水飞蓟(Milk thistle，Silybum marianum)

　　菊科(Asteraceae)水飞蓟属(Silybum)

　　学名：Silybum marianum

　　中文名：水飞蓟、乳蓟

【简介】

　　水飞蓟原生于地中海地区，之后广泛种植于东亚、欧、美和澳洲#3。水飞蓟的次级代谢物─水飞蓟素(silymarin)是主要的活性成分，它是混合物，由4种黄酮类成分组成，分别是水飞蓟宁(silidianin)、异水飞蓟宾(isosilibinin)、水飞蓟宾(silibinin)和水飞蓟丁(silichristin)#4，这些物质多存在于种子部分#1,5。不过，近期有研究表示，类似水飞蓟素结构的黄酮类物质，在紫花和白花品种其实可分离出合计多达23种#6。

民俗疗法

　　早在1世纪时水飞蓟即有药用纪录#7，它的花可用于毒菇误食的解毒#8，欧洲地区将花、叶和根部作为蔬菜食用。其种子萃取液被视为强肝补品，可预防或逆转肝中毒，且用于治疗肝、胆相关疾病已有2000年以上历史，包含肝炎、肝硬化、黄疸等症状#2,9-10。

特殊族群

　　水飞蓟可安全地使用于孩童#11、长者#12和怀孕妇女#13-14。水飞蓟也适合正接受癌症治疗的病患，因为它具有血液和肝脏的解毒功效#5,15。

【护肝功效】反应机制

　　水飞蓟宾能活化DNA聚合酵素、再生肝细胞和rRNA，并藉由抑制5-脂氧化酵素(5-lipoxygenase)生理路径减少肝发炎#5,16。大部分护肝的作用原理也包含自由基清除机制#1，水飞蓟素能促进活化淋巴细胞内抗氧化酵素#17-20，进而有稳定肝细胞膜、中和自由基和免疫调节等功效#10。

研究

　　根据大鼠研究#1，怀孕期间摄取水飞蓟素能有效预防酒精对腹中胎儿肝脏、脑部和胼胝体的危害。多项动物研究也证明水飞蓟素可保护肝脏减少多种化学毒素的危害，例如：四氯化碳(Carbon tetrachloride)#21、氟烷(halothane)#22和乙醯胺酚(acetaminophen)等#10,23-24。

　　40位酒精型肝硬化患者组成的临床试验结果#25-26，为期1个月的水飞蓟素治疗能使肝功能指数回复正常、活化淋巴细胞、减少酒精敏感性酵素的释放。每日2次服用240 mg水飞蓟宾(IdB-1016)的慢性肝炎患者#27，经7天治疗可有效降低肝指数，改善肝功能。97位多数因酗酒导致肝炎或肝指数异常患者参与的试验指出#28，每日服用420 mg水飞蓟素持续4周可明显降低肝指数，恢复正常肝功能。

　　从1986到1989年的追踪试验#29，每日3次给予103位酒精性肝硬化患者150 mg水飞蓟素持续2年，最终完成试验的57位患者结果表示，和未服水飞蓟素的对照组相比，其存活率并无明显差异。但在另一相似条件下包含170位患者的临床显示#30，水飞蓟素有助于增加酒精性肝硬化患者存活率，4年存活率为58%，且无副作用，而对照组仅39%。

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