B Y TTRNG I HC DC H NI ---------- PHM TH NHUNG NGHIN CU BI THUCCHA HUYT KHI TNH MCH CHI V THC VT, HA HCV THM D TC DNG IN VITRO KHA LUN TT NGHIP DC S H ni - 2013 B Y TTRNG I HC DC H NI ---------- PHM TH NHUNG NGHIN CU BI THUC CHA HUYT KHI TNH MCH CHI V THC VT, HA HCV THM D TC DNG IN VITRO KHA LUN TT NGHIP DC S Ngi hng dn: TS. Nguyn Hong Tun Ni thc hin: B mn Dc liuTrng i hc Dc H Ni H Ni - 2013 LI CM N Trongqutrnhthchinkhalunttnghip,tinhncrt nhiu s hng dn v gip ca thy c, gia nh v bn b. Ti xin trn trng by t lng bit n su sc ca mnh n TS. Nguyn Thu Hng v TS. Nguyn Hong Tun hai thy c tn tnh hng dn v ng vin ti gip ti hon thnh tt kha lun. Ti xin chn thnh cm n cc thy c gio, cc anh ch k thut vin b mnDcliutoiukinthunlichotitrongqutrnhthchin kha lun ny. Ticngxingilicmnsuscnccthyctrngihc Dc H Ni dy bo, du dt ti trong sut nhng nm hc va qua. Li cm n cui cng ti xin gi n gia nh, bn b nhng ngi lun quantm,ngvinvlchdatinhthnvngchcchotihonthnh kha lun ny. H Ni, ngy 15 thng 5 nm 2013 Sinh vinPhm Th Nhung MC LC Danh mc cc k hiu, ch vit tt Danh mc cc bng Danh mc cc hnh v T VN .................................................................................................. 1 Chng 1. TNG QUAN ............................. Error! Bookmark not defined. 1.1. Bi thuc cha huyt khi tnh mch chiError! Bookmark not defined. 1.2. Cy cau ................................................. Error! Bookmark not defined. 1.3. Cy da ................................................ Error! Bookmark not defined. 1.4. Cy chui ............................................. Error! Bookmark not defined. 1.5.Giithiuchungvqutrnhngmuvbnhhuytkhitnh mch chi.. ..................................................... Error! Bookmark not defined. Chng 2. I TNG V PHNG PHP NGHIN CUError! Bookmark no2.1. Nguyn vt liu v thit b .................. Error! Bookmark not defined. 2.1.1. Nguyn liu ..................................... Error! Bookmark not defined. 2.1.2. Ha cht, dng c ........................... Error! Bookmark not defined. 2.1.3. Thit b nghin cu ......................... Error! Bookmark not defined. 2.2. Ni dung nghin cu ........................... Error! Bookmark not defined. 2.2.1. Nghin cu v thc vt ................... Error! Bookmark not defined. 2.2.2. Nghin cu thnh phn ha hc ..... Error! Bookmark not defined. 2.2.3.Thmdnhhnginvitrocabithuctrnqutrnhng mu19 2.2.4.Thmdnhhnginvitro cabithuctrnsngngtptiu cu ............................................................. Error! Bookmark not defined. 2.3. Phng php nghin cu ................... Error! Bookmark not defined. 2.3.1. Xc nh tn khoa hc .................... Error! Bookmark not defined. 2.3.2. Nghin cu c im vi hc ........... Error! Bookmark not defined. 2.3.3. Nghin cu v ha hc ................................................................... 20 2.3.4.nhginhhnginvitro cabithuctrnqutrnhngmu ............................................................ Error! Bookmark not defined. 2.3.5.nhginhhnginvitro cabithuctrnsngngtptiu cu ............................................................................................................. 20 Chng 3. THC NGHIM, KT QU V BN LUNError! Bookmark not defi3.1.Xcnhtnkhoahcvnghincucimvihccamu nghin cu ................................................... Error! Bookmark not defined. 3.1.1. Cau .................................................. Error! Bookmark not defined. 3.1.2. Da .................................................................................................. 27 3.1.3. Chui ............................................................................................... 32 3.2. Nghin cu thnh phn ha hc ........................................................ 38 3.3. Nghin cu nh hng in vitro ca bi thuc trn qu trnh ng mu v trn s ngng tp tiu cu ........................................................... 45 3.4. Bn lun ............................................................................................... 51 Chng 4. KT LUN V XUT ....................................................... 54 4.1. Kt lun ................................................................................................ 54 4.2. xut ................................................................................................. 55 TI LIU THAM KHO DANH MC CC K HIU, CH VIT TT APTTThi gian Cephlin kaolin dddung dch GS.Gio s IC

Nng c ch ti thiu INCIMEDI Nghin cu tm sot huyt khi tnh mch su chi di khng triu chng NXB. Nh xut bn pp. page PTThi gian Quick tr. Trang TTThi gian thrombin DANH MC CC BNG Bng 1: Mt s loi thuc chi Musa Vit Nam Bng 2:Cc yu t ng mu.Bng 3: Ktqunhtnhccnhmchttrong3dcliucabi thuc bng phn ng ha hc Bng 4: Kt qu nh tnh cc nhm cht ca bi thuc bng phn ng ha hcBng 5: Thnh phn cc mu trong quy trnh th nghim nh gi nh hng ca bi thuc trn qu trnh ng mu Bng 6: Ktqunhginhhnginvitro cabithuctrncc thi gian PT, APTT, TT Bng 7: Thnh phn cc mu trong quy trnh th nghim nh gi nh hng ca bi thuc trn s ngng tp tiu cu Bng 8: Ktqunhginhhnginvitrocabithuctrns ngng tp tiu cu DANH MC CC HNH V Hnh 1.S qu trnh ng mu vi 2 con ng ni sinh v ngoi sinh Hnh 1.1. nh chp cy cau ti thc aHnh 1.2.nh chp cc c im cy cau.Hnh 1.3. nh chp dc liu r cau Hnh 1.4. nh chp vi phu r cau di knh hin vi Hnh 1.5. nh chp c im bt r cau di knh hin vi Hnh 2.1. nh chp cy da Hnh 2.2. nh chp dc liu r da Hnh 2.3. nh chp viphu r da dui knh hin vi Hnh 2.4. nh chp c im bt r da di knh hin vi Hnh 3.1. nh chp cy chui tiu ti thc aHnh 3.2. nh chp cc c im ca cy chui tiu Hnh 3.3. nh chp dc liu r chui tiu Hnh 3.4. nh chp vi phu r chui tiu di knh hin vi Hnh 3.5. nh chp c im bt r chui tiu di knh hin vi 1 T VN Huytkhitnhmchltcnghnmthaynhiuontnhmchnng hocsudoccmungcutobifibrinvhuytcu.Huytkhitnh mch c th gp nhiu ni nhng hay gp nht l chi di [6]. Huyt khi chi di c th theo mu n phi gy tc ng mch phi - gilthuyntcphi,lmtbnhl nngn,cth dn ntvongt ngt. 80% huyt khi tnh mch su khng c triu chng cho n khi xy ra bin chng nghimtrng l thuyn tc phi. Nu bnh nhn khng gp bin chng thuyn tc phi th c n 20-50% sau ny b hi chng hu huyt khi vi biu hin lot, au nhc v gii hn vn ng chi di [15]. Theo cc thng tin c a ra trong '' Hng dn chn oan, iu tri va d phong Thuyn tc-huyt khi tinh mach '' caHitimmchVitNam nm2011,Mminmckhong600.000camimc thuyn tc huyt khi tnh mch v d on c khong180.000 trng hp t vong do bin chng thuyn tc phi ca bnh huyt khi tnh mch su[19], [35]. Nghin cu INCIMEDI l nghin cu tm sot huyt khi tnh mch su chi di khng triu chng ti Vit Nam trn bnh nhn ni khoa nhp vin bng siu mDopplerdoGS.ngVnPhc,GS.PhmGiaKhivGS.Nguyn Ln Vit cng cng s thc hin ti cc bnh vin ln pha Nam v Bc cho thy c 22% bnh nhn c pht hin c huyt khi tnh mch su bng siu m Doppler, mc d khng c triu chng g . Kt qu ny chng minh rng t l huyt khi tnh mch su khng him gp nc ta [15]. Thuc thng c ch nh iu tr bnh huyt khi tnh mch chi l heparinvccthucchngngngung,nhngnhcimcacc thucnylcthgytaibinchymu[4].Mtxuhngkhciutr huyt khi tnh mch chi l s dng cc thuc t dc liu. Trong s cc bi 2 thuc dn gian cha bnh huyt khi tnh mch chi th bi thuc gm r cau, r da, rchui c nhn dn Hng Yn sdng cho hiu qu tng itt.ncta,cycau,cyda,cychuictrngphbinnhiu ni, c s dng rng ri trong i sng v trong y hc. Vi mong mun k tha v tip tc pht huy bi thuc dn gian Hng Yn, chng ti tin hnh ti Nghin cu bi thuc cha huyt khi tnh mch chi v thc vt, ha hc v thm d tc dng in vitro. vi cc mc tiu sau: 1- Nghincucimthcvtvcimvihcca3dcliu trong bi thuc. 2- nh tnh thnh phn ha hc ca 3 dc liu v ca bi thuc. 3- Thm d mt s tc dng in vitro ca bi thuc. 3 Chng 1. TNG QUAN 1.1. Bi thuc cha huyt khi tnh mch chi BithuccnhndnhuynKhoiChu,tnhHngYnsdng gm3vdcliurcauni,rdani,rchuitiu.Ccloirnykhi cntiurtgin,ddngbcbngtay.Dcliuthuvcra sch, ro, ct thnh tng on 2 cm, ly 9 on mi loi, em gi nt, cho vohmtrongmtphchncnnghoccthchovomunsi,ung thaynctrong ngy.Ngibnhunglintctrong1tun,saungh 1 tun tip theo, ri ung tip 1 tun th dng thuc. 1.2. Cy cau 1.2.1. V thc vt -Tn khoa hc:Areca catechu L., h Cau (Arecaceae) [16], [41]. -Tn khc: tn lang, binh lang, may lng (Ty), p lang (K Ho) [16]. -Tn nc ngoi:Areca-nut palm, betel nut palm, areca palm, catechu palm (Anh), arquier, noxi darec (Php) [16]. 1.2.1.1. c im thc vt loi Areca catechu L. Thn n c, mc ng, cao n 20 m, ng knh 10- 20 cm, mu xm, c nhiu vng t thy r. L c b hi phng ln, m ly thn, di ti 1m; cung l di khng qu 5 cm; gn chnh di n 2 m; mi bn gn chnh mang 20-30 l cht xp u n dng lng chim, dng thng ng; trung bnh l cht di 30- 60 cm, phn gia l rng 3-7 cm. Cm hoa l mt bng mo, phn nhnh; c nhiu nhnh hoa nh, ngon ngoo, mu vng lc; hoa c n c, xp xen k thnh 2 hng trn mt nhnh hoa, nh, rt thm gm 3 l 4 i, ba cnh mu trng, 6 nh [16]; hoa ci to hn, mc gc ca nhnh hoa, to hn c, bao hoa khng phn ha, bu trn 3 [16]. Qu mu vng, vng cam, hoc mu , hnh trng, kch thc 8 x 6 cm [16], [41]. 1.2.1.2. Phn b Trn th gii: Cau c ngun gc t Malaysia [41], hin nay c trng nhiu nht cc nc nhit i chu , ng Phi v o Thi Bnh Dng [37]. Ti Vit Nam: Cau l cy trng lu i v quen thuc Vit Nam. Cy c trng khp ni nht l vng trung du v ng bng. Cc tnh pha nam trng nhiu cau hn cc tnh pha bc [16]. 1.2.2. V ha hcThnhphnhahccarcaugmalcaloid,triterpen,ngvnhiu hp cht dbay hi l ester ca cc acid hu c [9], [13], [14]. TdchchitrcauthutihuynBnhSn,tnhQungNgi,mts hpchtcxcnhcutrcbaogm:2alcaloidllamotrigine,2-methyl-4-phenylquinoline,mt s ester nh tetradecanoic acid, 2-hydroxy-1-(hydroxymethyl)ethylester,hexanedioicacid,bis(2-ethylhexyl)ester,9-Octadecenoic acid (Z)-, methyl ester, I-(+)-ascorbic acid 2,6-dihexadecanoat, 1,2-benzenedicarboxylic acid, butyl 2-ethylhexyl ester [9]. Tc gi L Thanh Phc v Bnh Nguyn Anh Ho phn lp c 2 triterpen l lupeol, lupeol acetat vng,-D-trehalose tccphnon dchchitEtherduhavEthylacetatcarcautrngtihuynPhong in, thnh ph Cn Th [13], [14]. 1.2.3. Tc dng sinh hcNghin cu v tc dng chng oxi ha ca dch chit methanol r cau, s dng cht chun i chiu l trolox cIC50=10,14385 g. Kt qu cho thy dchchitmethanolrcauctcdngchngoxihaviIC50=21.1417 g, 5 kh nng chng oxiha tng ng vi cht chun troloxl 0,5998, nu coi kh nng chng oxi ha ca trolox l 1, tin cy ca kt qu th nghim l p