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Journal of Thai Traditional & Alternative Medicine Vol. 8 Nos. 2-3 May-December 2010 ÚÒÛ
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μ“√“ß∑’Ë Ò º≈°“√„™â√“ß®◊¥, ·Õ‚∑√æ’π ·≈– 2-PAM „π°“√·°âæ‘…‚ø≈‘¥Õ≈ ∑’Ë©’¥‡¢â“„μâº‘«Àπ—ß·°àÀπŸ·√μ„π¢π“¥ Ú ‰¡‚§√≈‘μ√/πÈ”Àπ—°
μ—« Ò °‘‚≈°√—¡ (¢π“¥∑’Ë∑”„ÀâÕ—μ√“μ“¬ª√–¡“≥√âÕ¬≈– ı, LD )*
50
¬“∑’Ë„Àâ·°âæ‘…‚ø≈‘¥Õ≈ Õ—μ√“μ“¬¢ÕßÀπŸ·√μ (√âÕ¬≈–)
Ò. ‰¡à„Àâ¬“·°âæ‘… ıˆ.ˆ˜ ± Û.ÛÛ
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Ú. √“ß®◊¥ (Ú ¡≈./Ò °.) Òˆ.ˆ˜ ± Û.ÛÛ**
Û. √“ß®◊¥ + atropine (Ò/Ò ‡°√π/Ò °. ©’¥‡¢â“„μâº‘«Àπ—ß) ı. ± Ú.¯˜**
Ù. atropine+2-PAM (Úı ¡°./Ò ¡≈./Ò °. ©’¥‡¢â“™àÕß∑âÕß) ı. ± Ú.¯˜**
ı. √“ß®◊¥ + atropine + 2-PAM ıˆ.ˆ˜ ± Û.ÛÛ
ˆ. √“ß®◊¥ + 2-PAM ıˆ.ˆ˜ ± Û.ÛÛ
*¥—¥·ª≈ß®“°μ“√“ß∑’Ë Ù ‡Õ° “√Õâ“ßÕ‘ßÀ¡“¬‡≈¢ ˘
** ·μ°μà“ßÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘μ‘∑’Ë §à“æ’ < .Ò ‡¡◊ËÕ‡∑’¬∫°—∫°≈ÿà¡∑’Ë Ò
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‚ø≈‘¥Õ≈ (Folidol §«“¡‡¢â¡¢âπ√âÕ¬≈– ı ¢Õß Bayer Leverkusen) π”¡“∑”„Àâ‡®◊Õ®“ß Ò/ı °àÕπ„Àâ·°à —μ«å∑¥≈Õß
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πÈ” °—¥√“ß®◊¥‡μ√’¬¡‚¥¬„™â„∫ ¥ Ò °√—¡ ∫¥ ‡μ‘¡πÈ” Ò ¡‘≈≈‘≈‘μ√ À¡—°‰«â Ò π“∑’ °√Õß¥â«¬ºâ“°äÕ´ Ú ™—Èπ ‡Õ“πÈ”‰ªÀ¡ÿπ‡À«’Ë¬ß ·¬°‡Õ“ à«ππÈ”„ ¡“„™â ‚¥¬
°√Õ°„Àâ∑“ßª“°∑—π∑’À≈—ß‰¥â√—∫‚ø≈‘¥Õ≈

ÒÚ ÒÙ
æ“√“‰∑ÕÕπ À√◊Õ‡¡‚∑¡‘≈ (Methomyl ´÷Ëß‡ªìπ “√°”®—¥ √ÿπ·√ß®“°ÕÕ√å°“‚πøÕ ‡øμ ·≈–°”≈—ß‰¥â√—∫°“√√—°…“¥â«¬
»—μ√Ÿæ◊™°≈ÿà¡§“√å∫“‡¡μ) æ∫«à“°≈‰°°“√μâ“πæ‘…¬“°”®—¥»—μ√Ÿ ·Õ‚∑√æ’π·≈– 2-PAM Õ¬Ÿà ‡æ√“–Õ“®∑”„Àâª√– ‘∑∏‘º≈„π°“√
æ◊™¢Õß√“ß®◊¥ Õ“®‡π◊ËÕß®“° “√ °—¥√“ß®◊¥∑”„Àâ√–¥—∫ √—°…“¥â«¬·Õ‚∑√æ’π·≈– 2-PAM ≈¥≈ß

‡Õπ‰´¡å‚§≈’π‡Õ ‡∑Õ‡√ ‡æ‘Ë¡¢÷Èπ À√◊Õ≈¥°“√¬—∫¬—Èß‡Õπ‰´¡å πÕ°‡Àπ◊Õ®“°°≈‰°°“√ÕÕ°ƒ∑∏‘Ï∑’Ë‡°’Ë¬«°—∫‡Õπ‰´¡å
ÒÚ,ÒÙ
‚§≈’π‡Õ ‡∑Õ‡√ μâ“πæ‘…¢Õß‡¡‚∑¡‘≈‚¥¬∑”„Àâ®”π«π ‚§≈’π‡Õ ‡∑Õ‡√ ·≈â« ƒ∑∏‘Ïμâ“πæ‘…¢Õß “√°”®—¥»—μ√Ÿæ◊™¢Õß
‡´≈≈åª√– “∑·≈–‡ âπ„¬ª√– “∑·≈–§«“¡‡¢â¡¢âπ¢Õß‡Õπ‰´¡å √“ß®◊¥ à«πÀπ÷ËßÕ“®‡π◊ËÕß®“°
ÒÚ
acetylcholine esterase ∫√‘‡«≥ duodenal mesenteric O ƒ∑∏‘Ïμâ“π°“√‡°‘¥ lipid peroxidation μâ“π
ÒÙ ¯
plexus ∑’Ë≈¥≈ß®“°æ‘…¢Õß‡¡‚∑¡‘≈°≈—∫‡æ‘Ë¡¢÷Èπ ÕÕ°´‘‡¥™—π μâ“πÕπÿ¡Ÿ≈Õ‘ √– ´÷Ëß™à«¬≈¥°“√∑”≈“¬‡´≈≈å
Õ¬à“ß‰√°Áμ“¡ ¡’ª√–‡¥Áπ∑’Ëπà“ —ß‡°μ‡°’Ë¬«°—∫º≈°“√»÷°…“ O ®“°°“√»÷°…“„π‡´≈≈åμ—∫ Hepa 1C1C7 “√ °—¥
ƒ∑∏‘Ï¢Õß√“ß®◊¥„π°“√μâ“πæ‘…¢Õß‚ø≈‘¥Õ≈À√◊Õ‡Õ∑‘≈ √“ß®◊¥¬—ß¡’ƒ∑∏‘Ï‡æ‘Ë¡ activity ¢Õß‡Õπ‰´¡å NADPH-quinone
æ“√“‰∑ÕÕπ„πÀπŸ·√μ¢Õßæ“≥’ ‡μ™–‡ π ·≈–™—™«¥’ oxidoreductase ´÷Ëß‡ªìπ xenobiotic metabolizing enzyme
ÒÒ ¯
∑Õß∑“∫ ‡¡◊ËÕªï ÚıÚÛ (μ“√“ß∑’Ë Ò) ´÷ËßºŸâ«‘®—¬√“¬ß“π«à“°“√ ∑’Ë™à«¬‡√àßªØ‘°‘√‘¬“√’¥—°™—π¢Õß “√°≈ÿà¡§«‘‚ππ
„™â√“ß®◊¥μâ“πæ‘…‚ø≈‘¥Õ≈®–‰¥âº≈¥’¬‘Ëß¢÷Èπ‡¡◊ËÕ„™â√à«¡°—∫·Õ Ú. ƒ∑∏‘Ïμâ“πæ‘…¢Õß ÿ√“ ®“°°“√∑’Ëª√–™“™π à«πÀπ÷Ëß
‚∑√æ’π (atropine) ´÷Ëß‡ªìπ¬“·°âæ‘…¬“¶à“·¡≈ß°≈ÿà¡ÕÕ√å°“‚π- ‰¥âπ”√“ß®◊¥¡“„™â„π°“√μâ“πæ‘…¢Õß ÿ√“ ‡™àπ „™â‡æ◊ËÕªÑÕß°—π

øÕ ‡øμ™π‘¥Àπ÷Ëß §◊Õ∑”„ÀâÀπŸμ“¬πâÕ¬°«à“°“√„™â√“ß®◊¥ À√◊Õ≈¥Õ“°“√‡¡“‡À≈â“ §≥–‡¿ —™»“ μ√å ®ÿÃ“≈ß°√≥å
‡æ’¬ßÕ¬à“ß‡¥’¬« (°≈ÿà¡ Û ‡∑’¬∫°—∫°≈ÿà¡ Ú) ·≈–ÀπŸ· ¥ßÕ“°“√ ¡À“«‘∑¬“≈—¬ ®÷ß‰¥â»÷°…“«‘®—¬ƒ∑∏‘Ï¢Õß√“ß®◊¥„π°“√μâ“πæ‘…

‡π◊ËÕß®“° cholinergic effect πâÕ¬∑’Ë ÿ¥ ·μà„π°√≥’∑’Ë„™â ¢Õß·Õ≈°ÕŒÕ≈åμàÕμ—∫ æ∫«à“ “√ °—¥¥â«¬πÈ”¢Õß√“ß®◊¥™à«¬
√“ß®◊¥√à«¡°—∫¬“·°âæ‘…·Õ‚∑√æ’π·≈– 2-PAM (pralidoxime) ªÑÕß°—π°“√μ“¬¢Õß‡´≈≈åμ—∫®“°æ‘…¢Õß·Õ≈°ÕŒÕ≈å∑—Èß„π
Òı
®–‡ÀÁπ‰¥â«à“√“ß®◊¥¡’º≈∑”„Àâª√– ‘∑∏‘º≈¢Õß¬“·°âæ‘…·Õ‚∑√ À≈Õ¥∑¥≈Õß·≈–„πÀπŸ·√μ∑’Ë‰¥â√—∫·Õ≈°ÕŒÕ≈å ‚¥¬∑”„Àâ
æ’π·≈– 2-PAM (´÷Ëß‡ªìπ¬“·°âæ‘…ÕÕ√å°“‚πøÕ ‡øμ∑’Ëπ‘¬¡„™â §à“ AST, ALT „πæ≈“ ¡à“·≈– triglyceride „πμ—∫≈¥≈ß
√à«¡°—π∑“ß§≈‘π‘°) ≈¥≈ßÕ¬à“ß¡“° (°≈ÿà¡ ı ‡∑’¬∫°—∫°≈ÿà¡ Û) ·≈–≈¥°“√‡ª≈’Ë¬π·ª≈ß∑“ß®ÿ≈æ¬“∏‘«‘∑¬“¢Õßμ—∫‡¡◊ËÕ‡ª√’¬∫

º≈°“√∑¥≈Õß„πÀπŸ·√μ∑’Ëæ∫„π°“√∑¥≈Õßπ’È‡ªìπ¢âÕ —ß‡°μ«à“ ‡∑’¬∫°—∫ÀπŸ∑’Ë‰¥â√—∫·Õ≈°ÕŒÕ≈åÕ¬à“ß‡¥’¬« ∑—Èßπ’È à«πÀπ÷Ëßπà“
√“ß®◊¥Õ“®‰¡à‡À¡“–∑’Ë®–„™â·°âæ‘…„π°√≥’∑’ËºŸâªÉ«¬¡’Õ“°“√æ‘… ®–‡π◊ËÕß®“° “√ °—¥¥â«¬πÈ”¢Õß√“ß®◊¥™à«¬≈¥°“√‡°‘¥ hepatic

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