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Journal of Thai Traditional & Alternative Medicine Vol. 11 No. 1 January-April 2013 67
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‰§√⇧√◊Õ°—∫ “√ aristolochic acid cinogenic to humans ∑”„Àâªí®®ÿ∫—πÀπ૬ߓπ∑’Ë
®“°°“√∑’Ëæ◊™ °ÿ≈ Aristolochia à«π¡“°¡’ “√ √—∫º‘¥™Õ∫‡√◊ËÕߧ«“¡ª≈Õ¥¿—¬¢ÕßÕ“À“√·≈–¬“„π
”§—≠‡ªìπ°√¥ aristolochic acids (√Ÿª∑’Ë 1) ´’Ëß∂Ÿ° À≈“¬ª√–‡∑»‰¡àÕπÿ≠“μ„Àâ„ à ¡ÿπ‰æ√ °ÿ≈π’È„π
‡ª≈’ˬπ·ª≈ß„π√à“ß°“¬‡ªìπ “√∑’Ë “¡“√∂®—∫°—∫¥’ μ”√—∫¬“·≈–§≥–∑”ß“π TMHS PWG (Traditional
‡ÕÁπ‡Õ‰¥â ®÷߇ªìπæ‘…μàÕ¬’π·≈–Õ“®π”‰ª Ÿà°“√‡°‘¥ Medicines - Health Supplements Product
¡–‡√Á߉¥â ·≈–‰§√⇧√◊Õ‡ªìπæ◊™„π °ÿ≈π’ȇ™àπ°—π »Ÿπ¬å Working Group) ¢ÕßÕ“‡´’¬π¿“¬„μâ ACCSQ
æ—≤𓬓‰∑¬·≈– ¡ÿπ‰æ√ °√¡æ—≤π“°“√·æ∑¬å (ASEAN Consultative Committee on Stan-
·ºπ‰∑¬·≈–°“√·æ∑¬å∑“߇≈◊Õ°®÷߉¥â«‘‡§√“–ÀåÀ“ dards and Quality) ‰¥â®—¥„Àâæ◊™ °ÿ≈ Aristolochia
aristolochic acids „πμ—«Õ¬à“߉§√⇧√◊Õ®“° 3 ·À≈àß ‡ªìπ ¡ÿπ‰æ√„π negative list §◊Õ‰¡à„Àℙ⇪ìπ
‰¥â·°à ‡™’¬ß„À¡à Õÿμ√¥‘μ∂å ·≈–®“°√â“π¢“¬¬“·ºπ Õߧåª√–°Õ∫„πμ”√—∫¬“·ºπ¥—È߇¥‘¡‡™àπ‡¥’¬«°—π
‚∫√“≥√â“πÀπ÷Ëß„π°√ÿ߇∑æœ æ∫ aristolochic acid ∑—Èßπ’ȇπ◊ËÕß®“°§π∑’Ë°‘πæ◊™∑’Ë¡’ aristolochic acid „π
1 √âÕ¬≈– 0.31, 0.34 ·≈– 0.31 ‚¥¬πÈ”Àπ—° (%w/ ¢π“¥ ŸßÀ√◊Õ‰¥â√—∫μàÕ‡π◊ËÕ߇ªìπ‡«≈“π“π ¡’‚Õ°“ Ÿß
w) à«π„πμ”√—∫¬“«‘ —¡æ¬“„À≠à´÷Ëß¡’‰§√⇧√◊Õ‡ªìπ ∑’Ë®–‡°‘¥‚√§‰μ (nephropathy) ·≈–¡–‡√ÁߢÕß
μ—«¬“ 1 „π 20 μ—«¬“„π Ÿμ√μ”√—∫π’È æ∫ aristolochic ‡¬◊ËÕ∫ÿº‘«¢Õß∑“߇¥‘πªí “«– à«π∫π [urothelial
4 1
acid 1 ª√–¡“≥√âÕ¬≈– 0.01 ·≈–¡’√“¬ß“π°“√μ√«® carcinoma of upper urinary tract (UUC)] ‰¥â·°à
æ∫ aristolochic acids „πμ—«Õ¬à“ß√“°‰§√⇧√◊Õ∑’Ë °√–‡æ“–ªí “«– ∑àÕ‰μ °√«¬‰μ æ∫«à“¢π“¥ – ¡
‡°Á∫®“°ªÉ“·≈–∑’Ë´◊ÈÕ®“°√â“π¢“¬ ¡ÿπ‰æ√‡¡◊ËÕμ√«® (cumulative dose) ¢Õßæ◊™ °ÿ≈ Aristolochia ∑’Ë
1
Õ∫¥â«¬«‘∏’ Thin Layer Chromatography °‘π‡ªìπªí®®—¬‡ ’ˬß∑’Ë ”§—≠ ‚¥¬æ∫«à“À“°°‘πæ◊™
æ«°π’È 200 °√—¡ (average herbal intake) ®–
æ◊™ °ÿ≈ Aristolochia ·≈– “√ aristolochic 8
¡’§«“¡‡ ’Ë¬ß 50% ∑’Ë®–‡°‘¥¡–‡√Áß
acid °—∫°“√‡°‘¥‚√§‰μ·≈–¡–‡√ÁߢÕß√–∫∫
À≈—°∞“π∑’ˬ◊π¬—πƒ∑∏‘Ï°àÕ¡–‡√ÁߢÕß ¡ÿπ‰æ√
∑“߇¥‘πªí “«–„π§π
°ÿ≈ Aristolochia ‡√‘Ë¡¡“‡¡◊ËÕª√–¡“≥™à«ßμâπ
√“¬ß“π¢ÕßÕߧå°√√–À«à“ߪ√–‡∑»¥â“π°“√«‘®—¬ §√‘ μå∑»«√√…∑’Ë 1990 ®“°°“√æ∫ºŸâªÉ«¬‚√§‰μ«“¬
‚√§¡–‡√Áß (International Agency for Research ®”π«π¡“°°«à“ 100 §π „πª√–‡∑»‡∫≈‡¬’ˬ¡ à«π
on Cancer, IARC) ´÷Ë߇ªìπÕߧå°√Àπ÷Ëß¿“¬„μâ ¡“°‡ªìπºŸâÀ≠‘ß ‡¡◊ËÕ¡’°“√ Õ∫ «π‚√§®÷ßæ∫«à“
Õߧ尓√Õπ“¡—¬‚≈° √–∫ÿ«à“¡’À≈—°∞“π‡æ’¬ßæÕ (suf- ºŸâªÉ«¬‡À≈à“π’ȉ¥â√—∫¬“≈¥§«“¡Õâ«π´÷Ë߇ªìπμ”√—∫¬“
ficient evidence) «à“æ◊™„π °ÿ≈ Aristolochia ∑”„Àâ ®’π®“° ¡ÿπ‰æ√®“°§≈‘π‘°‡¥’¬«°—π„π°√ÿß∫√— ‡´≈
‡°‘¥¡–‡√ÁߢÕß°√«¬‰μ (renal pelvis) ·≈–∑àÕ‰μ ¬“μ”√—∫π’ÈÕ—π∑’Ë®√‘ßμâÕß¡’μ—«¬“ ¡ÿπ‰æ√ Stephania
(ureter) „π§π‰¥â ·≈–®—¥„Àâ∑—Èßμ”√—∫¬“®“° ¡ÿπ‰æ√ tetrandra (Han Fang Ji) ´÷Ëß¡’ƒ∑∏‘Ï¢—∫ªí “«– ·μà
5
∑’Ë¡’æ◊™ °ÿ≈ Aristolochia , æ◊™∑’Ë¡’ “√ aristolochic
*A malignant neoplasm derived from transitional epithe-
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acid ·≈–μ—« “√ aristolochic acid Õ¬Ÿà„π°≈ÿà¡∑’Ëé
lium, occurring chiefly in the urinary bladder, ureter, or
°àÕ„À⇰‘¥¡–‡√Áß„π§π‰¥âé §◊Õ Õ¬Ÿà„π Group 1 - car- renal pelvis
