VIETHAM MEDICAL JOURNAL N°2 - APRIL • 2018 year review. J Pediatr Surg, 28(1), 92-95.
. Alehossein M (2012). Diagnostic Accuracy of Ultrasound in Determining the Cause of Bilious Vomitmg in Neonates.Iranian Journal of Radiology.
9(4), 190-194.
. Alois H (2011). "Transabdominal ultrasound of the gastrointestinal tract",European Course Book.
', Lawrence, M. J., Ford, W. D., Furness, M. E., Hayward, T., & Wilson, T. (2000). Congenital
duodenal obstruction: early antenatal 6. Couture A (2008). "Bowel Obstrudioti m
Neonates and Children", in Gastrointestinal Traa Sonography in Fetuses and Children, Couture A, Baud C, Editors, Springer: Germany, pp. 131-251 7. Hong Qui Quan (2011), " Chan doin tac'ti
trang bam sinh tai benh vien Viet Ddc giai doan 2004-2011"^ Luan van tot nghiep bac sy noi ttii
Dai hoc y Ha Not. '
TOI U'U HOA QUY TRINH CHIET XUAT MANGIFERIN Tir BAI THUOC BACH HO NHAN SAM THANG GIA VI - GN16
BANG PHAN MEM TIN HOC MODDE 8.0
Vu Binh Dirong', Ngo Thi Tuyet Mai', Nguyin Son Nam"
40% EtOH for 30 minutes at 55°C with ratio of solvent/feed was 11:1 (v/w, L/kq) in 2 tunes, ADDJicatton of this for exb-action of this remedv. the extracted vield archived 95.63%. Conclusion: This pnxedure can be apolied tn the modernization and dilli]
fomis oreoaretion of added Bach hoc Nhan sam RemaV.
Keywords: mangifenne, BHNST remedy, optimization, extraction,
1. DAT VAN OE
Bai thuoc Bach ho' Nhan sam thang nguyen mau gom cac vi thuoc Thach cao (Gypsum), Cam thao (Radix glycyrrhizae), Tri mau {Rhizama Anemarrhenae), Nhan sam (Radix Ginseng), Nganh me (Semen Oryzae Sativae), ia bai thuoc co phu'cfng ed tac dung thanh nhiet giai thu", tran kinh, sinh tan, ehi khat. Tuy nhien, de tang tliem tac dung tang sii'c ben cd tim eung nhu" Iclia nang chju ddng ganh nang nhiet bdi nang nong do bien doi khi hau da gia ttiem vi Oan sam (Radix Salviace lactlflorae). Bai thudc da di/flc nghien cu'u tac dung du'dc ly tren dpng vat thu'c nghiem va thiJ' lam sang cho thay cd ket qua kha quan trong dieu trj say nang say ndng [3,5]. Cac nghien cung chi ra rang cac thanh phan co tac dung ha nhiet chu yeu nhu' magiferir, sasarpogenin trong Tri mau, ton canxi trong Thach eao [4]. Tuy nhien, bai thuoe nay cd tan dang sd dijng dudi dang thude sac. Dang thuoc nay cd nhieu nhu'dc diem nhu': the tieh cong kenh, khd van chuyen, bao quan, sCr dung va do dn djnh khong cao. Vi vay, de gop phan^nang eao tiieu qua sd dung ciia bai thudc nay anco eac nghien cdu hien dai hda bat thudc nhu'chiet xuat hoat chat, bao che cao dmh ehuan, chuyen dang bao ehe hien dai. Trong tjai bao nay, chiJng toi thdng bao l<et qua nghien ctrtJ chiet xuat mangiferin (hoat chat eo tac dung trong Tri man) td bai thuoc Bach ho nhan sam thang gia ^ (BHNST). Day ta giai doan dau tien cua qua trinh nghien cu'u hien dai hoa bai thudc nay.
TOIVI TAT
Muc tieu. Khao sat cac yeu to anh hu'dng va li/a chon dUdc cac dteu kten toi Uu trong quy trinh chiet xuat hoat chat mangiferin tiT bai thuoc Bach ho nhan sam thatig gia vt. Odi tUdng nghien cdu Bai thuoc Bach ho nhan sam thang gia vi. PhUdng phap nghien cdu. chiet xuat mangiferin trong bat thuoc bang phUcJng phap chiet sieu am, tot Uu hoa cac dieu kien chiet xuat bang phan mem Modde 8.0, dmh lu'dng hoat chat mangiferin bang HPLC. Ket qua nghien ahr. Da u'ng dung phan mem tin hgc Modde 8,0 de tot u\j hoa cac yeu to anh hi/dng tdi hteu suat chiet xuat hoat chat mangiferin tir bai thuoc Bach ho nhan sam thang gia vj GN16, ket qua da lu'a chgn dUOc cac dieu kien tdi t/u gom: Sir dung phu'Ong phap chiet sieu am, dung mot chiet la EtOH 40% vdi ty le 11/1, tien hanh chiet xuat 2 lan trong 30 phijt 6 nhiet dp 65"C, Vdt cac dieu kien da lUa chon, hieu suat chiet xuat thu hot hoat chat dat 95,63%. Ket luan: Toi Uu hda du'cfc cac dieu kien trong^quy trinh chiet xuat mangiferin ti!c bat thuoc Bach ho nhan sam thang gia VI vdt hieu suat cao. Vdt ket qua nay c6 the (Tng dung trong nghien ctJU hien dai hda cung nhU san xuat cac dang bao che mdt tir bat thuoc nay.
SUIVIMARY
OPTIMIZATION OF MANGIFERIN EXTRACTION FROM ADDED BACH HO NHAN
SAM REMEDY BY MODDE 8.0 SOFTWAVE Obiective: Evaluate the extracting parameters on the mangifenne extraction procedure from added Bach ho nhan sam remedy. Materials: Added Bach tio nhan sam remedv remedv. Method. Ultrasonic extraction method usinq Modde 8.0 to optimize extraction parameters, quantitative analysis of manqifenne bv HPLC. Results:Ths. optimal condition was established including solvent of extraction was 'Hoc vien Quin y
^ Binh vien TW Quin doi 108 Chiu trach nhiem chinh: VQ Binh DUcfng Email: [email protected] Ngay nhan bat: 18.2.2018 Ngay ph^n bien khoa hoc: 30.3.2018 Ngay duyet bai: 11.4.2018
TAP CHi Y HOC VIET NAM TAP 465 - THANG 4 - SO 2 • 2018
11. NGUYEN V ^ T LIEU VA PHU'aNG PHAP IMGHIEN CU'U
2.1. Nguyen lieu hoa chat, thiet bi: Cae vi du'dc lieu trong tsai thuoc Bai thuoc Bach ho Nhan sam thang gdm: Thach cao (Gypsum), Cam thao (Radixglycyrrhizae), Tri m l u (Rhizoma Anemarrhenae), Nhan sam (Radix Ginseng), Nganh me (Semen Oryzae Sativae), Dan sam (Radix Salviace lactlflorae) dat tieu chuan cd sd va tieu chuan DDVN IV [1], Trong do, khoi lu'cfng Tri mau chiem 12,5% tdng khoi lu'dng bai thuoe.
Hda chat: mangiferin chuan (99,9%) ciiia Sigma; cac hoa chat, dung mdi dat tieu chuan tinh khiet phan ti'ch.
Thiet bj: P4ay chiet sieu am gia nhiet Sineo Uttrawave 1000; He thong phan ti'ch sac ky long hieu nang cao gom bdm cao ap Waters 1525, detector UV V\/ater 2874; va cac thiet bi khae dat beu chuan thi nghiem.
2.2. Phu'dng phip nghien cu'u
• Phu'dng phap chiet xuat: mangiferin du'dc chiet xuat tu' bai thudc bang phu'dng phap chiet khac nhau gom ehiet sieu am, vi song va chiet nong thong thu'dng: Can khoang chinh xac khoang 16 g bpt du'dc lieu ctJa bai thuoc (tiidng du'dng vdi khoang 2,0 g Tri mau), cho vao thiet bj ehiet, them dung mot chiet xuat vdi ty le nhat djnh. Tien hanh chiet xuat d nhiet dp, thdi gian va so tan ehiet trong khoang khao sat. Dich chiet thu du'dc dem ty tam 7000 vong/phtJt, tpc loai bo tap ehat. Bo sung vi^a dtJ the tich, ioc qua mang lpc 0,22|jm. Dinh lu'dng mangiferin trong dich chiet bang HPLC [2], Danh gia thdng qua hieu suat chiet xuat hoat chat
Hieu suat = m mangiferin 100 Trong do: m,nangife.in la khdi lu'dng mangiferin chiet du'cfc. mLT la khdi lu'dng mangiferin co trong bai thuoe. Trong do ham lu'cfng mangiferin trong du'dc lieu du'dc djnh lu'dng bang HPLC trong dich chiet 4 lan (den khi khong cdn phat hien hoat chat).
- Phu'dng phap thiet ke thi nghiem va tdi uli hda Tru'dc kht tien hanh tdi u'u hoa, tien hanh khao sat va tham dd sd bp cae yeu t d anh hu'dng nhieu den hieu suat chiet xuat cung nhu" khoang anh hu'dng. TLT dd Ida chpn dddc cac bien dpc tap va khoang bien dpc lap. Trong nghien eij'u nay ehtjng tdt khao sat eae bien dpc tap (cac yeu to anh hu'dng) gom: phu'dng phap chiet, nhiet dp, dung moi, t^ le dung mdi, thdi gian va so ^ n ehiet.
*Thiet ke thi nghiem: Sd dung phu'dng phap thiet ke theo mo hinh mat hdp tu* tat tam vdi su"
trd giup ciJa phan mem thiet ke thf nghiem tdi
u'u hoa Modde 8.0. [6] de khao sat cac yeu t d anh hu'dng tdi hieu suat chiet xuat. Cac yeu to nay du'dc gpi la tiien ddc lap hay tham so, hieu suat chiet xuat du'dc gpi la bien phtj thupe hay ham so (Y%). Sij' dung phan mem thtet ke toi u'u Modde 8.0 de thtet ke thi nghiem, phan mem du'a ra eac thi nghiem can tien hanh.
*Toi u'u hda: Sau khi co ket qua^ lam tht/c nghiem, stj" dung phan mem Modde de phan tich anh hu'dng ctJa eac bten dpc lap den hieu suat ehiet xuat (bien phu thuoc) bang viec thiet lap phu'dng hoi quy bac 2 ve moi tu'dng quan giij'a bien phu thuoc va bien doc lap. Phu'dng trinh co dang:
Y = bo + biXi ^ bjX; ^ b3X3+ bi(Xi)^ + b2(X2)^
+ b3(X3)' + bi,2,3(Xi X; X3 )
Ngoai ra, phan mem cdn du'a ra dii doan cac dieu kien tdi u'u de hieu suat ehiet xuat cao nhat (Y = max). Sau khi thu du'dc dieu kien toi u'u td phan mem, lam lai thi nghiem de tham djnh ket qua tdi u'u.
III. KET QUA NGHIEN CU'U
3.1. Kei qua khao sat sd bd cic yeu td anh hddng idi hieu suai chiet xuat
3.1.1. Kit qui xac dmh ham Iddng mangiferin trong bai thuoc BHNST
Can ehinh xac cac du'dc lieu trong bai thudc theo dtJng tl le vao binh chiet cua thiet bi chiet sieu am, them vao binh chiet 150 ml nUdc cat.
Chiet sieu am trong 60 phut d 60°C. Ly tam 3500 vong/phLit x 5 phut, gan lay dich ly tam. Ba chiet tiep them 2 lan nu'a. Gpp djch chiet vao binh djnh mire 500 ml, de on dinh d nhiet do phong, Sau dd, them nu'dc cat vt^a dtJ, loc qua mang 0,22 pm du'dc dung djch tiem sac ky. Ket qua dinh lu'dng cho thay, ham lu'dng mangiferin trong bai thuoc la 2,14 mg/g tinh theo dUdc lieu kho kiet.
3.1.2. Khio sat inh hu'dng cua phu'dng phap chief: Tien hanh khao sat cac phu'dng phap ehiet xuat khae nhau gom: chiet sieu am, chiet vi song va chiet nong thong thu'dng d eung dieu kien.
Ket qua cho thay phu'dng phap chiet sieu am cho hieu suat chiet xuat hoat chat cao nhat dat 82,78% trong khi chiet vi song dat 80,59% va thap nhat la chiet ndng thong thu'dng vdi hieu suat la 74,82%. Dieu nay cho thay sdng sieu am da lam tang hieu qua ciia qua trinh chiet xuat. Vi vay chung toi It/a chpn phu'dng phap chiet sieu am cho cac khao sat tiep theo
3.1.3. Khao sit inh hu'dng cua dung mil chiet: Tien hanh khao sat vdt cac dung mdi chiet xuat khac nhau la: nu'dc, EtOH d cac ndng do khac nhau 20%; 30% , 50%, 70% , 90% vdi
VIETNAM MEDICAL JOURNAL N°2 • APRIL • 20ia cung dieu kien chiet xuat d nhiet dp eo^C, thdi
gian 30 phut, vcfi ty le DL/DM 1:10, chiet 01 lan.
Ket qua thu dddc cho thay hteu suat ehiet ^ n g dan khi nong do EtOH tang dan tiJr 20% den 30%. Tuy nhieri khi tiep tuc tang nong dp EtOH thi hteu suat chiet xuat lai giam manh, dieu nay cd the la do khi nong dp EtOH cang tang thi lam tang giai phdng mpt so chat nhay, gay can trd cho qua trinh chiet xuat hoat chat. Trong eac nong dp khao sat EtOH 30% cho hieu suat ehiet cao nhiit dat 82,32%. Do vay, lu^ chpn dung mot ehiet la EtOH 30% de thu'c hien cae khao sat cac thong so tiep theo.
3.1.4. Kit qui khio sit inh hddng cua ty le dude lieu/dung moi chiet xuat
Tten hanh eae thf nghiem chiit xuat bat thuoc vdi dung moi EtOH 30%, d nhidt dp 60°C, trong thdt gian 30 phut, vdi ty te DL/DM khac nhau tan Iddt la: 1:5,1:7; 1:10; 1:12; Ket qua thu dddc cho thay: Kht ty te DL/DM cang tang thi hieu suat chiet tang theo tir 1/5 den 1/10 (dat 83,32%), song neu tiep tuc tang den tf le 1:12 thi \ii%u suat chiet xuat tang khdng dang ke (dat 86,1%). Vi vay de tiet kiem dung moi, nang luHng cung nhu" thdt gian co Ioal dung mdi d giat doan sau, chung tot Ida chon ti te DIVDI^ la 1:10 cho cac khao sat tiep theo.
3.1.5. Ket qui khio sat anh hddng cua thai' gian diietxuat
Tten hanh chiet xuat d cac khoang thdt gtan khac nhau la: 30, 45, 60, 90phut, vdi cung dteu kten: dung moi EtOH 30°, ty le DL/DM 1:10, nhiet dp 60°C,chiet 01 lan. Ket qua cho thay:
Trong khoang thdi gian chiet xuat tiT 30 den 45 phut thi hieu suat thu diidc cd xu hu'dng tang nhanh (sau 30 phut hieu suat la 83,32%, sau chiet 45 phut hteu suat dat 83,41%). Tuy nhien, neu tiep tuc tang thdt gian ten 90 phut thi hieu su3t ed xu hu'dng hdi giam dl. Do vay de tiet kiem thdt gtan cung nhu* nhten lieu chung toi chpn thdi gian chtet xuat la 30 phiJt cho cac khao sat tiep theo.
3.1.6. Ket qua khao sat anh hudng cua nhiet dp den chiet xuat
Tten hanh chiet xuat d cac dieu kten nhiet do khac nhau la: 30°C, 40°C, 50°C, eO^C, 70^ v^
80°C. Ket qua danh gta hteu s u i t chiet xuat dw thay: Nhiet dp chtet tang td 30°C ten eo^C Uil hteu suat tang (76,68% len 83^32%), nhuhg tiep tuc tang den BO^C hieu suat bat dau giam manti (67,33%). Dieu nay co the giai thfch la do tioat chat bj phan huy mot phan bdi nhiet dp trong qua trinh chiet x u a t
3.1.7. Ket qui khio sat anh hu'dng aia s3h chiet den hiiu suat chiet xuat
Ket qua khao sat so lan chtet xuat eho ttiSy:
Sau 02 tan chiet thi hieu suat ehiet xuat hocit chat kha eao (dat 95,54%). Neu ehiet them lan thij' 3 thi hieu suat chi tang them 1,83%. Vi vay, iz tiet kiem thc^ gtan va dung mot chtet trong nghien ciiu nay chung toi chpn so @n chtet la 2 lan.
3.2. Ket qui to/ Uu hda quy tiinh dtiel xuit boat chat id bai tiiuoc BHNST bing phan mem Modde 8.0
Td cac ket qua khao sat sd bp d phan tren nhan thay: Nhiet dp, nong dp dung mot EtOH, ly le DL/DM la cac yeu cd anh hu'dng tdt tdn dgn hteu suat chiet xuat mangiferin trong bai tiiuoc, Vi vay, tien hanh Ida chpn 3 yeu to nay lam biln dau vao cho thiet ke tot u^ quy trinh ehiet xuat vdt cac khoang khao sat nhd sau:
- Nhiet dd (Xi, "C): Td 35°C den 65*'C.
- Nong dp dung moi EtOH (X2, % ) : Tir 20%
den 40%.
- Ty le DtVDM (X3,g/ml): TCr 1:7 den 1:15. • - Bten dau ra la hteu suat chiet xuat hoat ctiat MA (Y % ) .
Phan mem Modde 8.0 du^a ra bo tn cac dieu kien khao sat chiet xuat theo md hinh mit hdp tu" tai tam (Central Composite Face - CCFquadratlc). Phan mem Modde 8.0 du^ ra ket qua thiet ke vdt 17 mau thdc nghiem, tten hanh chtet xuat thu'c nghiem theo cac thf nghiem da dUdc thtet ke nay. Sau moi thf nghiem, dinh lu'dng mangiferin trong djch chiet bang HPLC de xac dinh ham lu'dng hoat chat va tfnh toan hieu suat chiet xuat (Y%). Ket qua dude trinh ba^
trong bang 1.
Bang STT
N l N2 N3 N4 N5 NG
1. KSt qua thu'c nghiem theo thiet kSaJa phan mem Modde 8.0 Ma tran ma hoa
X , -1 1 -1 1 -1 1
Xz -1 -1 1 1 -1 -1
X j -1 -1 -1 -1 1 1
Di€u kien thifc nqhiem cac bien ( X i )
35 35 35 35 65 65
( X j ) 20 40 20 40 20 40
( X j ) 7 7 15 15 7 7
Hieu suit C°/o|
(Y) 85.06 91.10 . 95.57 . 90.91 70.24 93.39
TAP CHi Y HOC VIET NAM TAP 465 - THANG 4 s o 2 - 2 0 1 8
N7 N8 N9 NIO N i l N12 N13 N14 N15 N16 N17
-1 1 -1 1 0 0 0 0 0 0 0
1 1 0 0 -1 1 0 0 0 0 0
1 1 0 0 0 0 -1 1 0 0 0
65 65 50 50 50 50 35 65 50 50 50
20 40 20 40 30 30 30 30 30 30 30
15 15 10 10 7 15 10 10 10 10 10
80.38 96.05 87.40 95.34 88.97 92.97 96.43 94.45 93.55 93.45 93.44 TLT ket qua bang 1 , tien hanh phan tich danh gia anh hu'dng ctJa cac bien dau vao vdi bten dau ra, pham mem Modde 8.0 da du'a ra phu'dng trinh hoi quy ve tu'dng quan tuyen tinh sau: Y=92,15 - 2,45Xi + 4,81X2 + 2,71X3 + 0,78Xi^ - 3,28X? - 3,68X3^ - 2,27X2X3 + 4,68X2X1 + 0,31 X3X1, Vdi he sd tu'dng quan R^ = 0,982.
Phu'dng trinh tren cho thay cd moi tu'dng quan giiJa cac bien dau vao va bien dau ra rat mat thiet vdi he so R^= 0,982 (R^> 0,80 dat yeu cau). Hay not each khac la nhiet dp, ty le DL/DM va nong dp cija dung moi co anh hu'dng nhieu tdt hieu suat chiet xuat hoat chat.
Dong thdi phan mem eung du'a ra ket qua dd doan toi uu hoa va hinh anh mat dap phan tich anh hu'dng cua cac bien dpc tap den hieu suat chiet xuat (hinh 1 va hinh 2).
Hinh 1. H/nh inh mat dap ve anh hUdng cua yeu to diu vao den hieu suit chiet
Hinh 2. Dd thi phan tich inh hUdng cua yeu id dau vao din hiiu suit chiii Khi phan tich anh hu'dng ciia yeu t d ket hdp
va tuTng yeu t d dpc lap d tren cho thay: Khi tang nhiet dp chiet den 50'' C thi hieu suat chiet tang len, nhuiig khi tiep tuc tang nhiet dp len thi hieu suat lat giam. Tang nong dp dung moi (EtOH) thi hieu suat ehiet eOng tang len. Khi tang t^ le DM/DL thi hteu suat tang cao. Cd the thay mut dp anh hu'dng cua cae yeu to den hieu suat ehiet tang dan tu": Nong dp dung m6i< Ty le DM/DL
< nhiet do.
Phan mem modde 8.0 cung dda ra cae ket qua dd doan tdi u'u khac nhau d cac vndc khac nhau. Trong sd cac dieu kien do, chung tot li/a chpn sau de tien hanh kiem chij'ng lai ket qua tdi ud hda. Cac thong so toi u'u du'dc Ida chpn gdm:
-Nhiet do ( X , ) : 6 5 X - Nong do EtOH (X2): 40%
- T y l e DM/DL (X3): 11:1
- Vdt eac thong so tren phan mem dii doan hieu suat chtet la: Y =96,64%.
Tien hanh iam cac thf nghiem vdi cac dieu kien tdi u'u tren de kiem chu'ng lai ket qua dy*
doan eua phan mem dda ra. Ket qua trinh bay d bang 2.
Bang 2. Kit qui kiem chdng lai dU doin tren phin rtiem Modde 8.0
STT 1 2
Hieu suat chiet (<Vo) Du* doan
96,64 96,64
Thu'c nghiem 95,39 95,86
VIETNAM MEDICAL JOURNAL H°2 - APRIL - 2018
3 4 5 X ± S D
P
96,64 96,64 96,64 96,64
95,78 96,01 95,12 95,63 ± 0,36 P> 0,05 Ket qua bang 2 cho thay: Vdi cac dieu kien toi u'u etja phan mem du'a ra thi hieu suat chiet mangiferin dat 95,63% thap hdn khong dang ke so vdi du' doan cua phan mem (vdi p >0,05).
Nhu' vay, cd the su" dung dieu kien toi u'u ma phan mem du'a ra de chiet xuat hoat chat tii bai thudc BHNST.
Tii' cac ket qua khao sat, ehtJng tdi du'a ra quy trinh chiet xuat mangiferin td bat thuoc BHNST d quy mo phong thi nghiem gom; Sij' dung phu'dng phap chiet sieu am, dung moi chtet la EtOH 40% vdi ty le 11/1, tien hanh chiet xuat 02 lan trong 30 phut d nhiet dp 55°C. Vdi eac dieu kien da chon hieu suat chiet xuat hoat chat dat 95,63%. Tii quy trinh quy mo phong thi nghiem da tien hanh nang quy md chiet xuat len 1,0 kg du'dc lieu/me, l<et qua eho thay quy trinh ehiet xuat on dinh, d l dang van hanh va trien khai va hieu suat thu diidc khong eo sii khac biet nhteu khi ehiet d quy mo nhd.
IV. KET LUAN
Da u'ng dung phan mem tin hpc t^odd'e 8.0 de khao sat, tiici chpn du'dc cae thong sd tdi u'u trong ehiet xuat mangiferin td bai thuoc BHNST.
Ket qua da tim du'dc cac dieu kien tdi u'u gom:
Sii dung phu'dng phap ehiet sieu am, dung moi chiet la EtOH 4 0 % vdi ty te 1 1 / 1 , tien hanh chiet xuat 2 lan trong 30 phijt d nhiet dp 65°C. Vdi cac dieu kien da lu'a ehon, hieu suat ehiet thu hoi hoat chat dat 95,63%. Quy trinh chiet dn dinh de trien khai trong nghien cu'u hten dai hoa ciing nhu' san xuat eac san pham tit' bai thudc Bach ho Nhan sam thang gia vi.
TAI LIEU THAIVl KHAO
1 . Bo Y t e ( 2 0 0 9 ) , Du'gt dieh Viet Nam 4. NXB Y hoc. Ha Not.
i . V u Binh D u ' d n g , N g u y i n X u a n T r u n g , Ngo X u a n T r i n h , P h a m V a n H i e n , N g o T h i TuyS M a i ( 2 0 1 7 ^ , "Nghien ciiu d m h lu'cfng mangiferin trong trt m a u (Rhizoma anemarrhenae) bang ^ c ky long hieu nang cao " Tap chf Dude hoc, 6/2017
tr. 29-33. ' 3 . R e n , L.X., L u o , Y . F . , L i , X . , W u , Y.L. (2007).
"Antidepressant activity o f sarsasapogenin from Anemarrhena asphodeloides Bunge (Liliaceaej' Pharmazie, 62, 7 8 - 7 9 .
4 . Y o u n , U.3., J a n g , J . E . , N a m , J . W . , Lee, Y . 1 , S o n , Y . M . , S h i n , H . J . , H a n , A.R., Chang, 1 , S e o , E.K. ( 2 0 1 1 ) . "Anti-respiratory syncytial wrus (RSV) activity o f ttmosaponin A I I I from the rhizomes o f Anemarrhena asphodeioide^', J. f^ed.
Plants Res., 5, 1 0 5 2 - 1 0 6 5 .
3 . C h i e n - J u n g L i n , Y i - C h a n g S u , Cheng-Hting L e e , T s a i - C h u n g Li Y u C h e n , a n d Sunny ( 2 0 1 3 ) "Bai-Hu- T a n g , Ancient Chinese Meidicitie Formula, May Provide a New CompletnentBry T r e a t m e n t Option f o r Sepsis"
h t t p : / / d x . d o i . o r g / 1 0 . 1 1 5 5 / 2 0 1 3 / 1 9 3 0 8 4 . 6 . S a r t o r i u s S t e d i m B i o t e c h c o m p a n y (2013).
User guide Bio Pat Modde,
DANH GIA KIEN THU'C, THirc HANH COA NGirai BENH DIEU TRI
NO! TRU VE QUYEN Lm BAO HIEM Y TE TAI KHOA NOI BENH VIEN DA KHOA TJNH NAM DINH NAM 2017
Dang Thi Mai Linh', Vu Trung Kien^ Vu Phong Tiic'
T O M TAT
Muc tieu: Danh gia kien thii'c, thtJc hanh ctJa ngUdi benh dieu trj not triJ ve quyen Idi Bao hiem y t e tai khoa Hpi Benh vten Da khoa t i n h Nam Oinh nam 2017. Ddi tUdng^ nghien cdu: ngUdi benh dieu t r i npi t r u tat khoa Npi Benh vten Da khoa t i n l i Nam Dinti n3m 2017. Phu'dng phap nghien cii'u: phu'Ong ptiap
'Bao hiem xa hoi tinh Nam Dmh
^Tru'dng Dai hoc YDWdc Thii Binh Chiu trach nhiem c h i n h : Dang Thi Mai Lmh Email: [email protected] Hgay nhan bai: 2,2.2018 Ngay phan bien khoa hgc: 30.3.2018 Ngay duyet bai: 11.4.2018
m o t a qua cuoc dieu t r a c a t ngang. Kit qui nghien cdu: Benh nhan n a m chiem t y le 5 4 , 9 % ; nhom tuS chiem t y le nhteu nhat la 60-69 t u o i (chiem 30,5%); ty le ngi/di benh biet ve luat b a o hiem y t e la 81,3%;
nguon t h o n g t i n biet v e bao hiem y t e nhteu nhatia phUdng tien t r u y e n t h o n g dai c h t i n g ; 8 9 % ngu'di benti cho raiig t a t ea ngUdi dan d e u du'dc tham gia mua bao hiem y t e ; theo ngUdi benh muc' dich de tham gia bao hiem y t e de chia se nit r o Idii 6 m chiem 52,1%;
d e gitip n g u d i d a n tiet kiem phong kht om chietn 4 9 , 5 % ; t y le d d i tUdng d a sii dung the bao hiem y ^ 2 lan t r o n g nam 2 0 1 7 la 3 1 , 3 % ; c d 6 5 , 7 % tigu'di benh phat tra t h e m t i e n kht sty dung t h e bao hiem y tede kham chu'a b e n h .
Td khda: Kham chUa benh b a o hiem y te, quy bao hiem y t e .
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