wu-Ling-San formula three times daily for 1 month. The control group took 2 gm placebo formula three times daily for 1 month. All the patients received 24-hour urine collection was performed of multiple urinary parameters after complete the study. The serum liver, renal function and electrolyte was also collected. Results: A total of 10 patients were enrolled, of whom 7 (70%) were men and 3 (30%) were women. All the patients completed of the study. The mean age was 50.7 years old (range 40 to 59). The patients reported a lifetime total of 3 to 6 (average 4.2) stone episodes. The patients had undergone 2 to 3 (average 2.5) stone procedures. The baseline urine. 16.

(23) output level was 226˃̈́ˇˆˇʳml/day in Wu-Ling-San formula (WLS)group and 2660̈́ˋˇˇʳml/day in placebo group. After treatment with Wu-Ling-San formula group, the mean urine output level increased to 2580r526ml/day (percentage of change, 14.1%). With placebo therapy, the. mean decreased slightly to 2660.0r850ml/day (percentage of change, -0.1%). Compare with both group, WLS group significantly increased the urine output. (student t-test, p<0.05). No patient complain of side effects, including fatigue, dizziness, impotence, musculoskeletal symptoms, or gastrointestinal disturbance. The serum liver function, renal function, electrolyte and urinary parameters were no significant change in both groups. Conclusions: Wu-Ling-San formula is a promising adjunct to surgical and medical management of kidney stones. Compare with potassium citrate, they might be better accepted by patients than medications taken three times daily because of the lower gastrointestinal disturbance. Active therapy with Wu-Ling-San Formula did have a positive effect on the urine volume without electrolyte imbalance. Patients need ongoing education and encouragement to meet the goals of urinary output, and treatment with Wu-Ling-San Formula might help patients reach these goals. Keywords Calcium oxalate; Urinary Stone; Traditional Chinese medicine, Wu-Ling-San Formula; Nephrolithiasis. 17.

(24) Ver.1.4. 16/May/2007. Γᡏ၂ᡍ‫ہ‬঩཮ቩࢗ ‫ذ‬໺इ‫ۺ‬ᙴଣࣴ‫ز‬ीฝਜ. ԃ. ࡋǺΐΜϤ. ीฝӜᆀǺύᛰϖऴණჹ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡ ߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ. ࣴ‫ز‬ख़ᗺǺɍՋᙴᖏ‫زࣴ׉‬ɍύᙴࣴ‫ز‬ɎύՋᙴ ่ӝࣴ‫ز‬. ҙፎൂՏǺ‫ذ‬໺इ‫ۺ‬ᙴଣ‫ֿݜ‬Ѧࣽ೽. Ь ࡭ ΓǺ݅‫ػ‬ቼ. ᙴৣᛝӜǺ 18.

(25) ‫ذ‬໺इ‫ۺ‬ᙴଣΐΜϤԃࡋ஑ਢࣴ‫ز‬ीฝਜ! ύЎǺύᛰϖऴණჹ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ. ीฝӜᆀ. ीฝጓဦǺ. मЎǺ! The influence of Wu-ling-San on the promotive and inhibitory factors for stone. formation in patients with calcium oxalate stone ୺ՉൂՏ ‫ذ‬໺इ‫ۺ‬ᙴଣ‫ֿݜ‬Ѧࣽ೽ ࣴ‫ز‬ሦୱ ύՋᙴ่ӝࣴ‫ز‬. ीฝᜪձ. Ɏཥቚीฝ. ɍ‫ុۯ‬ीฝ. Ӣֿၡ่ҡࢂ΋ଯൺว౗ϐ੯ੰǴӵคϷਔϐ፾྽ೀ౛Ǵᇸ߾ੵภǵՈֿǴख़߾Їଆ ௳Ոੱǵ๝૰ᆃ฻‫ٳ‬วੱǴჹ‫ܭ‬ᙴᕍϷ‫཮ޗ‬ԋҁ๱ჴࣁ΃؈ख़ϐॄᏼ 1ǹҁჴᡍϐҞ‫ޑ‬ ࣴ‫ز‬ख़ᗺ. ջࣁᔈҔύाϖऴණǴࣴ‫ځز‬ჹ‫ܭ‬ൺวࠠ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾Ϸ‫ڋ׭‬Ӣηϐቹ ៜǹаය‫פ‬р΃ୋբҔեЪԖਏϐБ‫ٰݤ‬Ⴃ่ٛҡϐൺวǴа೷ᅽቶεϐ่ҡੰ஻ဂǶ. ीฝ‫܄‬፦ ɍ୷ᘵ. ɎᔈҔࣴ‫ز‬ Ծ. ୺Չයज़. ɍ‫زࣴೌמ‬. 96/7/1. ɍ‫ೌמ‬௢ቶ. ଆ. ҁԃࡋीฝǺ. ɍՉࡹଛӝ. ɍ‫ځ‬д. Ծ. 96/7/1. ଆ. Կ. 97/6/30. З. ӄำीฝǺ Կ. 96/12/31 З. ӄԃीฝ࿶຤ǺཥѠჾϖΜѤ࿤Ѥί΋ԭΒΜϡ᏾ ԃ ࡋ. ࣴ‫ ز‬ҙፎߎᚐ Ьᆅᐒᜢ ୺Չीฝ ୺Չीฝ ፎ༤Πӈσ୺Չԃࡋϐਡ‫ۓ‬ኧǵҁԃࡋϐҙፎኧǵаࡕӚ ਡ‫ߎۓ‬ᚐ ‫ۓݤ‬Ⴃᆉ ،ᆉኧ ԃࡋϐႣ՗ኧ. ΓΚ ȐΓ. Γ٣຤. ཰୍຤ ᆢៈ຤ ਓၮ຤ ‫׷‬਑຤ ೛ഢ຤ ᆅ౛຤. ȑ 96 ԃ ࿶຤ၮҔ. 3. 544120. 15000. ɎԾՉࣴ‫ ز‬100 ʘ д. ɍ‫ࣚ཰ૼہ‬. ʘ. 529120 ɍ‫ૼہ‬Ꮲࣚ. ʘ. ɍ‫ೌמ‬Ї຾. ʘ. БԄ. ɍ‫ځ‬. Ѝр໨Ҟ. ɍ࿶தЍр! ! ! ! ! щϡȐ! ! ʘȑ. Ⴃ՗ԋ݀. ϭ‫ೌמ‬౽ᙯ. ৎ. ɍ‫ೌמ‬Ї຾. ໨. ɍ‫୍ܺೌמ‬. ৎ. ɍ‫ೌמ‬ൔ֋. ໨. ϭ஑ճᕇள. ໨. ɍ๱ ҹ ៾. ໨. ɎፕЎว߄. 1 ጇ. ɍཥ ౢ ࠔ. ໨. ϭၗૻᘉණ. Γ. ;Γω୻‫ػ‬. Γ. ɍ‫ځ‬. ʘ ɍၗҁЍр! ! ! ! ! щϡȐ! ! ʘȑ. д. ीฝЬ࡭ ݅‫ػ‬ቼ Γ. ᙍᆀ Ь‫ݯ‬ᙴৣ. ႝ၉. 0966230701 E-Mail [email protected] om.tw. ीฝ୺Չ ݅‫ػ‬ቼ ᖄ๎Γ. ႝ၉ 0966230701. ໺੿. 047296805. 19. E-Mail [email protected] om.tw.

(26) ມǵीฝᄔाǺፎᄔॊҁीฝϐҞ‫ޑ‬ᆶჴࡼБ‫ݤ‬Ϸᜢᗖຒ. ύᛰϖऴණჹ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ ύЎᄔाᇥܴ ֿၡ่ҡࢂ໻ԛ‫ֿܭ‬ၡགࢉǴಃΒத‫ֿࣽݜޑـ‬੯ੰǴՠ‫ځ‬ԋӢ‫ޑ‬ፄᚇǵ ‫ݯ‬ᕍ‫֚ޑ‬ᜤǵᙴᕍԋҁ‫޸ޑ‬຤Ǵࠅᇻε‫ֿܭ‬ၡགࢉǶᏵߥӺ՗ीǴѠ᡼Ӧ୔Ԗ 5 Կ 10ʝ‫ޑ‬Γම࿶ᑡ஻‫่ڙ҅܈‬ҡϐधǶԖ΋ъа΢‫ੰޑ‬Γ‫ ܭ‬5 Կ 10 ԃ໔཮ ൺวǶ‫؂‬ԃ 15ʘൺว౗Ƕൺว౗ӧΎԃϣଯၲ 60%Ƕ1 Ӣֿၡ่ҡࢂ΋ଯൺว౗ϐ੯ੰǴӵคϷਔϐ፾྽ೀ౛Ǵᇸ߾ੵภǵՈֿǴ ख़߾Їଆ௳Ոੱǵ๝૰ᆃ฻‫ٳ‬วੱǴჹ‫ܭ‬ᙴᕍϷ‫཮ޗ‬ԋҁ๱ჴࣁ΃؈ख़ϐॄ ᏼǹҁჴᡍϐҞ‫ޑ‬ջࣁᔈҔύᛰϖऴණ 9-10Ǵࣴ‫ځز‬ჹ‫ܭ‬ൺวࠠ૛ለ่້ҡ஻ ‫ޣ‬ϐ่ҡߦ຾Ϸ‫ڋ׭‬Ӣηϐቹៜ 11ǹаය‫פ‬р΃ୋբҔեЪԖਏϐБ‫ٰݤ‬Ⴃٛ ่ҡϐൺวǴа೷ᅽቶεϐ่ҡੰ஻ဂǶ ჴᡍБ‫ࣁݤ‬ჴᡍಔ΋ 40 ΓǴϖऴණ 2g ‫؂‬ВΟԛ໭ࡕܺҔǴӅܺҔΟঁДǴ ٠ӭസНᆢ࡭‫؂‬Вֿໆ>2000ccǶჹྣಔ 40 ΓǴ๏ϒӼኃᏊ 2g ‫؂‬ВΟԛ໭ࡕ ܺҔǴӅܺҔΟঁДǴ٠ӭസНᆢ࡭‫؂‬Вֿໆ>2000ccǶᢀჸ‫ܺځ‬ᛰ߻Ϸܺᛰ ࡕ΋‫ک‬ΟঁДϐՈనᔠࢗǵֿనᔠࢗǵဎ೽ X ӀϷ๝᠌ຬॣ‫ݢ‬ᔠࢗϐᡂϯǴࢂ ցԖཥғԋϐ่ҡϷ‫ܭ‬Ոనᆶֿనύࢂց཮ౢғᡂϯǶ ಍ीϩ‫݋‬ճҔ SPSS ೬ᡏ຾Չ t-test ಍ीǴp ॶ<0.05 ᇡࣁ‫ܭ‬಍ीᏢ΢‫ڀ‬Ԗᡉ 20.

(27) ๱ϐৡ౦Ƕ ᜢᗖຒǺϖऴණǵ่ҡႣٛǵ૛ለ่້ҡ. 21.

(28) ୖǵीฝϣ৒ ΋ǵीฝጔଆǺፎ௶ॊҁीฝౢғϐङඳϷख़ा‫܄‬ ֿၡ่ҡࢂ໻ԛ‫ֿܭ‬ၡགࢉǴಃΒத‫ֿࣽݜޑـ‬੯ੰǴՠ‫ځ‬ԋӢ‫ޑ‬ፄᚇǵ ‫ݯ‬ᕍ‫֚ޑ‬ᜤǵᙴᕍԋҁ‫޸ޑ‬຤Ǵࠅᇻε‫ֿܭ‬ၡགࢉǶᏵߥӺ՗ीǴѠ᡼Ӧ୔Ԗ 5 Կ 10ʝ‫ޑ‬Γම࿶ᑡ஻‫่ڙ҅܈‬ҡϐधǶԖ΋ъа΢‫ੰޑ‬Γ‫ ܭ‬5 Կ 10 ԃ໔཮ ൺวǶ‫؂‬ԃ 15ʘൺว౗Ƕൺว౗ӧΎԃϣଯၲ 60%Ƕ1 ϖऴණ‫ܭ‬ύᙴϐᔈҔ΢ࣁ੃НဍϐᏊǴᖐΥНྒྷϣଶ‫܌‬ठНဍ‫ي‬ख़ǵλߡ όճǴࣣё٬ҔǴᖏ‫׉‬΢Ҕ‫ܭ‬གߵԖ༾዗ǵα෰ǵ੾ཀྵǵλߡόճ฻Ǵჹ‫࡚ܭ‬ ᄌ‫܄‬๝‫ݹ‬ǵ‫ݹط‬ǵᆮા‫ݹ‬ǵ࡚‫܄‬ဉग‫ݹ‬ǵНᘞǵНဍ‫܈‬ဎ೽Ћೌࡕ௨ֿ֚ᜤ֡ ԖਏǶ ӧ౜жᛰ౛ᏢБय़Ǵϖऴණ‫ڀ‬ԖճֿϷ‫ל‬๵բҔ 9-10ǶճֿբҔёߦ຾ ‫ֿݜ‬ၰ่ҡ௨рǴ‫ځ‬ύ፜ऴǵἐऴǵқҀǵᐛᘞ֡ԖճֿբҔǶԶਦ݄ᙖ‫ׯ‬๓ ՈనൻᕉǴЀ‫ࢂځ‬๝᠌ՈనൻᕉǴуமճֿբҔ 9-10Ƕ Ъ‫ל‬๵բҔё‫ڋ׭‬གࢉ ‫่܄‬ҡ‫׎‬ԋǴ‫ځ‬ύਦ݄ჹࢬՉ‫܄‬གߵੰࢥǵ‫ݹޤ‬ౚ๵ǵฟ੯ఎ๵ǵεဉఎ๵฻ Ԗ‫׭‬๵բҔǴ፜ऴᎇගనჹߎ໳Յဟ๻ౚ๵ǵεဉఎ๵Ԗ‫ڋ׭‬բҔ 9-10ǶќѦ ਦ݄ǵᐛᘞჹဉगѳྖԼԖှยբҔǴёᔅշᒡֿᆅѳྖԼ‫ܫ‬᚞Ǵߦ຾‫ֿݜ‬ၰ ่ҡ௨р 9-10Ƕ ԜѦӧύ୯ᙴᛰεᏢഋЎᲑ௲௤ϐࣴ‫ز‬Ψ᛾ჴǴϖऴණ‫ܭ‬ᡏѦ၂ᡍϐύǴ ‫ޑ‬ዴԖ‫ڋ׭‬૛ለ่້඲‫׎‬ԋǵᏉ໣‫ک‬ԋߏϐфਏǶ ‫ܭ‬Ў᝘ύ 11Ǵ૛ለ่້ҡϐߦ຾ӢηхࡴΑֿనύϐ້ᚆηǵ૛ለਥᚆηǴ 22.

(29) ‫ڋ׭‬ӢηхࡴΑֿనύϐᗔᚆηǵᘗᘔለਥᚆηǶ Ӣֿၡ่ҡࢂ΋ଯൺว౗ϐ੯ੰǴӵคϷਔϐ፾྽ೀ౛Ǵᇸ߾ੵภǵՈֿǴ ख़߾Їଆ௳Ոੱǵ๝૰ᆃ฻‫ٳ‬วੱǴჹ‫ܭ‬ᙴᕍϷ‫཮ޗ‬ԋҁ๱ჴࣁ΃؈ख़ϐॄ ᏼǹҁჴᡍϐҞ‫ޑ‬ջࣁᔈҔύᛰϖऴණǴࣴ‫ځز‬ჹ‫ܭ‬ൺวࠠ૛ለ่້ҡ஻‫ޣ‬ϐ ่ҡߦ຾Ϸ‫ڋ׭‬Ӣηϐቹៜ 11ǹаය‫פ‬р΃ୋբҔեЪԖਏϐБ‫ٰݤ‬Ⴃ่ٛҡ ϐൺวǴа೷ᅽቶεϐ่ҡੰ஻ဂǶ. 23.

(30) ΒǵीฝҞ‫ޑ‬Ǻፎ⒕煭␆浣⒦承ҁीฝ‫܌‬ाၲԋϐҞ኱аϷ‫܌‬ाֹԋϐπբ໨ ҞǴᔈᗉխ‫ݱޜ‬ϐ௶ॊǶ ҁࣴ‫ޑز‬Ҟ‫ޑ‬Ώ௖૸ύᛰϖऴණჹ΢ֿၡ่ҡႣٛ‫ޑ‬ਏ݀Ƕҁࣴ‫ࣁز‬ය΋ ԃǴஒϩࣁΟයǴ‫؂‬යႣ‫୺ۓ‬ՉπբҞ኱ӵΠǺ ಃ΋ය(1-2 ঁД)ǺύᛰᇙբϷࣴ‫ز‬շ౛૽ግǴ٬ࣴ‫ز‬շ౛ዕ஼ੱ‫ރ‬ୢ‫߄ڔ‬Ǵ٠ ዴ‫ۓ‬բ཰ࢬำǶ ಃΒය(2-9 ঁД)Ǻᑔᔠੰ஻Ǵ٠‫׫‬ᆶᛰ‫ނ‬Ƕ‫؂‬Տ஻‫ۓޣ‬යௗ‫ڙ‬΢ֿၡ่ҡຑ՗Ǵ ٠‫ܜ‬ՈϷᡍֿǴаᢀჸ‫ܺځ‬ᛰ߻ࡕϐᡂϯǶ ಃΟය(10-12 ঁД)Ǻ᏾౛ᖏ‫׉‬ኧᏵǴ຾Չ಍ीϩ‫݋‬Ǵ٠ኗቪࣴ‫ز‬ൔ֋. 24.

(31) ΟǵჴࡼБ‫ݤ‬Ϸ຾Չ‫؁‬ᡯǺፎᇡาᎅࣔჴࡼҁԃࡋीฝ‫܌‬௦ҔϐБ‫ݤ‬Ϸ‫؁‬ᡯǴࣴ ‫ز‬ीฝᔈ၁ಒᇥܴࣴ‫ز‬೛ीǵၗ਑ԏ໣Ϸϩ‫݋‬Б‫ݤ‬Ƕ 9 ࣴ‫ز‬೛ीǺ ¾ ຾ՉБԄǺProspective Study ¾ ჹྣಔᒿᐒϩଛϐѳՉಔࣴ‫ز‬ ¾ ‫ޓ‬ϯБԄǺൂ‫ޓ‬ ¾ ᒿᐒϩࢴǺ٩ႝတ໶ኧ߄ᒿᐒᒧ‫ڗ‬Ǵ٠ᇙԋߞ࠾‫ੰٮ‬Γ‫ڗܜ‬Ƕ 9 ‫ڙ‬၂‫ޣ‬Ǻ Ɋᒧ᏷኱ྗǺ 1.૛ለ่້ҡੰ஻(ϐ߻ϐ่ҡϩ‫ࣁ݋‬૛ለ่້ҡ) 2.Ԗੱ‫ރ‬ϐ่ҡൺวε‫ٿܭ‬ԛ Ɋ௨ନ኱ྗ 2-8Ǻ 1.. ൾ‫܄‬ဍዦ‫ٳ‬ମᙯ౽. 2.. ୋҘ‫ރ‬ဏфૈϗ຾. 3.. ᆒઓ੯஻. 4.. ๝λᆅለՈੱ. 5.. ‫سֿݜ‬಍่ᄬ౦த. 6.. ᄌ‫ֿ܄‬ၡགࢉ. 25.

(32) 7.. ମ፦౧᚞஻‫ޣ‬. 8.. ภ॥. 9.. ᄌ‫܄‬ဎᘞ. 10. ᚶѫ 11. ‫ط‬๝фૈό٫‫ޣ‬ Ɋʳଏрᐒ‫ڋ‬Ǻ 1. ӵ‫ڙ‬၂‫ܭޣ‬၂ᡍύวғ่ҡൺวϐ௃‫ݩ‬ǴջಖЗҁ၂ᡍǴ٠җ ीฝЬ࡭Γ٩ֿၡ่ҡೀ౛চ߾ࣁ‫ִځ‬๓ೀ౛Ƕ 2. ӵ‫ڙ‬၂‫ܭޣ‬၂ᡍύวғᚶѫϐ௃‫ݩ‬Ǵᗨฅϖऴණۘคठ྾जϐ ൔᏤǴՠ㵝‫؃‬Ӽӄଆ‫ـ‬ǴջಖЗҁ၂ᡍǶ 3. ӵ‫ڙ‬၂‫ܭޣ‬၂ᡍύวғᅪ՟ჹϖऴණၸ௵ϐ௃‫ݩ‬ǴջಖЗҁ၂ ᡍǴ٠җीฝЬ࡭Γ٩ᛰ‫ނ‬ၸ௵ೀ౛চ߾ࣁ‫ִځ‬๓ೀ౛Ƕ Ɋʳ‫ڙ‬၂‫ޣ‬ኧҞǺ 80 ΓǴх֖ჴᡍಔ 40 ΓϷჹྣಔ 40 Γ. 26.

(33) 9 ࣴ‫ز‬Б‫ݤ‬Ǻ 9 ჴᡍಔ: 1. ϖऴණ 2g ‫؂‬ВΟԛ໭ࡕܺҔǴӅܺҔΟঁДǶ ӭസНᆢ࡭‫؂‬Вֿໆ>2000ccǶ 9 ჹྣಔ: ӼኃᏊ 2g ‫؂‬ВΟԛ໭ࡕܺҔǴӅܺҔΟঁДǶ ӭസНᆢ࡭‫؂‬Вֿໆ>2000ccǶ. 9 ᛰ‫ނ‬ёૈϐୋբҔ 9Ǻ ¾ Ҟ߻ё‫ࢗٮ‬᎙ϐЎ᝘΢Ǵჹ‫ܭ‬ϖऴණ٠คୋբҔϷό‫ؼ‬ϸᔈϐวғǶ ¾ ϖऴණϐᐛᘞǴ‫੆ځ‬ᆯણ 1~2g/kg ష‫ܭ‬Ⴉ਑ύᗯεқႵΟঁДǴ‫ܭ‬ᡉ༾᜔ Π‫ط‬ಒझϷ๝߈Ԕλᆅϐᡂ‫܄‬ǴՠԜჴᡍ࠻Ꮚໆᇻε‫΃ܭ‬૓‫ݯ‬ᕍᏊໆǶՠ 㵝‫؃‬Ӽӄଆ‫ـ‬Ǵ‫ط‬๝фૈό٫‫ࡌޣ‬᝼ϮуΕԜ၂ᡍǶќуΕҁ၂ᡍϐ‫ڙ‬၂ ‫ޣ‬Ѹ໪ௗ‫ۓڙ‬යϐ‫ط‬๝фૈᔠࢗǶ ¾ ϖऴණҞ߻‫ܭ‬ёࢗࢗ᎙ϐЎ᝘΢Ǵ٠คठ྾ज‫܄‬ǴՠࣁӼӄଆ‫ـ‬Ǵ‫ܭ‬ჴᡍ ය໔ᚶѫ‫ޣ‬ǴಖЗҁჴᡍǶ ¾ ӢӚΓᡏ፦όӕǴҺՖᛰ‫֡ނ‬Ԗёૈวғၸ௵ϸᔈǴ‫ރੱځ‬хࡴܺᛰࡕआ ੶ǵҜጥཝ᝚ǵⶁഞ੶ǵࣗ߾‫֚֎ڥ‬ᜤǴӵԖၸ௵౜ຝวғǴፎҥջଶЗ ܺᛰᆶीฝЬ࡭Γೱ๎Ƕ. 27.

(34) 9 ၂ᡍ‫܌‬ा଺ϐᖏ‫׉‬ᢀჸǺ ຾Ε၂ᡍ߻ϐ୷ҁᔠࢗхࡴ 2-8Ǻ ՈనᔠࢗǺGOT, GPT, BUN, CR, NA, K, CL, UA, SUGER(AC),CA,P ֿనᔠࢗǺ24HRS URINE Ccr, CALCIUM, Mg, URIC ACID, CITRATE, OXALATE,P ဎ೽ X ӀϷ๝᠌ຬॣ‫ݢ‬ᔠࢗǶ ၂ᡍ΃ঁДϷΟঁДࡕ 2-8Ǻ ՈనᔠࢗǺGOT, GPT, BUN, CR, NA, K, CL, UA, SUGER(AC),CA,P ֿనᔠࢗǺ24HRS URINE Ccr, CALCIUM, Mg, URIC ACID, CITRATE, OXALATE,P ဎ೽ X ӀϷ๝᠌ຬॣ‫ݢ‬ᔠࢗǶ 9 ಍ीϩ‫݋‬Ǻ ճҔ SPSS ೬ᡏ຾Չ t-test ಍ीǴp ॶ<0.05 ᇡࣁ‫ܭ‬಍ीᏢ΢‫ڀ‬Ԗᡉ๱ϐৡ౦Ƕ. 28.

(35) Ѥǵख़ाୖԵЎ᝘Ǻ References •. 1.Lee, Y.H., W.C. Huang, J.Y. Tsai, C.M. Lu, W.C Chen., M.H. Lee, H.S. Hsu, J.K. Huang and L.S.Chang. Epidemiological studies on the prevalence of upper urinary calculi in Taiwan. Urol. Int. 68: 172-177, 2002.. •. 2. Whalley, N. A., Meyers, A. M., Martins, M. and Margolius, L. P.: Long-term effects of potassium citrate therapy on the formation of new stones in groups of recurrent stone formers with hypocitraturia. Brit. J. Urol., 78: 10, 1996.. •. 3. Cicerello, E., Merlo, F., Gambaro, G., Maccatrozzo, L., Fandella, A., Baggio, B. and Anselmo, G.: Effect of alkaline citrate therapy on clearance of residual renal stone fragments after extracorporeal shock wave lithotripsy in sterile calcium and infection nephrolithiasis patients. J. Urol., 151: 5, 1994.. •. 4. Hofbauer, J., Hobarth, K., Szabo, N. and Marberger, M.: Alkali citrate prophylaxis in idiopathic recurrent calcium oxalate urolithiasis: a prospective randomized study. Brit. J. Urol., 73: 362, 1994.. •. 5.Ettinger, B., C.Y. Pak, J.T. Citron, C. Thomas, B. dams-Huet and A. Vangessel. Potassium-magnesium citrate is an effective prophylaxis against recurrent calcium oxalate nephrolithiasis. J. Urol. 158: 2069–73, 1997.. •. 6. Barcelo, P., Wuhl, O., Servitge, E., Rousaud, A. and Pak, C. Y. C.: Randomized double-blind study of potassium citrate in idiopathic hypocitraturic calcium nephrolithiasis. J. Urol., 150: 1761, 1993.. •. 7. Freitas, A.M., N. Schor, M.A. Boim. The effect of Phyllanthus niruri on urinary inhibitors of calcium oxalate crystallization and other factors associated with renal stone formation. BJU. Int. 89: 829-834, 2002.. •. • •. 8. Kato Y, Yamaguchi S, Yachiku S, Nakazono S, Hori J, Wada N, Hou K. Changes in urinary parameters after oral administration of potassium-sodium citrate and magnesium oxide to prevent urolithiasis. Urology. Jan;63(1):7-11.2004 9. ࣥࡲ‫؟‬ΕࣥࡲؓΕࣥན൐ Κխᢐᢐ෻ᖂ ഏ‫م‬ᒳ᤟塢 1995Κ228-9 10. ᝔ࣔ‫ޘ‬Κֱᕪᖂ ഏ‫م‬խഏ᠔ᢐઔߒࢬ 1999: 201-202. • •. 11. Patrick C. Walsh; Alan B. Retik .Campbell's urology. 8th ed 2002: 3230-3260 12. UTSUNOMIYA MΔKOIDE TΔYAMAGUCHI SΔet al.The effect of kompou medicine on the growth and aggregation of calcium oxalate crystal in vitro. Acta Urol Jpn. 37 ΰ10α:1097.1101.1991.. •. 13. KAWAMURA KΔMORIYAMA MΔNAKAJIMA CΔet al.The inhibi-tory effects of Takusha on the formationΔgrowth and aggregation of calcium oxalate crystal in vitro..Acta. 29.

(36) Urol Jpn.39(8α:695-700.1998. •. 14.YASUI TΔFUJITA KΔSATOMΔet al.The effect of takushaΔa kampo medicineΔon renal stone formation and osteopontin expression in a rat urolithiasis model. .Urol Res..27 ΰ3α:194-199.1999.. 30.

(37) ϖǵԃࡋႣ‫ۓ‬຾ࡋǺа Gantt Chart ߄Ңҁԃࡋϐ୺Չ຾ࡋǴຑᥛࢤૠ྽ᓮჄ٨։‫ڣ‬ ച۩ၞ৫֗ีᗨၞ৫Ƕ ‫ڣ‬৫ Дԛ ಃ. ಃ. ಃ. ಃ. ಃ. ಃ. ಃ. ಃ. ಃ. ಃ. ಃ. ಃ ഢຏ. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Д. Д. Д. Д. Д. Д. Д. Д. Д. Д. Д. Д. πբ໨Ҟ ύᛰྗഢ ࣴ‫ز‬շ౛૽ግ ᑔᒧ‫ڙ‬၂‫ޣ‬ ‫ۓ‬ය‫ܜ‬Ո ֹԋӚ໨ෳ‫ۓ‬ ϩ‫݋‬ኧᏵ ኗቪൔ֋. πբ୺Չ຾ࡋಕीԭϩК 5%. 10% 15% 20% 30% 40% 50% 60% 70% 80% 90%. ࿶຤୺Չ຾ࡋಕीԭϩК. ϩԃಕᑈ຾ࡋК. 31. 100%.

(38) ϤǵΓΚଛ࿼Ǻᜪձឯፎϩձ༤ቪЬ࡭Γǵ‫ڐ‬ӕЬ࡭Γǵࣴ‫ز‬঩ǵ஑Һࣴ‫ز‬ շ౛ǵঋҺࣴ‫ز‬շ౛฻Ƕࣴ‫ز‬շ౛ӵ҂ዴ‫ۓ‬ΓᒧǴ‫ۉځ‬Ӝឯё༤ቪࡑငǶ Ь࡭Γǵ‫ڐ‬ӕЬ࡭Γǵࣴ‫ز‬঩ሡߕ਱ԄΜѤϐᏢ࿶ᐕᇥܴਜǶ. ᜪ. ձ ‫ۉ‬. Ь࡭Γ. Ӝ౜. ᙍ ӧҁीฝϣᏼҺϐ␆浣πբ‫܄‬፦ǵ໨ҞϷጄൎ. ݅‫ػ‬ቼ Ь‫ݯ‬ᙴৣ ჴᡍϐ຾ՉǵΓ঩૽ግǵၗ਑᏾౛ǵ಍ीϩ‫݋‬ǵ ੰᐕଓᙫǵፕЎኗቪ. ‫ڐ‬ӕЬ. ݅प౰ ‫ ֿ ݜ‬Ѧ ࣽ Չࡹ‫ڐ‬ፓǵፕЎࡰᏤ. ࡭Γ ঋҺࣴ. ೽೽ߏ ࡑင. ၗ਑᏾౛ǵ಍ीϩ‫݋‬ǵੰᐕଓᙫ. ‫ز‬շ౛. 32.

(39) ᜪ ձ ‫ۉ‬. Ȑ v ȑЬ࡭Γ. Ӝ. ݅‫ػ‬ቼ. Ꮲ. Ȑ ȑ‫ڐ‬ӕЬ࡭Γ. ‫ ܄‬ձ. ‫ت‬. Ȑ. ȑࣴ‫ز‬Γ঩. рғԃДВ. 1974/12/12. ᐕȐ᏷‫ځ‬ख़ा‫ޣ‬༤ቪȑ Ꮲ. ਠ. Ӝ. ᆀ. Ꮲ. ύ୯ᙴᛰεᏢ. Տ. ᙴᏢγ. ଆّԃД. ஑ ߏ. 1993/7~2000/6. ‫ֿݜ‬Ѧࣽ Ѡчଭିᙴଣ ࿶. Րଣᙴৣǵ ᕴᙴৣ. ‫ֿݜ‬Ѧࣽ੯ੰ. 2000/7~2005/6. ᐕȐፎࡪ୍ܺਔ໔Ӄࡕ໩‫ׇ‬༤ቪᆶ౜ගीฝԖᜢϐ࿶ᐕȑ ܺ. ୍. ᐒ. ᄬ. Ϸ. ൂ. Տ. ᙍ. ౜ҺǺᄆϯ‫ذ‬໺ᙴଣ‫ֿݜ‬Ѧࣽ. ϐ࣬ᜢࣴ‫ز‬ीฝ ߈ϖԃϣමୖᆶ. ी. ฝ. Ӝ. ᆀ. Ь‫ݯ‬ᙴৣ. ᆀ. ଆّԃД 2005/7~ّϞ. ଆّԃД. ᅽѭষМᚯੴᝄख़ࡋࡰኧϐྗዴࡋ ࣴ‫ز‬. ಃ΋բ‫ޣ‬. ଭିᙴଣ. 2003/7~2005/ 7. ମࣧ๚ϣচว‫܄‬రЃՈᆅዦࣴ‫ز‬. ಃ΋բ‫ޣ‬. ଭିᙴଣ. 2001/6~2003/ 6. ीฝЍජᐒᜢ. ଆّԃД. ीฝЍජᐒᜢ. ଆّԃД. ी. ฝ. Ӝ. ᆀ. ᜢࣴ‫ز‬ीฝ ҙፎύϐ࣬. ीฝЍජᐒᜢ. ᜢࣴ‫ز‬ीฝ ୺Չύϐ࣬. ीฝϣᏼҺπբ. ी. ฝ. Ӝ. ᆀ. ࿶. ຤. ҙ ፎ ࿶ ຤. ࣴ‫ز‬Γ঩ᛝകǺ. Ь࡭ΓᛝകǺ 33.

(40) ᜪ. ձ. ‫ۉ‬. Ӝ. Ȑ. ȑЬ࡭Γ. ݅प౰. Ꮲ. Ȑ vȑ‫ڐ‬ӕЬ࡭Γ ‫ ܄‬ձ. ‫ت‬. Ȑ. ȑࣴ‫ز‬Γ঩. рғԃДВ. ᐕȐ᏷‫ځ‬ख़ा‫ޣ‬༤ቪȑ Ꮲ. ਠ. Ӝ. ᆀ. Ꮲ. Տ. ଆّԃД. ύ୯ᙴᛰεᏢ. ᙴᏢγ. Ѡчଭିᙴଣ. ‫ֿݜ‬Ѧࣽ Րଣᙴৣǵ. ஑ ߏ. ‫ֿݜ‬Ѧࣽ੯ੰ. ᕴᙴৣ ࿶. ᐕȐፎࡪ୍ܺਔ໔Ӄࡕ໩‫ׇ‬༤ቪᆶ౜ගीฝԖᜢϐ࿶ᐕȑ ܺ. ୍. ᐒ. ᄬ. Ϸ. ൂ. Տ. ᙍ. ౜ҺǺᄆϯ‫ذ‬໺ᙴଣ‫ֿݜ‬Ѧࣽ. ᆀ. ЬҺ. ฝ ߈ϖԃϣමୖ ᜢࣴ‫ز‬ीฝ ୺Չύϐ࣬. ी. ฝ. Ӝ. ᆀ. ी. ฝ. Ӝ. ᆀ. ीฝϣᏼҺπ բ. ࿶. ຤. ଆّԃД 200~ّϞ. ीฝЍජᐒᜢ. ଆّԃД. ीฝЍජᐒᜢ. ଆّԃД. ᜢࣴ‫ز‬ीฝ ҙፎύϐ࣬. Predictor of to Dutasteride therapy in Taiwan BPH patient. 500000. Sexuality and management of BPH with Alfuzosin (SAMBA). 500000. Sanofi Aventis company. 7/2006~6/200 7. ҙ ፎ ࿶ ຤. ीฝЍජᐒᜢ. ଆّԃД. ी. ฝ. Ӝ. ᆀ. ࣴ‫ز‬Γ঩ᛝകǺ. Taiwan continence 7/2006~6/200 society 7. Ь࡭ΓᛝകǺ. 34.

(41) ፄቩቩࢗཀ‫(߄ـ‬96.03.02) ीჄӜᆀ. ύᛰϖऴණჹ΢ֿၡ่ҡႣٛϐ߻ᘳ‫زࣴ܄‬. Ь࡭Γ. ݅‫ػ‬ቼ. ୍ܺൂՏ/ᙍᆀ ‫ذ‬໺इ‫ۺ‬ᙴଣ‫ֿݜ‬Ѧࣽ IRB ҙፎጓဦ 960202 ቩࢗ‫ޣ‬΋Ǻ 1. ٩Ь࡭Γ‫ޑ‬เᙟǴҁࣴ‫ޑز‬Ҟ‫ޑ‬ςҗᢀჸϖऴණ‫ڋ׭‬Ꮚ่ҡ‫ޑ‬ൺวᙯࣁᢀჸ ϖऴණࢂց‫ׯ‬ᡂ஻‫ֿޑޣ‬ύ่ҡ‫ڋ׭‬ӢηϷߦ຾ӢηǶჹࣴ‫ز‬ीฝԶ‫ق‬Ǵ೭ ࢂࡐख़ε‫ׯޑ‬ᡂǶࡌ᝼Ь࡭Γࢂց‫زࣴׯ׳‬ᚒҞࣁ“ύᛰϖऴණჹ૛ለ่້ҡ ஻‫ޣ‬ϐֿన่ҡߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ”ǴӵԜωૈଛӝࣴ‫ز‬Ҟ‫ޑ‬Ƕӕਔ Ь࡭ΓѸ໪ஒֿၰ่ҡߦ຾Ϸ‫ڋ׭‬Ӣη‫ޑ‬Ў᝘ࢗԵ૶ၩ‫ܭ‬ीฝጔଆύǴᇥܴ ೭٤Ӣηჹֿ่ҡ‫ޑ‬ቹៜǶќѦǴᗨූࣴ‫ز‬Ҟ‫ޑ‬ςԖ‫ׯ‬ᡂǴՠीฝਜύ‫ࣴޑ‬ ‫ز‬Ҟ‫(ޑ‬P6)ǵीฝᄔाύ‫زࣴޑ‬Ҟ‫(ޑ‬P4)Ϸ‫ڙ‬၂‫ޣ‬ӕཀਜύ‫زࣴޑ‬Ҟ‫ޑ‬ϐϣ৒ ֡ሡख़ཥ‫ׯ׳‬Ƕ 2. ҁࣴ‫ز‬ीฝ‫ޑ‬Ҟ‫ޑ‬ς‫ࣁׯ׳‬ᢀჸϖऴණჹ่ҡ‫ڋ׭‬Ϸߦ຾Ӣη‫ޑ‬ቹៜǹӧเ ᙟύΨග‫ډ‬ाᢀჸ‫ڙ‬၂‫ֿޣ‬ύᘗᘔለਥǵ૛ለਥǵ້ǵᕗ‫ޑ‬ᡂϯǴՠჴᡍБ ‫ݤ‬ύ٠คෳ‫ֿۓ‬ύᕗϐ໨ҞǴࢂցѸ໪ံӈǶ. ቩࢗ‫ޣ‬ΒǺ 1. IRB ቩࢗཀ‫ ـ‬2ǴPI ،‫ۓ‬аᢀჸ‫ڙ‬၂‫ޣ‬ϐ”‫؂‬В”ֿໆǾ଺಍ीϩ‫݋‬Ǵՠࣴ‫ز‬ Б‫ݤ‬Ώ،‫ܺۓ‬Ҕ 3 ঁДǴό‫ֿޕ‬నஒӵՖ௦໣ǻ. ᏾ᡏቩ่ࢗ݀Ǻ! ɍӕཀ!!!!!5অ҅ࡕӕཀ!!!!ɍόӕཀ! ! ፎ،‫زࣴۓ‬Ь࡭ΓࢂցሡӈৢୖуΓᡏ၂ᡍ‫ہ‬঩཮཮᝼! ɍሡӈৢ!!5όሡӈৢ! ሡӈৢচӢǺɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕ !. 35.

(42) ፄቩਢҙፎ߄(96.03.02) IRB ጓဦ. ीฝጓဦ. 960202. ԏЎВය ीฝᚒҞ. ύᛰϖऴණჹ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ. ࣴ‫ز‬ԋ঩. ύЎ‫ۉ‬Ӝ. मЎ‫ۉ‬Ӝ. ႝ၉/ϩᐒ. e-mail. Ь࡭Γ. ݅‫ػ‬ቼ. ! Eugene Lin!. 0966230701. [email protected]. ᖄ๎Γ. ݅‫ػ‬ቼ. ! Eugene Lin!. 0966230701. [email protected]. ᡂ‫׳‬Ўҹ. Ɏीฝਜ. Ɏ‫ڙ‬၂‫ޣ‬ӕཀਜ Ɏঁਢൔ֋߄. ‫ހ‬ҁ. Ver.1.2. Ver.1.2. Вය. 2/Mar/2007 2/Mar/2007. ‫ڙ‬၂‫ޣ‬Γ ኧ. 90 Γ. ಃ΋ԛଌቩВය. ଌቩԛኧ. ɍಃΒԛቩࢗ ɎಃΟԛቩࢗ ɍʳ ಃѤԛቩࢗ. നࡕ΋ԛଌቩВය. ҙፎ‫ރ‬ᄊ. Ɏ‫ז‬ೲቩࢗȐ༾λ൯ࡋᡂ‫׳‬ȑ ɍʳ ΋૓ቩࢗȐຬၸ༾λ൯ࡋᡂ‫܈׳‬ᡂ‫ޑ׳‬ᚒ‫཮׷‬ቹៜ‫ڙ‬၂‫ޑޣ‬Ӓᓀ‫܄‬ȑ. IRB ཀ‫ـ‬. ٩Ь࡭Γ‫ޑ‬เᙟǴҁࣴ‫ޑز‬Ҟ‫ޑ‬ςҗᢀჸϖऴණ‫ڋ׭‬Ꮚ่ҡ‫ޑ‬ൺวᙯࣁ ᢀჸϖऴණࢂց‫ׯ‬ᡂ஻‫ֿޑޣ‬ύ่ҡ‫ڋ׭‬ӢηϷߦ຾ӢηǶჹࣴ‫ز‬ीฝ Զ‫ق‬Ǵ೭ࢂࡐख़ε‫ׯޑ‬ᡂǶࡌ᝼Ь࡭Γࢂց‫زࣴׯ׳‬ᚒҞࣁ“ύᛰϖऴණ ჹ૛ለ่້ҡ஻‫ޣ‬ϐֿన่ҡߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ”ǴӵԜωૈଛ ӝࣴ‫ز‬Ҟ‫ޑ‬ǶӕਔЬ࡭ΓѸ໪ஒֿၰ่ҡߦ຾Ϸ‫ڋ׭‬Ӣη‫ޑ‬Ў᝘ࢗԵ૶ ၩ‫ܭ‬ीฝጔଆύǴᇥܴ೭٤Ӣηჹֿ่ҡ‫ޑ‬ቹៜǶќѦǴᗨฅࣴ‫ز‬Ҟ‫ޑ‬ ςԖ‫ׯ‬ᡂǴՠीฝਜύ‫زࣴޑ‬Ҟ‫(ޑ‬P6)ǵीฝᄔाύ‫زࣴޑ‬Ҟ‫(ޑ‬P4)Ϸ‫ڙ‬ ၂‫ޣ‬ӕཀਜύ‫زࣴޑ‬Ҟ‫ޑ‬ϐϣ৒֡ሡख़ཥ‫ׯ׳‬Ƕ. PI ӣᙟ. 1. ς‫زࣴׯ׳‬ᚒҞࣁ“ύᛰϖऴණჹ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾ӢηϷ ‫ڋ׭‬Ӣη‫ޑ‬ቹៜȹǶ 2. Ў᝘ٰྍςቚӈ‫ܭ‬ीฝጔଆύǶ 3. ‫ڙ‬၂‫ޣ‬ӕཀਜύ‫زࣴޑ‬Ҟ‫ޑ‬ϐϣ৒ςख़ཥ‫ׯ׳‬Ƕ. ɍʳ Ь࡭ΓЋн. Ver.1.2 2/Mar/2007. ᖴᖴாᝊ຦ϐཀ‫ـ‬Ǽ 36. 96 ԃ 02 Д 02 В 96 ԃ 03 Д 04 В.

(43) অ‫ࡕׯ‬. 1.Ӣֿၡ่ҡࢂ΋ଯൺว౗ϐ੯ੰǴӵคϷਔϐ፾྽ೀ౛Ǵᇸ߾ੵภǵ ՈֿǴख़߾Їଆ௳Ոੱǵ๝૰ᆃ฻‫ٳ‬วੱǴჹ‫ܭ‬ᙴᕍϷ‫཮ޗ‬ԋҁ๱ჴࣁ ΃؈ख़ϐॄᏼ 2ǹҁ ҁჴᡍϐҞ‫ޑ‬ջࣁᔈҔύाϖऴණǴࣴ‫ځز‬ჹ‫ܭ‬ൺว ࠠ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾Ϸ‫ڋ׭‬Ӣηϐቹៜǹаය‫פ‬р΃ୋբҔե ЪԖਏϐБ‫ٰݤ‬Ⴃ่ٛҡϐൺวǴа೷ᅽቶεϐ่ҡੰ஻ဂǶ! (ीฝਜύ‫زࣴޑ‬Ҟ‫ ޑ‬p4ǵीฝᄔाύ‫زࣴޑ‬Ҟ‫ ޑ‬p5)! 3/!‫ܭ‬Ў᝘ύ 22Ǵ૛ ૛ለ่້ҡϐߦ຾ӢηхࡴΑֿనύϐ້ᚆηǵ૛ለਥ ᚆηǴ‫ڋ׭‬ӢηхࡴΑֿనύϐᗔᚆηǵᘗᘔለਥᚆηǶ! (ीฝਜύीฝጔଆ p5) 4/ҁჴᡍϐҞ‫ޑ‬ջࣁᔈҔύᛰϖऴණ. :.21. Ǵࣴ ࣴ‫ځز‬ჹ‫ܭ‬ൺวࠠ૛ለ่້ҡ. ஻‫ޣ‬ϐ่ҡߦ຾Ϸ‫ڋ׭‬Ӣηϐቹៜ 11ǹаය‫פ‬р΃ୋբҔեЪԖਏϐБ ‫ٰݤ‬Ⴃ่ٛҡϐൺวǴа೷ᅽቶεϐ่ҡੰ஻ဂǶ! )‫ڙ‬၂‫ޣ‬ӕཀਜύ‫زࣴޑ‬Ҟ‫ ޑ‬p1) IRB ཀ‫ـ‬. 3. ҁࣴ‫ز‬ीฝ‫ޑ‬Ҟ‫ޑ‬ς‫ࣁׯ׳‬ᢀჸϖऴණჹ่ҡ‫ڋ׭‬Ϸߦ຾Ӣη‫ޑ‬ቹ ៜǹӧเᙟύΨග‫ډ‬ाᢀჸ‫ڙ‬၂‫ֿޣ‬ύᘗᘔለਥǵ૛ለਥǵ້ǵᕗ‫ޑ‬ ᡂϯǴՠჴᡍБ‫ݤ‬ύ٠คෳ‫ֿۓ‬ύᕗϐ໨ҞǴࢂցѸ໪ံӈǶ. PI ӣᙟ. ‫ܭ‬ጓቪਔᒪᅅǴςံ΢Ǵᖴᖴாᝊ຦ϐཀ‫ـ‬Ǽ. অ‫ࡕׯ‬. ຾Ε၂ᡍ߻ϐ୷ҁᔠࢗхࡴ 3.9Ǻ! ՈనᔠࢗǺHPU-!HQU-!CVO-!DS-!OB-!L-!DM-!VB-! TVHFS)BD*-DB-Q! ֿనᔠࢗǺ35IST!VSJOF!Dds-!DBMDJVN-!Nh-!VSJD!BDJE-! DJUSBUF-!PYBMBUF-Q Q! ဎ೽ Y ӀϷ๝᠌ຬॣ‫ݢ‬ᔠࢗǶ! ၂ᡍ΃ঁДϷΟঁДࡕ 3.9Ǻ! ՈనᔠࢗǺHPU-!HQU-!CVO-!DS-!OB-!L-!DM-!VB-! TVHFS)BD*-DB-Q! ֿనᔠࢗǺ35IST!VSJOF!Dds-!DBMDJVN-!Nh-!VSJD!BDJE-! DJUSBUF-!PYBMBUF-Q Q! ဎ೽ Y ӀϷ๝᠌ຬॣ‫ݢ‬ᔠࢗǶ! (ीฝਜύीฝጔଆ p9). IRB ཀ‫ـ‬. IRB ቩࢗཀ‫ ـ‬2ǴPI ،‫ۓ‬аᢀჸ‫ڙ‬၂‫ޣ‬ϐ”‫؂‬В”ֿໆǾ଺಍ीϩ‫݋‬Ǵՠ ࣴ‫ز‬Б‫ݤ‬Ώ،‫ܺۓ‬Ҕ 3 ঁДǴό‫ֿޕ‬నஒӵՖ௦໣ǻ. PI ӣᙟ. চ߾΢ӵ݀‫ڙ‬၂‫ޣ‬ё૶ᒵ 3 ঁДύϐ‫؂‬Вֿໆӆуаѳ֡ϐࣁന٫Ǵՠ Եໆ‫୺ډ‬Չय़ჹ‫ڙܭ‬၂‫ޣ‬ၨᜤၲԋǴࡺ౜ᔕаܺᛰ߻Ϸܺᛰࡕ΃‫ک‬Οঁ 37.

(44) Дϐ 24 λਔֿໆࣁྗ(Ӣ‫ڙ‬၂‫ޣ‬Ѹ໪ԏ໣ܺᛰ߻Ϸܺᛰࡕ΃‫ک‬ΟঁДϐ 24 λਔֿన‫ڙ‬ᔠ*Ƕᖴᖴாᝊ຦ϐཀ‫ـ‬Ǽ. 38.

(45) ፄቩቩࢗཀ‫(߄ـ‬96.03.16) ीჄӜᆀ. ύᛰϖऴණჹ૛ለ่້ҡ஻‫ߦޣ‬຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ. Ь࡭Γ. ݅‫ػ‬ቼ. ୍ܺൂՏ/ᙍᆀ ‫ذ‬໺इ‫ۺ‬ᙴଣ‫ֿݜ‬Ѧࣽ IRB ҙፎጓဦ 960202 ቩࢗ‫ޣ‬΋Ǻ 1.ҁࣴ‫ز‬ፄቩς٩ा‫ࣁׯ׳؃‬ȸύᛰϖऴණჹ૛ለ่້ҡ஻‫ߦޣ‬຾ӢηϷ‫ڋ׭‬ Ӣη‫ޑ‬ቹៜȹǴՠࢂ‫ڙ‬၂‫ޣ‬ӕཀਜϐႣය၂ᡍਏ݀(p2)ࠅϝߥ੮ࣁȸ෧ե่ҡൺ ว౗Ϸ่ҡϐғԋȹǴԜᔈঅ‫“ࣁׯ‬ϖऴණёफ़ե่ҡғԋӢη‫܈‬ගϲ่ҡ‫ڋ׭‬ Ӣη”Ƕ 2.ࣴ‫ز‬ीฝ‫ࡕׯ׳‬Ǵࣴ‫ز‬ᚒҞ‫ޑ‬मЎᆶύЎόֹӄ಄ӝ(‫ـ‬ीฝਜ p3)ࡌ᝼‫ࣁׯ׳‬ ȸThe influence of Wu-ling-San on the promotive and inhibitory factors for stone formation in patients with calcium oxalate stone”Ǵၨࣁӝ‫ە‬Ƕ. ቩࢗ‫ޣ‬ΒǺ 1. 24h ϐֿనᇆ໣ǴஒӵՖᆶ‫ڙ‬၂‫ޣ‬ၲԋӅ᛽ǻ. ᏾ᡏቩ่ࢗ݀Ǻ! ɍӕཀ!!!!!5অ҅ࡕӕཀ!!!!ɍόӕཀ! ! ፎ،‫زࣴۓ‬Ь࡭ΓࢂցሡӈৢୖуΓᡏ၂ᡍ‫ہ‬঩཮཮᝼! ɍሡӈৢ!!5όሡӈৢ! ሡӈৢচӢǺɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕɕ ! !. 39.

(46) ፄቩਢҙፎ߄(96.03.16) IRB ጓဦ. ीฝጓဦ. 960202. ԏЎВය ीฝᚒҞ. ύᛰϖऴණჹ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ. ࣴ‫ز‬ԋ঩. ύЎ‫ۉ‬Ӝ. मЎ‫ۉ‬Ӝ. ႝ၉/ϩᐒ. e-mail. Ь࡭Γ. ݅‫ػ‬ቼ. ! Eugene Lin!. 0966230701. [email protected]. ᖄ๎Γ. ݅‫ػ‬ቼ. ! Eugene Lin!. 0966230701. [email protected]. ᡂ‫׳‬Ўҹ. Ɏीฝਜ. Ɏ ‫ ڙ‬၂ ‫ ޣ‬ӕ ཀ Ɏঁਢൔ֋߄. ɍʳ Ь࡭ΓЋн. ਜ ‫ހ‬ҁ. Ver.1.3. Вය. 16/Mar/2007 16/Mar/2007. ‫ڙ‬၂‫ޣ‬Γ ኧ. 90 Γ. ಃ΋ԛଌቩВය. ଌቩԛኧ. ɍಃΒԛቩࢗ ɍಃΟԛቩࢗ ɎಃѤԛቩࢗ. നࡕ΋ԛଌቩВය. ҙፎ‫ރ‬ᄊ. Ɏ‫ז‬ೲቩࢗȐ༾λ൯ࡋᡂ‫׳‬ȑ ɍʳ ΋૓ቩࢗȐຬၸ༾λ൯ࡋᡂ‫܈׳‬ᡂ‫ޑ׳‬ᚒ‫཮׷‬ቹៜ‫ڙ‬၂‫ޑޣ‬Ӓᓀ‫܄‬ȑ. IRB ཀ‫ـ‬. ቩࢗ‫ޣ‬΋Ǻ ҁࣴ‫ز‬ፄቩς٩ा‫ࣁׯ׳؃‬ȸύᛰϖऴණჹ૛ለ่້ҡ஻‫ߦޣ‬຾ӢηϷ ‫ڋ׭‬Ӣη‫ޑ‬ቹៜȹǴՠࢂ‫ڙ‬၂‫ޣ‬ӕཀਜϐႣය၂ᡍਏ݀(p2)ࠅϝߥ੮ࣁ ȸ෧ե่ҡൺว౗Ϸ่ҡϐғԋȹǴԜᔈঅ‫“ࣁׯ‬ϖऴණёफ़ե่ҡғԋ Ӣη‫܈‬ගϲ่ҡ‫ڋ׭‬Ӣη”Ƕ. PI ӣᙟ. Ⴃය၂ᡍਏ݀ς‫”ࣁ҅׳‬ϖऴණёफ़ե่ҡғԋӢη‫܈‬ගϲ่ҡ‫ڋ׭‬Ӣ η”Ƕ ᖴᖴாᝊ຦ϐཀ‫ـ‬Ǽ. IRB ཀ‫ـ‬. ࣴ‫ز‬ीฝ‫ࡕׯ׳‬Ǵࣴ‫ز‬ᚒҞ‫ޑ‬मЎᆶύЎόֹӄ಄ӝ(‫ـ‬ीฝਜ p3)ࡌ᝼ ‫ࣁׯ׳‬ȸThe influence of Wu-ling-San on the promotive and inhibitory factors for stone formation in patients with calcium oxalate stone”Ǵၨࣁӝ ‫ە‬Ƕ. Ver.1.3. Ver.1.3 16/Mar/2007. 40. 96 ԃ 02 Д 02 В 96 ԃ 03. Д 16 В.

(47) PI ӣᙟ. मЎᚒҞς‫ࣁׯ׳‬ȸThe influence of Wu-ling-San on the promotive and inhibitory factors for stone formation in patients with calcium oxalate stone” ᖴᖴா‫ࡰޑ‬ᏤǼ. IRB ཀ‫ـ‬. ቩࢗ‫ޣ‬ΒǺ 24h ϐֿనᇆ໣ǴஒӵՖᆶ‫ڙ‬၂‫ޣ‬ၲԋӅ᛽ǻ. PI ӣᙟ. ஒҗ PI ᒃԾᆶ‫ڙ‬၂‫ޣ‬ှញ٠ྎ೯ǴӢҁჴᡍҞ‫ࣁޑ‬ᢀჸϖऴණࢂցёफ़ ե่ҡғԋӢη‫܈‬ගϲ่ҡ‫ڋ׭‬ӢηǴࡺѸ໪‫ܭ‬၂ᡍ߻Ϸ΃‫ک‬ΟঁДਔ ԏ໣ 24hr ֿన‫ڙ‬ᔠǴԜှញϐπբϷӅ᛽Ѹ໪‫ܭ‬ᛝु‫ڙ‬၂‫ޣ‬ӕཀਜϐ߻ ֹԋǴӵ‫ڙ‬၂‫ޣ‬ϝค‫ݤ‬ଛӝǴջค‫ݤ‬уΕҁ၂ᡍीჄǶ ᖴᖴா‫ࡰޑ‬ᏤϷᝊ຦ϐཀ‫ـ‬ǼǼ. 41.

(48) ᐉᤜ࿨࣠ຏव।. IRB ᒳᇆ. 960202. ૠ྽‫ټ‬ጠ. խᢐն૔ཋኙ౻Ꭸၩ࿨‫ف‬൛ृআၞ‫ڂ‬՗֗‫ڂࠫލ‬՗ऱᐙ᥼. ᄎᤜཚ‫ڻ‬. 96 ‫ڣ‬৫รԲ‫ڻ‬ᄎᤜ. ᐉᤜ࿨࣠. ɍʳ μு଱νΚு࿇‫ء‬ᄎ‫ٵ‬რᜯ‫ݩ‬ᇢ᧭ᢞࣔ஼ Ϯ. ‫׌‬਍Գ. ᄎᤜֲཚ. ࣥߛᐜ. 96 ‫ ڣ‬04 ִ 21 ֲ. μଥ‫إ‬৵ு଱ν Κଥ‫إ‬৵Δᆖ଺‫׌‬ᐉࡡ୉ᐉ਷ຏመΔு࿇‫ٵ‬რᜯ‫ݩ‬ ᇢ᧭ᢞࣔ஼. ɍʳ μଥ‫إ‬৵ᓤᐉνΚ༼໴IRBՀ‫ڻ‬ᄎᤜᐉ਷ ɍʳ μլு଱νΔ෻‫ط‬Κ_________________ ɍʳ ᓮૠ྽‫׌‬਍Գ٨ஂ೶‫ף‬Գ᧯ᇢ᧭ࡡ୉ᄎᄎᤜΔ෻‫ط‬Κ__________ ‫ދ‬ปધᙕ. ᚨଥ‫إ‬๠. 1. 2.. ு଱__0__ป ଥ‫إ‬৵ு଱__11_ป. 3.. ଥ‫إ‬৵ᓤᐉ__0__ป. 4.. լு଱__0__ป. 5.. ࣋ඵ__0__ป. ૠ྽஼Κ 1. ઔߒ๻ૠ‫ࡳ଺ط‬Կิ‫ิࠟګޏ‬Κኔ᧭ิն૔ཋΔኙᅃิ‫ڜ‬ᐣᕪΖᑌ ‫ء‬ᑇ‫ ิޢط‬30 ԳΔ᜔٥ 90 ԳΔ‫ ګޏ‬2 ิΔ‫ ิޢ‬40 ԳΖ 2. ն૔ཋኙ࣍ቃ߻࿨‫ف‬ய࣠ऱ֮᣸໴‫ܫ‬ᓮ٨‫נ‬Ζ 3. ౏ԵΕඈೈයٙΔ࠹ᇢृಯ‫נ‬ᖲࠫᓮᇖ‫ך‬ᎅࣔΖ ࠹ᇢृ‫ٵ‬რ஼ 1. ֮‫ဲشڗ‬૞Ց፿֏Ζ 2. ኙ࣍౻Ꭸၩ࿨‫ف‬ऱఐԳΔិ឴Ꭸሧऱए᛭‫ڶ‬ԫࡳ‫ګ‬யΔ‫܀‬ն૔ཋऱ ए᛭ய࣠‫ؾ‬ছࡸ‫˿˿˸̊ آ‬ˀ˷̂˶̈̀˸́̇Δ‫ڕ܃‬۶‫࠹ڇ‬ᇢृ‫ٵ‬რ஼Ղ༉ᨃ࠹ ᇢृԱᇞ‫ףה‬Եᇢ᧭৵‫ױڶ‬౨૞൷࠹ն૔ཋΕࢨ‫ڜ‬ᐣᕪۖॺិ឴Ꭸ ሧए᛭Δۖᣋრ‫ף‬ԵઔߒΛն૔ཋए᛭ऱய࣠Εᢞᖕ‫ؘ‬ႊ‫ܧ‬෼Ζ 3. ‫ܫ‬व࠹ᇢृΔ‫ٺ‬ጟֱऄऱቃ߻‫ګ‬ய‫ڕ‬۶Λ‫ٵ‬ழ૞ᨃ‫ה‬वሐΔ‫ף‬Եᇢ ᧭৵լਢ‫۞הط‬աެࡳ‫ה‬૞ୌԫጟए᛭ֱऄΔۖਢૠ྽‫׌‬਍Գ‫א‬ᙟ ᖲֱ‫ڤ‬։಻Δຍࠄᇷಛ૞‫ך‬։‫ܫ‬वΖ 4. ኙွ‫ܶץ‬ՖࢤΔ‫࣠ڕ‬ᡖ؋༉ඈೈΔೈԱ‫گ‬ூছඈೈᡖ؋Δ‫گ‬ூ৵ᇢ ᧭ཚၴ‫ؘ‬ႊ‫ܫ‬व࠹ᇢृආ࠷ᝩ؋ൻਜΔ‫ڂ‬੡ն૔ཋኙ઼ࠝऱᐙ᥼‫آ‬ वΖ 42.

(49) 5. ʻԲʼቃཚᇢ᧭ய࣠Κψն૔ཋ‫܅૾ױ‬࿨‫ڂګسف‬՗ࢨ༼֒࿨‫ڂࠫލف‬ ՗ω Δ۶ᘯ࿨‫ڂګسف‬՗Ε‫ڂࠫލ‬՗ຍ‫؁‬ᇩ‫ا‬ฒ઎լᚩΖᓮଥ‫إ‬Ζਢ ‫ܡ‬ଥ‫ګޏ‬ϙቃ߻࿨‫ف‬༚࿇ࢨ૾‫܅‬࿨‫ف‬༚࿇ऱᖲ෷ϙΖ 6. ࠹ᇢृ‫ٵ‬რ஼ՂᏁ૞ᏺ‫ ˇ˅ ף‬՛ழऱᜤ࿮ሽᇩΖ ᓤᐉ࿓‫ݧ‬. 1. ᓮࠉՂ૪ᐉ਷რߠΔ‫א‬ψᓤᐉூ‫ع‬ᓮ।ωດය‫៿ڃ‬Ζ 2. ଥ‫ޏ‬๠Δ‫ؘ‬ႊΚ‫א‬ψษ ษ᧯+‫ڗ‬ցጻࢍ+ࢍᒵωᑑ‫ق‬Ζ 3. ᓤᐉழᓮലಬᐉ֮ٙ堚໢Εᓤᐉ‫ع‬ᓮ஼Εଥ‫إ‬৵ૠ྽஼Ε࠹ᇢृ‫ٵ‬ რ஼ԫ‫ڤ‬Կٝബ‫ڃ‬࿯Գ᧯ᇢ᧭ࡡ୉ᄎఽ஼Ζ 4. ‫ڶڕ‬ጊംᓮၞԫ‫ޡ‬ፖ⊺ટெᜤ࿮ΔሽᇩΚ7256166 ᠏ 66088Ζ. ‫׌‬ٚࡡ୉᡽‫ټ‬. ᡽‫ֲټ‬ཚ. 43. ___‫ֲ___ִ___ڣ‬.

(50) ፄቩਢҙፎ߄(96.05.16) IRB ጓဦ. ीฝጓဦ. 960202. ԏЎВය ीฝᚒҞ ύᛰϖऴණჹ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ ࣴ‫ز‬ԋ঩ ύЎ‫ۉ‬Ӝ. मЎ‫ۉ‬Ӝ. ႝ၉/ϩᐒ. e-mail. Ь࡭Γ. ݅‫ػ‬ቼ. ! Eugene Lin!. 0966230701. [email protected]. ᖄ๎Γ. ݅‫ػ‬ቼ. ! Eugene Lin!. 0966230701. [email protected]. ᡂ‫׳‬Ўҹ Ɏीฝਜ. Ɏ ‫ ڙ‬၂ ‫ ޣ‬ӕ ཀ Ɏঁਢൔ֋߄. ɍʳ Ь࡭ΓЋн. ਜ ‫ހ‬ҁ. Ver.1.4. Вය. 16/May/2007 16/May/2007. Ver.1.4. Ver.1.4 16/May/2007. ‫ڙ‬၂‫ޣ‬Γ 80 Γ ኧ. ಃ΋ԛଌቩВය. ଌቩԛኧ ɍಃΒԛቩࢗ ɍಃΟԛቩࢗ ɎಃѤԛቩࢗ. നࡕ΋ԛଌቩВය. 96 ԃ 02 Д 02 В 96 ԃ 05 Д 16 В. ҙፎ‫ރ‬ᄊ Ɏ‫ז‬ೲቩࢗȐ༾λ൯ࡋᡂ‫׳‬ȑ ɍʳ ΋૓ቩࢗȐຬၸ༾λ൯ࡋᡂ‫܈׳‬ᡂ‫ޑ׳‬ᚒ‫཮׷‬ቹៜ‫ڙ‬၂‫ޑޣ‬Ӓᓀ‫܄‬ȑ IRB ཀ‫زࣴ ـ‬೛ीҗচ‫ۓ‬Οಔ‫ׯ‬ԋ‫ٿ‬ಔǺჴᡍಔϖऴණǴჹྣಔӼኃᏊǶኬҁኧ җ‫؂‬ಔ 41 ΓǴᕴӅ :1 ΓǴ‫ׯ‬ԋ 3 ಔǴ‫؂‬ಔ 51 ΓǶ! PI ӣᙟ. ीฝਜ೽ϩςঅ‫ࣁׯ‬ǺჴᡍБ‫ࣁݤ‬ჴᡍಔ΋ 51 ΓǴϖऴණ 3h ‫؂‬ВΟԛ ໭ࡕܺҔǴӅܺҔΟঁДǴ٠ӭസНᆢ࡭‫؂‬Вֿໆ?3111ddǶჹྣಔ 51 ΓǴ๏ϒӼኃᏊ 3h ‫؂‬ВΟԛ໭ࡕܺҔǴӅܺҔΟঁДǴ٠ӭസНᆢ࡭‫؂‬ Вֿໆ?3111ddǶ ᖴᖴாᝊ຦ϐཀ‫ـ‬Ǽ. IRB ཀ‫ ـ‬ϖऴණჹ‫ܭ‬Ⴃ่ٛҡਏ݀‫ޑ‬Ў᝘ൔ֋ፎӈрǶ!. PI ӣᙟ. •. ीฝਜ Sfgfsfodf ೽ϩǺ • 9. ࣥࡲ‫؟‬ΕࣥࡲؓΕࣥན൐ Κխᢐᢐ෻ᖂ ഏ‫م‬ᒳ᤟塢 199ˈΚ ˅˅ˋˀˌ •. ˄˃ˁʳ ᝔ࣔ‫ޘ‬Κֱᕪᖂ ഏ‫م‬խഏ᠔ᢐઔߒࢬ 1999: 201-202 44.

(51) • •. 11. Patrick C. Walsh; Alan B. Retik .Campbell's urology. 8th ed 2002: 3230-3260 12. UTSUNOMIYA MΔKOIDE TΔYAMAGUCHI SΔet al.The effect of kompou medicine on the growth and aggregation of calcium oxalate crystal in vitro. Acta Urol Jpn. 37 ΰ10α:1097.1101.1991.. •. 13. KAWAMURA KΔMORIYAMA MΔNAKAJIMA CΔet al.The inhibi-tory effects of Takusha on the formationΔgrowth and aggregation of calcium oxalate crystal in vitro..Acta Urol Jpn.39(8α:695-700.1998.. •. 14.YASUI TΔFUJITA KΔSATOMΔet al.The effect of takushaΔ a kampo medicineΔon renal stone formation and osteopontin expression in a rat urolithiasis model. .Urol Res..27 ΰ3α:194-199.1999.. ᖴᖴாᝊ຦ϐཀ‫ـ‬Ǽ IRB ཀ‫ ـ‬યΕǵ௨ନచҹǴ‫ڙ‬၂‫ޣ‬ଏрᐒ‫ڋ‬ፎံкᇥܴǶ!. PI ӣᙟ. Ɋᒧ᏷኱ྗǺ! 2/૛ለ่້ҡੰ஻)ϐ߻ϐ่ҡϩ‫ࣁ݋‬૛ለ่້ҡ*! 3/Ԗੱ‫ރ‬ϐ่ҡൺวε‫ٿܭ‬ԛ! 3.9 Ɋ௨ନ኱ྗ Ǻ! 2/ൾ‫܄‬ဍዦ‫ٳ‬ମᙯ౽! 3/ୋҘ‫ރ‬ဏфૈϗ຾! 4/ᆒઓ੯஻! 5/๝λᆅለՈੱ! 6/‫سֿݜ‬಍่ᄬ౦த! 7/ᄌ‫ֿ܄‬ၡགࢉ! 8/ମ፦౧᚞஻‫!ޣ‬ 9/ภ॥! :/ᄌ‫܄‬ဎᘞ! 21/ᚶѫ! 22/‫ط‬๝фૈό٫‫!ޣ‬ Ɋଏрᐒ‫ڋ‬Ǻ! 2/ӵ‫ڙ‬၂‫ܭޣ‬၂ᡍύวғ่ҡൺวϐ௃‫ݩ‬ǴջಖЗҁ၂ᡍǴ٠җीฝЬ ࡭Γ٩ֿၡ่ҡೀ౛চ߾ࣁ‫ִځ‬๓ೀ౛Ƕ! 3/ӵ‫ڙ‬၂‫ܭޣ‬၂ᡍύวғᚶѫϐ௃‫ݩ‬Ǵᗨฅϖऴණۘคठ྾जϐൔᏤǴ 45.

(52) ՠ㵝‫؃‬Ӽӄଆ‫ـ‬ǴջಖЗҁ၂ᡍǶ! 4/ӵ‫ڙ‬၂‫ܭޣ‬၂ᡍύวғᅪ՟ჹϖऴණၸ௵ϐ௃‫ݩ‬ǴջಖЗҁ၂ᡍǴ٠ җीฝЬ࡭Γ٩ᛰ‫ނ‬ၸ௵ೀ౛চ߾ࣁ‫ִځ‬๓ೀ౛Ƕ! ! ᖴᖴா‫ࡰޑ‬ᏤϷᝊ຦ϐཀ‫ـ‬Ǽ IRB ཀ‫ڙ ـ‬၂‫ޣ‬ӕཀਜЎӷҔຒाαᇟϯǶ! ! PI ӣᙟ. ςӄय़ख़ཥঅ҅‫ڙ‬၂‫ޣ‬ӕཀਜ٠ஒ‫ځ‬αᇟϯǶ ᖴᖴா‫ࡰޑ‬ᏤϷᝊ຦ϐཀ‫ـ‬Ǽ!. IRB ཀ‫ ـ‬ჹ‫ܭ‬૛ለ่້ҡ‫ੰޑ‬ΓǴᘗᘔለႇ‫ݯޑ‬ᕍԖ΋‫ۓ‬ԋਏǴՠϖऴණ‫ݯޑ‬ᕍ ਏ݀Ҟ߻ۘ҂ xfmm.epdvnfouǴգӵՖӧ‫ڙ‬၂‫ޣ‬ӕཀਜ΢൩ᡣ‫ڙ‬၂‫ޣ‬Αှ дуΕ၂ᡍࡕԖёૈाௗ‫ڙ‬ϖऴණǵ‫܈‬ӼኃᏊԶߚᘗᘔለႇ‫ݯ‬ᕍǴԶᜫ ཀуΕࣴ‫ز‬ǻϖऴණ‫ݯ‬ᕍ‫ޑ‬ਏ݀ǵ᛾ᏵѸ໪և౜Ƕ! ! PI ӣᙟ. ς‫ڙܭ‬၂‫ޣ‬ӕཀਜύቚӈǺ! ¾ ϖऴණёफ़ե่ҡϐൺว౗Ƕ ¾ ϖऴණ‫ܭ‬ύᙴϐᔈҔ΢ࣁ੃НဍϐᏊǴჹ‫࡚ܭ‬ᄌ‫܄‬๝‫ݹ‬ǵ‫ݹط‬ǵᆮ ા‫ݹ‬ǵ࡚‫܄‬ဉग‫ݹ‬ǵНᘞǵНဍ‫܈‬ဎ೽Ћೌࡕ௨ֿ֚ᜤ֡ԖਏǶ ¾ ӧ౜жᛰ౛ᏢБय़Ǵϖऴණ‫ڀ‬ԖճֿϷ‫ל‬๵բҔǶ ¾ ճֿբҔёߦ຾‫ֿݜ‬ၰ่ҡ௨рǴ‫ځ‬ύ፜ऴǵἐऴǵқҀǵᐛᘞ֡ ԖճֿբҔǶԶਦ݄ᙖ‫ׯ‬๓ՈనൻᕉǴЀ‫ࢂځ‬๝᠌ՈనൻᕉǴуம ճֿբҔǶ ¾ Ъ‫ל‬๵բҔё‫ڋ׭‬གࢉ‫่܄‬ҡ‫׎‬ԋǴ‫ځ‬ύਦ݄ჹࢬՉ‫܄‬གߵੰࢥǵ ‫ݹޤ‬ౚ๵ǵฟ੯ఎ๵ǵεဉఎ๵฻Ԗ‫׭‬๵բҔǴ፜ऴᎇගనჹߎ໳ Յဟ๻ౚ๵ǵεဉఎ๵Ԗ‫ڋ׭‬բҔǶ ¾ ϖऴණύ‫ޑ‬ਦ݄ǵᐛᘞჹဉगѳྖԼԖှยբҔǴёᔅշᒡֿᆅѳ ྖԼ‫ܫ‬᚞Ǵߦ຾‫ֿݜ‬ၰ่ҡ௨рǶ ¾ ԜѦӧύ୯ᙴᛰεᏢഋЎᲑ௲௤ϐࣴ‫ز‬Ψ᛾ჴǴϖऴණ‫ܭ‬ᡏѦ၂ᡍ ϐύǴ‫ޑ‬ዴԖ‫ڋ׭‬૛ለ่້඲‫׎‬ԋǵᏉ໣‫ک‬ԋߏϐфਏǶ! ¾ ϖऴණऊё෧ե 30-40%ϐ่ҡൺว౗Ƕ! ¾ Sfgfsfodf! :/!݅‫ے‬ѿǵ݅‫ے‬ѳǵ݅ඳர!Ǻύᛰᛰ౛Ꮲ!୯ҥጓ᝿ᓔ!2::6Ǻ339.: 21/!ᖴܴ‫׸‬ǺБᏊᏢ!୯ҥύ୯ᙴᛰࣴ‫!܌ز‬2:::;!312.313! 22/!Qbusjdl!D/!Xbmti<!Bmbo!C/!Sfujl!/Dbnqcfmm(t!vspmphz/!9ui fe!. 46.

(53) 3113;!4341.4371! 12. UTSUNOMIYA MΔKOIDE TΔYAMAGUCHI SΔet al.The effect of kompou medicine on the growth and aggregation of calcium oxalate crystal in vitro. Acta Urol Jpn. 37ΰ10α:1097.1101.1991. 13. KAWAMURA KΔMORIYAMA MΔNAKAJIMA CΔet al.The inhibi-tory effects of Takusha on the formationΔgrowth and aggregation of calcium oxalate crystal in vitro..Acta Urol Jpn.39(8α:695-700.1998. 14.YASUI TΔFUJITA KΔSATOMΔet al.The effect of takushaΔa kampo medicineΔon renal stone formation and osteopontin expression in a rat urolithiasis model. .Urol Res..27ΰ3α:194-199.1999. ! ᖴᖴா‫ࡰޑ‬ᏤϷᝊ຦ϐཀ‫ـ‬ǼǼ! IRB ཀ‫ڙޕ֋ ـ‬၂‫ޣ‬ǴӚᅿБ‫ޑݤ‬ႣٛԋਏӵՖǻӕਔाᡣд‫ޕ‬ၰǴуΕ၂ᡍࡕ όࢂҗдԾρ،‫ۓ‬дाব΋ᅿ‫ݯ‬ᕍБ‫ݤ‬ǴԶࢂीฝЬ࡭ΓаᒿᐒБԄϩ ଛǴ೭٤ၗૻाкϩ֋‫ޕ‬Ƕ! ! PI ӣᙟ. ς‫ڙܭ‬၂‫ޣ‬ӕཀਜύቚӈ! 2/ ໺಍ϐᘗᘔለႇણ҃ऊё෧ե 21.61&ϐ่ҡൺว౗Ƕ! 3/ ϖऴණऊё෧ե 41.51&ϐ่ҡൺว౗Ƕ! 4/ ൂપസН٠ᆢ࡭‫؂‬Вֿໆ?3111dd ऊё෧ե 26&ϐ่ҡൺว౗Ƕ! 5/ ࣁᆢ࡭ࣴ‫࠼ޑز‬ᢀ‫܄‬Ǵ‫཮ॺך‬٣Ӄஒಔձးुӧߞ࠾ύǴ྽ாӕཀу Εࣴ‫ز‬ਔǴ཮‫ڗܜ‬΋ঁߞ࠾،‫ۓ‬ாஔ‫ڙ‬ব΋ಔ‫ݯ‬ᕍǴԶόࢂாԾҗ ᒧ᏷ाуΕব΋ಔǴӕਔாό཮‫ޕ‬ၰா೏ϩଛ‫ډ‬ব΋ಔǶ! ! ᖴᖴா‫ࡰޑ‬ᏤϷᝊ຦ϐཀ‫ـ‬ǼǼ!. IRB ཀ‫ ـ‬ჹຝх֖ζ‫܄‬Ǵӵ݀ᚶѫ൩௨ନǴନΑԏਢ߻௨ନᚶѫǴԏਢࡕ၂ᡍය ໔Ѹ໪֋‫ڙޕ‬၂‫ޣ‬௦‫ڗ‬ᗉѫ௛ࡼǴӢࣁϖऴණჹज‫ޑٽ‬ቹៜ҂‫ޕ‬Ƕ! ! PI ӣᙟ. ς‫ڙܭ‬၂‫ޣ‬ӕཀਜύቚӈଏрᐒ‫ڋ‬Ǻ! ӵ‫ڙ‬၂‫ܭޣ‬၂ᡍύวғᚶѫϐ௃‫ݩ‬Ǵᗨฅϖऴණۘคठ྾जϐൔᏤǴՠ 㵝‫؃‬Ӽӄଆ‫ـ‬ǴջಖЗҁ၂ᡍǶ! ! 47.

(54) ᖴᖴா‫ࡰޑ‬ᏤϷᝊ຦ϐཀ‫ـ‬Ǽ!. Ȩϖऴණёफ़ե่ҡғԋӢη‫܈‬ගϲ IRB ཀ‫ڙ ـ‬၂‫ޣ‬ӕཀਜύ)Β*Ⴃය၂ᡍਏ݀Ǻ ่ҡ‫ڋ׭‬Ӣηȩ ǴՖᒏ่ҡғԋӢηǵ‫ڋ׭‬Ӣη೭ѡ၉҇౲࣮όᔉǶፎঅ ҅Ƕࢂցঅ‫ׯ‬ԋȹႣ่ٛҡൺว‫܈‬फ़ե่ҡൺว‫ޑ‬ᐒ౗ȹ! PI ӣᙟ. ς‫ڙܭ‬၂‫ޣ‬ӕཀਜύ)Β*Ⴃය၂ᡍਏ݀ǺҁჴᡍϐҞ‫ޑ‬ջࣁᔈҔύᛰϖ ऴණǴႣ่ٛҡൺว‫܈‬फ़ե่ҡൺว‫ޑ‬ᐒ౗Ƕ! ᖴᖴா‫ࡰޑ‬ᏤϷᝊ຦ϐཀ‫ـ‬Ǽ!. IRB ཀ‫ڙ ـ‬၂‫ޣ‬ӕཀਜ΢ሡाቚу 35 λਔ‫ޑ‬ᖄ๎ႝ၉Ƕ! ! PI ӣᙟ. ς‫ڙܭ‬၂‫ޣ‬ӕཀਜύቚӈ 35 λਔ‫ޑ‬ᖄ๎ႝ၉ 0933090403! ᖴᖴா‫ࡰޑ‬ᏤϷᝊ຦ϐཀ‫ـ‬Ǽ!. 48.

(55) ‫ ذ‬໺ इ ‫ ۺ‬ᙴ ଣ ᖏ ‫ ׉‬၂ ᡍ ‫ ڙ‬၂ ӕ ཀ ਜ ၂ᡍӜᆀǺύᛰϖऴණჹ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ ୺ՉൂՏǺ. ‫ذ‬໺ᙴଣ‫ֿݜ‬Ѧࣽ೽. ၂ᡍЬ࡭ΓǺ. ݅‫ػ‬ቼ. ᖄ๎ႝ၉Ǻ 04-7813888 ext 72128. ᙴৣ. ࣴ‫ز‬ीჄᜅշ‫ޣ‬Ǻ ‫ذ‬໺इ‫ۺ‬ᙴଣ ‫ڙ‬၂‫ۉޣ‬ӜǺ. ੰᐕဦዸǺ. ‫܄‬ձǺ ೯ૻӦ֟Ǻ. ԃសǺ. ᖄ๎ႝ၉Ǻ ᆙ࡚ᖄ๎ΓǺ(ᆙ࡚‫ݩރ‬ϐೀ౛) ऩԖҺՖᆙ࡚௃‫ݩ‬ǵ໾্ǵୋբҔ‫ځ܈‬дό൨த‫يޑ‬ᡏ‫ݩރ‬ӧ၂ᡍය໔วғǴፎ୍Ѹҥ‫څ‬ ᖄ๎аΠႝ၉Ǻ ၂ᡍЬ࡭Γ‫ۉ‬ӜǺ ݅‫ػ‬ቼ ႝ၉Ǻ 04-7813888 ext 72128 24 λਔᆙ࡚ᖄ๎ΓǺ ႝ၉Ǻ 0933090403. ᙴৣ. ݅‫ػ‬ቼ ᙴৣ. (΋) ၂ᡍҞ‫ޑ‬Ǻ ֿၡ่ҡࢂ΋ঁଯൺว౗ϐ੯ੰǴӵ݀ؒԖϷਔϐ፾྽ೀ౛Ǵᇸ߾ੵภǵՈֿǴख़߾Ї ଆ௳Ոੱǵ๝૰ᆃ฻‫ٳ‬วੱǴჹ‫ܭ‬ᙴᕍϷ‫཮ޗ‬ԋҁ๱ჴࣁ΃؈ख़ϐॄᏼǹҁࣴ‫ز‬Ҟ‫ޑ‬ӧ௖ ૸ύᛰϖऴණჹ‫ܭ‬Ⴃ่ٛҡൺว‫܈‬फ़ե่ҡൺวᐒ౗‫ޑ‬ਏ݀Ƕ (Β) Ⴃය၂ᡍਏ݀Ǻ ¾ ϖऴණёफ़ե่ҡϐൺว౗Ƕ ¾ ϖऴණ‫ܭ‬ύᙴϐᔈҔ΢ࣁ੃НဍϐᏊǴჹ‫࡚ܭ‬ᄌ‫܄‬๝‫ݹ‬ǵ‫ݹط‬ǵᆮા‫ݹ‬ǵ࡚‫܄‬ဉग‫ݹ‬ǵ НᘞǵНဍ‫܈‬ဎ೽Ћೌࡕ௨ֿ֚ᜤ֡ԖਏǶ ¾ ӧ౜жᛰ౛ᏢБय़Ǵϖऴණ‫ڀ‬ԖճֿϷ‫ל‬๵բҔǶ ¾ ճֿբҔёߦ຾‫ֿݜ‬ၰ่ҡ௨рǴ‫ځ‬ύ፜ऴǵἐऴǵқҀǵᐛᘞ֡ԖճֿբҔǶԶਦ ݄ᙖ‫ׯ‬๓ՈనൻᕉǴЀ‫ࢂځ‬๝᠌ՈనൻᕉǴуமճֿբҔǶ ¾ Ъ‫ל‬๵բҔё‫ڋ׭‬གࢉ‫่܄‬ҡ‫׎‬ԋǴ‫ځ‬ύਦ݄ჹࢬՉ‫܄‬གߵੰࢥǵ‫ݹޤ‬ౚ๵ǵฟ੯ఎ ๵ǵεဉఎ๵฻Ԗ‫׭‬๵բҔǴ፜ऴᎇගనჹߎ໳Յဟ๻ౚ๵ǵεဉఎ๵Ԗ‫ڋ׭‬բҔǶ ¾ ϖऴණύ‫ޑ‬ਦ݄ǵᐛᘞჹဉगѳྖԼԖှยբҔǴёᔅշᒡֿᆅѳྖԼ‫ܫ‬᚞Ǵߦ຾‫ݜ‬ ֿၰ่ҡ௨рǶ ¾ ԜѦӧύ୯ᙴᛰεᏢഋ‫ؙ‬ӓ௲௤ϐࣴ‫ز‬Ψ᛾ჴǴϖऴණ‫ܭ‬ᡏѦ၂ᡍϐύǴ‫ޑ‬ዴԖ‫ڋ׭‬ 49.

(56) ૛ለ่້඲‫׎‬ԋǵᏉ໣‫ک‬ԋߏϐфਏǶϖ ϖऴණऊё෧ե 30-40%ϐ่ҡൺว౗Ƕ (Ο) ‫ي‬Ј΢ёૈᏤठϐୋբҔǵό፾‫܈‬ӒᓀǺ ¾ Ҟ߻ё‫ࢗٮ‬᎙ϐЎ᝘΢Ǵჹ‫ܭ‬ϖऴණ٠คୋբҔϷό‫ؼ‬ϸᔈϐวғǶ ¾ ϖऴණϐᐛᘞǴ‫੆ځ‬ᆯણ 1~2g/kg ష‫ܭ‬Ⴉ਑ύᗯεқႵΟঁДǴ‫ܭ‬ᡉ༾᜔Π‫ط‬ಒझϷ ๝߈Ԕλᆅϐᡂ‫܄‬ǴՠԜჴᡍ࠻Ꮚໆᇻε‫΃ܭ‬૓‫ݯ‬ᕍᏊໆǶՠ㵝‫؃‬Ӽӄଆ‫ـ‬Ǵ‫ط‬๝ф ૈό٫‫ࡌޣ‬᝼ϮуΕԜ၂ᡍǶќуΕҁ၂ᡍϐ‫ڙ‬၂‫ޣ‬Ѹ໪ௗ‫ۓڙ‬යϐ‫ط‬๝фૈᔠࢗǶ ¾ ӢӚΓᡏ፦όӕǴҺՖᛰ‫֡ނ‬Ԗёૈวғၸ௵ϸᔈǴ‫ރੱځ‬хࡴܺᛰࡕआ੶ǵҜጥཝ ᝚ǵⶁഞ੶ǵࣗ߾‫֚֎ڥ‬ᜤǴӵԖၸ௵౜ຝวғǴፎҥջଶЗܺᛰᆶीฝЬ࡭Γೱ๎Ƕ ϖऴණҞ߻‫ܭ‬ёࢗࢗ᎙ϐЎ᝘΢Ǵ٠คठ྾ज‫܄‬ǴՠࣁӼӄଆ‫ـ‬Ǵ‫ܭ‬ჴᡍය໔ᚶѫ‫ޣ‬Ǵ ፎ֋‫ޕ‬٠ಖЗҁჴᡍǶ. (ϖ) ‫ځ‬дёૈ‫ݯޑ‬ᕍϷ‫ځ‬ᇥܴǺ ¾ ჹ‫ܭ‬૛ለ่້ҡ‫ޑ‬஻‫ޣ‬ǴёаܺҔᘗᘔለႇણ҃٠ӭസНǴ໺಍ϐᘗᘔለႇણ҃ऊё ෧ե 10-50%ϐ่ҡൺว౗Ƕ ¾ ӭസН٠‫ۓ‬යଓᙫǴൂપസН٠ᆢ࡭‫؂‬Вֿໆ>2000cc ऊё෧ե 15%ϐ่ҡൺว౗Ƕ (Ϥ) ‫ځ‬дёૈ‫ޑ‬ཞѨ‫܈‬ճ੻Ǻ ாคሡॄᏼᆶҁࣴ‫ز‬Ԗᜢϐᛰ‫ނ‬຤ҔϷᚐѦғԋϐᔠෳ຤ҔǶ (Ύ) ୖуҁࣴ‫ز‬ीჄ‫ڙ‬၂‫ঁޣ‬Γ៾੻ஒ‫ߥډڙ‬ៈ ¾ ҁࣴ‫ز‬ीჄϐ୺Չᐒᄬஒᆢៈாӧࣴ‫ز‬ၸำ྽ύᔈளϐ៾੻Ƕ ¾ ாӧࣴ‫ز‬ၸำύёᒿਔᄖӣӕཀǴଏр၂ᡍǴόѸ࿶ၸЬ࡭ΓӕཀǴЪό཮ЇଆҺՖ όඍ‫܈ז‬ቹៜ‫ځ‬Вࡕ‫ޑ‬ᙴᕍྣ៝Ƕ ¾ ӵ݀ว౜ҺՖཥ‫ޑ‬ၗૻԖёૈ཮ቹៜாᝩុୖᆶᖏ‫׉‬၂ᡍ‫ޑ‬ཀᜫਔǴா‫܈‬ா‫ۓݤޑ‬ж ౛Γ཮೏ջਔ֋‫ޕ‬Ƕ ¾ ӵ݀ӵாӢҺՖ౛җటύЗࣴ‫ز‬ϐୖᆶǴፎᖄ๎ࣴ‫ز‬Ь࡭Γ‫ ܈‬24 λਔᆙ࡚ᖄ๎ΓǶ ¾ ‫ذ‬໺इ‫ۺ‬ᙴଣஒӧ‫܌ࡓݤ‬ೕጄϐำࡋϣຎாϐၗ਑ࣁᐒஏǶாҭᕕှࣴ‫ز‬ᜅշ‫ޣ‬Ȑቷ ୘ȑǵፁғ࿿ᆶ‫ذ‬໺इ‫ۺ‬ᙴଣΓᡏ၂ᡍ‫ہ‬঩཮ࣣԖ៾ᔠຎா‫ޑ‬ၗ਑Ƕ (Ζ) ‫ڙ‬၂‫ޣ‬ᖂܴਜ а΢‫ޑ‬ၗૻς࿶ӛ‫ך‬ᇥܴǴ‫ך‬Ԗᐒ཮၌ୢԜीฝ‫ޑ‬ԖᜢୢᚒǴ‫ך‬ςΑှЪӕཀୖᆶԜ ໨ࣴ‫ز‬ीჄǶӵ݀‫ך‬аࡕԖୢᚒǴ‫ך‬ёаᆶ‫ذ‬໺इ‫ۺ‬ᙴଣ‫ػ݅ޑ‬ቼᙴৣᖄ๎Ƕ ɍ၂ᡍЬ࡭Γ ‫ۉ‬ӜǺ ‫ڙ‬၂‫ޣ‬ᛝӜ ི҅‫ۉ‬ӜǺ. ɍ‫ڐ‬ӕЬ࡭Γ. ɍࣴ‫ز‬ж౛Γ. ᛝӜǺ. ᛝӜВයǺ. ᛝӜǺ. ᛝӜВයǺ. 50.

(57) Ver.1.6. 28/Jul/2007. ᄆᔭ‫ذ‬໺इ‫ۺ‬ᙴଣࣴ‫ز‬ीฝਜ. ԃ. ࡋǺΐΜϤ. ीฝӜᆀǺύᛰϖऴණჹ૛ለ่້ҡ஻‫ޣ‬ϐ่ҡ ߦ຾ӢηϷ‫ڋ׭‬Ӣη‫ޑ‬ቹៜ. ࣴ‫ز‬ख़ᗺǺɍՋᙴᖏ‫زࣴ׉‬ɍύᙴࣴ‫ز‬ɎύՋᙴ ่ӝࣴ‫ز‬. ҙፎൂՏǺᄆᔭ‫ذ‬໺इ‫ۺ‬ᙴଣ‫ֿݜ‬Ѧࣽ. Ь ࡭ ΓǺ݅‫ػ‬ቼ. ᙴৣᛝӜǺ. 51.