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在本研究的第Ⅱ部分 ,已经报告了和芍药甘草汤 (SGT)合用的抗菌剂组合AMPC MET (amoxicillin ,AMPC ,andmetronidazole ,MET)显著降低了SGT中甘草酸 (glycyrrhizin ,GL)的生物利用度 ,原因在于其降低了肠内细菌将GL代谢成甘草次酸 (18β glycyrrheticacid ,GA)的活性。在本文 ,即本研究的第Ⅲ部分 ,笔者对AMPC MET的降低作用的持续时间以及可减少这种作用的适当的合并给药方案进行了探讨。实验结果显示 ,肠内细菌的GL代谢活性被AMPC MET降低后 ,需要 12d才可恢复到正常水平 ,而AMPC MET给药 1d后开始进行SGT给药 ,被AMPC MET显著降低了的肠内细菌的GL代谢活性以及GA血药浓度 4d后得以快速恢复到正常水平。本研究的结果表明 ,在抗菌剂和SGT的合并疗法中 ,为了减少抗菌剂对SGT中GL生物利用度的影响 ,可在抗菌剂给药 1d或 2d后对SGT进行连续投药。该给药方案也可应用于临床上。
In part II of this study, it has been reported that the combination of antibacterial agents AMPC MET (amoxicillin, AMPC, and and metronidazole, MET) combined with peony licorice decoction (SGT) significantly reduces the bioavailability of glycyrrhizin (GL) in SGT. The reason is that it lowers the activity of intestinal bacteria to metabolize GL to glycyrrhetic acid (GA). In this article, Part III of this study, the authors explored the duration of the reduced effect of AMPC MET and the appropriate combined dosing regimen that can reduce this effect. The experimental results showed that the GL metabolic activity of intestinal bacteria was reduced by AMPC MET, it took 12 days to return to normal levels, and after 1 day of administration of AMPC MET, SGT administration was started, and the intestinal bacteria significantly reduced by AMPC MET. The GL metabolic activity and GA plasma concentration quickly returned to normal levels after 4 days. The results of this study indicate that, in the combined therapy of antibacterial agents and SGT, in order to reduce the influence of the antibacterial agents on the bioavailability of GL in SGT, continuous administration of SGT may be performed 1 day or 2 days after the administration of the antibacterial agent. The dosing regimen can also be applied clinically.