水飛薊素 / 奶薊草
**水飛薊素 (Silymarin)** 是一種從奶薊草 (*Silybum marianum*) 種子中提取的黃酮木脂素複合物。它在獸醫學中被廣泛用作**肝臟保護營養保健品**。 * **主要用途：** 用於犬、貓及其他物種的急慢性肝病、肝硬化及發炎性肝病的管理。 * **毒素解毒劑：** 在攝入嚴重肝毒性物質（如毒鵝膏蘑菇 *Amanita phalloides*）後，作為肝臟保護劑的作用尤為顯著。 * **腫瘤學支持：** 新興的實驗室數據表明，它可能有助於預防某些癌症，並減輕特定化療方案的肝毒性副作用。 > **臨床要點：** 由於水飛薊素是一種營養保健品，市售非處方產品的品質和生物利用度差異極大。強烈建議使用獸醫專用配方（水飛薊賓與磷脂醯膽鹼結合的植物脂質體技術），因為其胃腸道吸收率遠優於標準提取物。
作用機制: Silymarin exerts its hepatoprotective effects through multiple synergistic pathways. **Silibinin** (or silybin) is the most biologically active component of the complex. * **Antioxidant & Free Radical Scavenging:** Inhibits lipid peroxidase and beta-glucuronidase. It directly scavenges reactive oxygen species (ROS) and significantly increases intracellular **glutathione** levels in the liver. * **Membrane Stabilization:** Alters the outer hepatocyte cell membrane structure, competitively blocking the binding and transmembrane transport of hepatotoxins (e.g., amatoxins from poisonous mushrooms). * **Anti-inflammatory:** Inhibits the cytotoxic, inflammatory, and apoptotic effects of **Tumor Necrosis Factor-alpha (TNF-α)** and modulates leukotriene synthesis. * **Antifibrotic:** Reduces hepatic stellate cell activation, thereby decreasing hepatic collagen formation and slowing the progression of cirrhosis. * **Regenerative:** Stimulates ribosomal RNA polymerase A → enhances protein synthesis and accelerates hepatocyte regeneration.
各物種劑量
- Therapeutic dosage (general) · 50-250 mg/day · PO · q24h · Suggested dose range
- Adjunctive therapy for chronic liver disease · 20-50 mg/kg per day · PO · q24h · Extrapolated from human, monkey, rodent and dog research
- Chronic liver disease and ameliorating the effects of anticonvulsants · 50-200 mg · PO · q12-24h
- Hepatotoxicity, hepatic recovery/regeneration, hepatic fibrosis · 20-50 mg/kg/day · PO · q24h
- General hepatic support · 4-8 mg/kg/day · PO · q24h
- Therapeutic dosage (general) · 50-250 mg/day · PO · q24h · Suggested dose range
- Adjunctive therapy for chronic liver disease · 20-50 mg/kg per day · PO · q24h · Extrapolated from human, monkey, rodent and dog research
- Chronic liver disease and ameliorating the effects of anticonvulsants · 50-200 mg · PO · q12-24h
- Hepatotoxicity, hepatic recovery/regeneration, hepatic fibrosis · 20-50 mg/kg/day · PO · q24h
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Known hypersensitivity or allergy to the Asteraceae/Compositae plant family (ragweed, marigolds, daisies)
- Use caution with whole plant extracts (not the seed extract) in patients where exogenous estrogens are contraindicated, due to potential estrogen-like activity
不良反應
- Gastrointestinal upset (mild nausea, vomiting, diarrhea)
- Allergic reactions in patients sensitive to the Asteraceae/Compositae plant family
- Generally very well tolerated
- Rare mild gastrointestinal upset
藥物相互作用
- CYP2C9 Substrates (e.g., warfarin, amitriptyline, verapamil) · Silymarin may inhibit cytochrome P450 isoenzyme 2C9 (CYP2C9). Use caution with narrow therapeutic index drugs metabolized by this pathway.
- CYP3A4 Substrates · May inhibit CYP3A4, though clinical significance is currently undetermined.
- Drugs undergoing hepatic glucuronidation (acetaminophen, diazepam, morphine, lamotrigine) · Silymarin may increase the clearance of these drugs (not applicable in cats). Clinical significance is undetermined.
監測
- Clinical efficacy (resolution of clinical signs)
- Liver enzyme panels (ALT, AST, ALP, GGT)
- Hepatic function tests (Bilirubin, Bile Acids, BUN, Albumin)
- Liver enzymes (ALT, AST, ALP, GGT)
- Total bilirubin
- Bile acids
- Clinical signs of hepatic disease (e.g., icterus, lethargy, appetite)
過量
Overdoses are highly unlikely to cause significant morbidity due to the supplement's high safety margin. Mild gastrointestinal effects (vomiting, diarrhea) may be seen and should be treated in a supportive and symptomatic manner.
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