活力藥師網

驅特異Zyretc是一種抗組織胺antihistamine，對於過敏有相當的療效驅特異的成份為Cetirizine,Cetirine為Anti-H1之抗過敏治療劑且無明顯的Anti-Cholinergic及Anti-Serotonin作用

在有效劑量內Cetirine不會通過腦血管障璧對中樞神經沒有作用部會產生安眠及行為異常現象

衛生署核可適應症為季節性鼻炎結合膜炎過敏性鼻炎蕁麻疹過敏性搔癢等過敏現象
Cetirizine的作用

1. 迅速抑制外生性組織胺
2. 對內生性組織胺的釋出有抑制作用
3. 抑制由Vasoactive Intestinal Polypeptide和Substance P所引起之過敏反應
4. 抑制初期皮膚過敏反應時組織胺界質的作用
5. 明顯抑制發炎性細胞(例如esoinophils)的移動,而降低持發性皮膚過敏反應的介質釋放
6. 顯著的降低氣喘患者的支氣管對組織胺的過度反應
7. 降低由特殊過敏原引起的過敏反應

也不知道是不是這市場太好賺，自從第一個益生菌品牌樂亦康上市以後，陸續就有許多的廠牌出現在市面上，大部分的廠牌都要號稱是許清祥博士研發或者是指導，好像沒有沾上許清祥博士的話，這益生菌就算不得準，另外益生菌都要強調自己是活菌，似乎只要強調活菌就可以賣上很高的價錢!!!我們就來介紹一下幾個常見的廠牌吧!!

樂亦康

可以說是益生菌的始祖，當初由許清祥博士創立景岳和光惠這兩家公司，景岳打算走生物科技代工平台，光惠負責銷售 ；計畫相當不錯，經過了幾年的銷售以後，在市場上已經有相當的知名度了．

益敏康(康敏)

益敏康算是跟樂亦康有點親戚關係，這東西還是許清祥博士發明的，他創立了景岳以後，因為一些原因，居然跟Apple的賈伯斯一樣，被趕出了董事會，只好流浪到淡水，到了東宇公司以後，又重新做了益敏康這個品牌．

這是一個新手媽媽在msn上問我的問題，基於可能也有新手媽媽會有這樣的疑問，我就一起在這邊回答!!!

這個問題的答案是沒有任何關係，過敏的定義就不在這邊討論，不過還是要解釋一下喝牛奶會拉肚子的原因.

不知道是不是因為上帝不小心漏掉還是故意安排的，東方人喝牛奶來就比較容易拉肚子，而西方人不會，所以東方人只好喝豆漿代替，西方人不知道是不是因為喝牛奶，所以長的又高又壯，但是因為拉肚子而不喜歡喝牛奶的人，倒是占大部分.

我們吃進去的東西要消化，得靠身體裡面各種各樣的enzyme(有翻譯成酶或者是酵素)，如果喝了牛奶以後，身體裡面的一種乳糖酶就要開始工作了，這種酶負責把牛奶裡面的乳糖分解成葡萄糖及半乳糖，但是如果身體裡面的乳糖酶不夠多，而不能夠把乳醣分解成葡萄糖及半乳糖，以致腸內堆積大量的乳糖，而這些乳糖就會被腸道中的壞菌所利用，趁機將乳糖分解成氫氣、二氧化碳、乳酸、以及其他的有機酸刺激腸道，而且這許多代謝產物使腸內的滲透壓升高，所以許多水分便滲透到腸管裏面去，將腸腔脹得比較大，因而出現拉肚子、腹脹或腹絞痛等症狀,我們稱之為”乳醣不耐症”，在東方人當中是一種常見的營養吸收障礙,甚至高達九成的比例.

那如果是喝牛奶會拉肚子的話，是不是所有的乳製品都不能碰呢???其實也不是，反而優酪乳可以喝(或者是所有的乳酸菌飲料都可以)因為乳酸菌可以幫忙將乳糖分解，以減少乳糖不耐症的發生．

乳糖不耐症分為原發性及續發性，原發性的先天性乳糖不耐症，指從嬰兒時期一喝奶就腹瀉(這時候要到藥局去買貴貴的止瀉奶粉)，續發性則是因腸胃炎造成腸黏膜受損而無法正常吸收乳糖(這時候也要乖乖的去買止瀉奶粉，吃個兩星期，等到腸胃恢復正常才能改喝一般的奶粉)，而國人最常見的則屬原發性.

那如何改善乳糖不耐症呢??有幾個簡單的方法
1.減少喝奶量,因為喝的少，相對乳糖的量會少一點
2.多喝一段時間讓腸子適應，每天喝牛奶使腸內的乳糖脢受刺激逐漸增加到一定的程度
3.奶粉沖泡稀一點
4.喝溫牛奶

對於習慣過敏的老病號來說，每當季節交替時，便會開始打噴涕、鼻塞，衛生紙是整包整包的的用，甚至整天昏昏沉沉，實在讓人痛苦不堪；不過季節的交替一年也碰不上幾次，但有一種病患是對食物過敏者，急性會引起全身紅疹，更會於生活中表現不明頭痛、酸痛、關節疼痛等症狀，也找不出過敏原，造成生活上極度的不便。如果你也曾經出現過上述症狀，可是卻找不到確定原因為何，千萬不要以為是卡到陰，有可能是過敏惹的禍！

許多過敏患者一遇到過敏原，就會立即出現過敏症狀，這非常容易分辨與判斷，但卻也有不少的過敏，並非在接觸過敏原當下就會展現，可能是重複接觸過敏原數天之後，才會慢慢出現，這種過敏稱為「延遲性過敏」。「延遲性過敏」與「立即性過敏」有些不同，延遲性過敏者是因為長期攝食某種食物，例如牛奶、堅果類食物等等，導致免疫系統對此類食物出現過敏反應，症狀除了皮膚問題之外，多以關節酸疼、肌肉酸痛、頭痛或慢性疲勞等表現。

現在人工作壓力大，所以上述症狀容易讓人誤以為是工作壓力過大的症狀，但即使辭去工作還是一樣，就可以考慮往過敏的方向思考。

下一篇介紹嬰兒拉肚子的問題

說起這益生菌，市場上可說是五花八門，但不是所有的菌種都有一樣的效果，所以今天高藥師就來介紹一下益生菌的菌種

Lactobacillus paracasei，也就是LP菌，益生菌的先鋒，市場上第一個打益生菌的樂亦康，就是主要添加LP菌，但是在LP菌的這麼多菌株中，並不是每一菌株都有效，經過長時間的實驗，才確定Lactobacillus paracasei 33，這一株菌，有最棒的效果，稱之為Lp33，也因為良好的效果，統一集團才把這個Lp33菌加入他們的優酪乳裡面，你到7-11都可以買到。

Lactobacillus Fermentum，也就是LF菌，根據一篇2005年的醫學報導，Lactobacillus Fermentum用於治療異位性皮膚炎之效果相當優良，實驗中有26個病患服用LF菌，27個服用安慰劑。

Clin Exp Allergy. 2005 Dec ;35 (12):1557-64 16393321
Clinical effects of probiotics are associated with increased interferon-gamma responses in very young children with atopic dermatitis.
Background We recently demonstrated that administration of probiotics resulted in significant clinical improvement in very young children with moderate-to-severe atopic dermatitis (AD). The purpose of this study was to determine the underlying immunological effects that are associated with these apparent clinical benefits. Methods Peripheral blood mononuclear cells (PBMC) were isolated from children (n=53) at baseline and at the end of an 8-week supplementation period during which they received a probiotic (Lactobacillus fermentum PCCtrade mark) (n=26) or a placebo (n=27). A further sample was collected at 16 weeks (8 weeks after ceasing the supplement). Cytokine (IL-5, IL-6, IL-10, IL-13, IFN-gamma and TNF-alpha) responses to allergens (egg ovalbumin (OVA), beta lactoglobulin (BLG), house dust mite (HDM)), vaccines (tetanus toxoid (TT)), diphtheria toxoid (DT)), intestinal flora (heat-killed Lactobacillus (HKLB)), heat-killed Staphylococcus aureus (HKSA), Staphylococcus aureus enterotoxin B (SEB) and mitogen (phytohaemaglutinin (PHA)) were compared. Results The administration of probiotics was associated with a significant increase in T-helper type 1(Th1-type) cytokine IFN-gamma responses to PHA and SEB at the end of the supplementation period (week 8: P=0.004 and 0.046) as well as 8 weeks after ceasing supplementation (week 16: P=0.005 and 0.021) relative to baseline levels of response. No significant changes were seen in the placebo group. The increase in IFN-gamma responses to SEB was directly proportional to the decrease in the severity of AD (r=-0.445, P=0.026) over the intervention period. At the end of the supplementation period (week children receiving probiotics showed significantly higher TNF-alpha responses to HKLB (P=0.018) and HKSA (P=0.011) but this was no longer evident when supplementation ceased (week 16). Although IL-13 responses to OVA were significantly reduced in children receiving probiotics after 8 weeks (P=0.008), there were no other effects on allergen-specific responses, and this effect was not sustained after ceasing supplementation (week 16). There were no effects on vaccine-specific responses, or on responses to any of the stimuli assessed. Conclusion The improvement in AD severity with probiotic treatment was associated with significant increases in the capacity for Th1 IFN-gamma responses and altered responses to skin and enteric flora. This effect was still evident 2 months after the supplementation was ceased. The lack of consistent effects on allergen-specific responses suggests that the effects of probiotics may be mediated through other independent pathways, which need to be explored further.

Lactobacillus Rhamnosus GG，也就是LGG菌，是相當有名的一隻菌株，是屬於鼠李糖乳酸桿菌的菌種，醫學上對於它的研究資料相當的多。芬蘭的科學家曾經在世界知名的Lancet研究期刊l發表了重要的研究成果，他們選定具有異位性體質家族病史的159位孕婦，其中治療組孕婦在生產前2-4週就需每日服用二顆內含一百億單位的LGG菌，產後如有餵母奶的婦女仍需繼續服用，若沒餵母奶的嬰兒則開始餵食LGG菌至嬰兒六個月大。結果共有132位孕婦完成研究並追蹤直到其小孩滿二歲為止，研究發現，餵食益生菌治療組的64位婦女的小孩中只有15位在二歲前出現異位性皮膚炎的症狀；而對照組68位婦女的小孩則有31位在二歲前出現異位性皮膚炎，因此服用LGG菌似乎具有顯著的預防異位性皮膚炎發生的效果。

Lactobacillus johnsonii，也就是LJ菌，我稍微搜尋一下，並沒有國際醫學上的發表，但是在國內台大有做實驗，只是不知道這樣的報告能不能算數。不過在我的臨床經驗，對於蕁麻疹，異位性皮膚炎還不錯。

Lactobacillus paracasei Collins et al. 1989, sp. nov.
Type strain: strain ATCC 25302 = CCUG 32212 = CIP 103918 = DSM 5622 = IFO (now NBRC) 15889 = JCM 8130 = LMG 13087 = NCIMB 700151 (formerly NCDO 151).
Reference: COLLINS (M.D.), PHILLIPS (B.A.) and ZANONI (P.): Deoxyribonucleic acid homology studies of Lactobacillus casei, Lactobacillus paracasei sp. nov., subsp. paracasei and subsp. tolerans, and Lactobacillus rhamnosus sp. nov., comb. nov. Int. J. Syst. Bacteriol., 1989, 39, 105-108.

—> Lactobacillus paracasei nom. rejic.
Reference: DICKS (L.M.T.), Du PLESSIS (E.M.), DELLAGLIO (F.) and LAUER (E.): Reclassification of Lactobacillus casei subsp. casei ATCC 393 and Lactobacillus rhamnosus ATCC 15820 as Lactobacillus zeae nom. rev., designation of ATCC 334 as the neotype of L. casei subsp. casei, and rejection of the name Lactobacillus paracasei. Int. J. Syst. Bacteriol., 1996, 46, 337-340.
Original article in IJSEM Online

Note 1: According to Rule 56a of the International Code of Nomenclature of Bacteria (1990 revision), only the Judicial Commission can place a name on the list of rejected names. Therefore, this proposal is provisional and needs to be awarded by the Judicial Commission.

Note 2: In a previous paper, Dellaglio et al. 1991 [1] requested that ATCC 334 be designated in place of ATCC 393 as the neotype of Lactobacillus casei subsp. casei and that Lactobacillus paracasei be rejected as a synonym of Lactobacillus casei, as the latter would be defined by the proposed neotype. The Judicial Commission concluded that there is not enough basis for concern about confusion leading to serious consequences in industrial microbiology to justify awarding an exception to the Rules and voted to deny the request [2].
References:
1 DELLAGLIO (F.), DICKS (L.M.T.), Du TOIT (M.) and TORRIANI (S.): Designation of ATCC 334 in place of ATCC 393 (NCDO 161) as the neotype strain of Lactobacillus casei subsp. casei and rejection of the name Lactobacillus paracasei (Collins et al., 1989). Request for an opinion. Int. J. Syst. Bacteriol., 1991, 41, 340-342.
2 WAYNE (L.G.): Actions of the Judicial Commission of the International Committee on Systematic Bacteriology on requests for opinions published between January 1985 and July 1993. Int. J. Syst. Bacteriol., 1994, 44, 177-178.

Note 3: The proposal of Dicks et al. 1996, is sustained by Mori et al. 1997 [1], and by the Subcommittee on the taxonomy of Bifidobacterium, Lactobacillus and related organisms [2, 3].
References:
1 MORI (K.), YAMAZAKI (K.), ISHIYAMA (T.), KATSUMATA (M.), KOBAYASHI (K.), KAWAI (Y.), INOUE (N.) and SHINANO (H.): Comparative sequence analyses of the genes coding for 16S rRNA of Lactobacillus casei-related taxa. Int. J. Syst. Bacteriol., 1997, 47, 54-57.
Original article by Mori et al. 1997 in IJSEM Online
2 BIAVATI (B.): International Committee on Systematic Bacteriology. Subcommittee on the taxonomy of the Bifidobacterium, Lactobacillus and related organisms. Minutes of the meetings, 26 and 29 August 1996, Budapest, Hungary. Int. J. Syst. Evol. Microbiol., 2001, 51, 257-258.
Original article by Biavati 2001 in IJSEM Online (PDF Format)
3 KLEIN (G.): International Committee on Systematic Bacteriology. Subcommittee on the taxonomy of Bifidobacterium, Lactobacillus and related organisms. Minutes of the meetings, 22 and 23 September 1999, Veldhoven, The Netherlands. Int. J. Syst. Evol. Microbiol., 2001, 51, 259-261.
Original article by Klein 2001 in IJSEM Online (PDF Format)

Note 4: Dellaglio et al. request that the strains of Lactobacillus casei and Lactobacillus paracasei Collins et al. 1989 be united into a single taxon, Lactobacillus casei.
Reference: DELLAGLIO (F.), FELIS (G.E.) and TORRIANI (S.): The status of the species Lactobacillus casei (Orla-Jensen 1916) Hansen and Lessel 1971 and Lactobacillus paracasei Collins et al. 1989. Request for an Opinion. Int. J. Syst. Evol. Microbiol., 2002, 52, 285-287.
Original article in IJSEM Online

Lactobacillus paracasei subsp. paracasei Collins et al. 1989, subsp. nov.
Type strain: strain ATCC 25302 = CCUG 32212 = CIP 103918 = DSM 5622 = IFO (now NBRC) 15889 = JCM 8130 = LMG 13087 = NCIMB 700151 (formerly NCDO 151).
Reference: COLLINS (M.D.), PHILLIPS (B.A.) and ZANONI (P.): Deoxyribonucleic acid homology studies of Lactobacillus casei, Lactobacillus paracasei sp. nov., subsp. paracasei and subsp. tolerans, and Lactobacillus rhamnosus sp. nov., comb. nov. Int. J. Syst. Bacteriol., 1989, 39, 105-108.

Note: The taxon Lactobacillus paracasei subsp. paracasei Collins et al. 1989, encompasses the type strain of Lactobacillus casei subsp. alactosus Mills and Lessel 1973 (Approved Lists 1980) and the type strain of Lactobacillus casei subsp. pseudoplantarum Abo-Elnaga and Kandler 1965 (Approved Lists 1980).

Lactobacillus fermentum Beijerinck 1901, species.
Type strain: strain ATCC 14931 = CCUG 30138 = CIP 102980 = DSM 20052 = IFO (now NBRC) 15885 = JCM 1173 = LMG 6902 = NCCB 46038 = NCIMB 11840 (formerly NCDO 1750) = NRRL B-4524.
Synonyms: “Bacillus δ” von Freudenreich 1895, “Bacillus casei δ” von Freudenreich and Thöni 1904, “Lactobacterium fermentum” (Beijerinck 1901) van Steenberge 1920.
Etymology: L. neut. n. fermentum (nominative in apposition), that which causes fermentation, leaven, ferment.
References: SKERMAN (V.B.D.), McGOWAN (V.) and SNEATH (P.H.A.) (editors): Approved Lists of Bacterial Names. Int. J. Syst. Bacteriol., 1980, 30, 225-420. [BEIJERINCK (M.W.): Sur les ferments lactiques de l'industrie. Archives Néerlandaises des Sciences Exactes et Naturelles (Section 2), 1901, 6, 212-243.]

Lactobacillus johnsonii Fujisawa et al. 1992, sp. nov.
Type strain: strain ATCC 33200 = CCUG 30725 = CIP 103620 = DSM 10533 = JCM 2012 = VPI 7960.
Reference: FUJISAWA (T.), BENNO (Y.), YAESHIMA (T.) and MITSUOKA (T.): Taxonomic study of the Lactobacillus acidophilus group, with recognition of Lactobacillus gallinarum sp. nov. and Lactobacillus johnsonii sp. nov. and synonymy of Lactobacillus acidophilus group A3 (Johnson et al. 1980) with the type strain of Lactobacillus amylovorus (Nakamura 1981). Int. J. Syst. Bacteriol., 1992, 42, 487-491.

Lactobacillus rhamnosus (Hansen 1968) Collins et al. 1989, comb. nov.
Type strain: strain ATCC 7469 = CCUG 21452 = CIP A157 = DSM 20021 = IFO (now NBRC) 3425 = JCM 1136 = LMG 6400 = NCAIM B.01147 = NCCB 46033 = NCIMB 6375 (formerly NCDO 243) = NCTC 12953 = NRRL B-442 = VKM B-574.
Basonym: ¤ Lactobacillus casei subsp. rhamnosus Hansen 1968 (Approved Lists 1980).
Reference: COLLINS (M.D.), PHILLIPS (B.A.) and ZANONI (P.): Deoxyribonucleic acid homology studies of Lactobacillus casei, Lactobacillus paracasei sp. nov., subsp. paracasei and subsp. tolerans, and Lactobacillus rhamnosus sp. nov., comb. nov. Int. J. Syst. Bacteriol., 1989, 39, 105-108.

Note: In the paper by Collins et al. 1989, Lactobacillus rhamnosus is proposed as a new species.

下一篇要介紹益生菌常見的廠牌