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HYPERICUM L. TÜRLERİNİN BİYOLOJİK AKTİVİTELERİ, TIBBİ KULLANIMLARI VE İLAÇLARLA ETKİLEŞİMLERİ Yüksek Lisans Tezi

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HYPERICUM L. TÜRLERİNİN BİYOLOJİK AKTİVİTELERİ, TIBBİ KULLANIMLARI VE İLAÇLARLA ETKİLEŞİMLERİ Yüksek Lisans Tezi T.C. EGE ÜNİVERSİTESİ Sağlık Bilimleri Enstitüsü HYPERICUM L. TÜRLERİNİN BİYOLOJİK AKTİVİTELERİ, TIBBİ KULLANIMLARI VE İLAÇLARLA ETKİLEŞİMLERİ Yüksek Lisans Tezi Gizem ELBAY Farmakognozi Anabilim Dalı İzmir 2019 T.C. EGE ÜNİVERSİTESİ Sağlık Bilimleri Enstitüsü HYPERICUM L. TÜRLERİNİN BİYOLOJİK AKTİVİTELERİ, TIBBİ KULLANIMLARI VE İLAÇLARLA ETKİLEŞİMLERİ Yüksek Lisans Tezi Gizem ELBAY Danışman Prof. Dr. Hüsniye KAYALAR Farmakognozi Anabilim Dalı Fitoterapi İzmir 2019 Önsöz Halk arasında sıklıkla depresyon tedavisinde ve yara iyileştirici olarak kullanılan Hypericum türleri pek çok biyolojik aktiviteye sahiptir. Ancak çok sayıda ilaçla etkileşime girmesi nedeniyle kullanırken dikkatli olunması gereken türlerdir. Bu çalışmada Hypericum türlerinin halk arasında kullanımları, sahip oldukları biyolojik aktiviteler ve etkileşime girdiği ilaçlar araştırılmıştır. Bu çalışmanın konusunun belirlenmesinde ve hazırlanma sürecinin her aşamasında değerli bilgilerini ve zamanını benden esirgemeyen, bana yol gösteren danışman hocam Sayın Prof. Dr. Hüsniye KAYALAR’a teşekkürlerimi özellikle belirtmek istiyorum. İZMİR – 2019 GİZEM ELBAY Özet Hypericum L. Türlerinin Biyolojik Aktiviteleri, Tıbbi Kullanımları ve İlaçlarla Etkileşimleri Antarktika dışında dünyanın her kıtasında yayılış gösteren 484 Hypericum L. (Hypericaceae) türü bulunmaktadır. Ülkemizde bulunan 96 Hypericum türünün 47’si endemiktir. St John’s wort olarak tanınan Hypericum bitkileri, çeşitli tıbbi özellikleri nedeniyle, geleneksel tıptaki kullanımlarıyla iyi bilinmektedir. Bazı Hypericum türleri pek çok ülkede (Avrupa ülkeleri, ABD) yerel halk tarafından hastalıkların tedavisinde kullanılmaktadır. Halk arasında dahilen antidepresan, spazm giderici, kurt düşürücü olarak, haricen antiseptik ve özellikle yanık yaraları başta olmak üzere yara iyileştirici olarak kullanılmaktadır. Hypericum cinsi Türkiye'de “kantaron” olarak adlandırılır. Bu familyanın en çok bilinen ve kullanılan türü Hypericum perforatum L. Türkiye’de “sarı kantaron, binbirdelik otu, kanotu, kılıçotu, mayasılotu, yaraotu, koyunkıran, batof’’ adlarıyla, uzun yıllardan beri çok iyi bilinen ve kullanılan tıbbi bir bitkidir. St John’s wort’un çiçekli kısımları, geleneksel Avrupa tıbbında, nevralji, anksiyete, nevroz ve depresyon tedavisinde yüzyıllardır kullanılmaktadır. Hayvan deneyleri ve klinik deneyler sonucunda antidepresan etkinliği kanıtlanan Hypericum perforatum L. bugün hafif ve orta şiddetteki depresyonların tedavisinde başarıyla kullanılmaktadır. Literatürde, Hypericum ektstrelerinin, ilaç metabolizmasından sorumlu hepatik enzimleri indüklediğini ve ilaçların serum düzeylerini ve terapötik etkinliğini azaltabileceğini gösteren çok sayıda rapor bulunmaktadır. Bu çalışmada Hypericum L. türlerinin biyolojik aktivitelerinin, yapılan çalışmalarda gösterilen tıbbi etkilerinin, halk arasındaki kullanımlarının ve ilaçlarla etkileşimlerinin derlenmesi amaçlanmıştır. Anahtar kelimler: Hypericum; sarı kantaron; bitki-ilaç etkileşimleri II Abstract Biological Activities of Hypericum L. Species, Their Medicinal Uses and Their Interactions with Drugs There are 484 Hypericum L. (Hypericaceae) species spreading in every continent of the world except Antarctica. 47 of the 96 Hypericum species found in our country are endemic. Hypericum plants, known as St John's wort, are well known for their use in traditional medicine because of their various medicinal properties. Some Hypericum species are used in many countries (European countries, USA) by local people to treat diseases. As an internal antidepressant, antispasmodic, anthelmintic, externally used as antiseptic and for wound healing, especially in burn wounds. The genus Hypericum is called as “kantaron” in Turkey. The most commonly known and used species of this genus in Turkey is Hypericum perforatum L. which is called as ‘‘sarı kantaron, binbirdelik otu, kanotu, kılıçotu, mayasılotu, yaraotu, koyunkıran, batof’’ is very well known medicinal herb used in traditional medicine for many years. The flowering parts of St John’s wort have been used in traditional European medicine for centuries to treat neuralgia, anxiety, neurosis and depression. Hypericum perforatum L., which has proven antidepressant efficacy as a result of animal and clinical trials, is used successfully in the treatment of mild and moderate depressions today. There are numerous reports in the literature that Hypericum extracts induce hepatic enzymes responsible for drug metabolism and may reduce serum levels and therapeutic efficacy of drugs. In this study, it was aimed to compile the biological activities of Hypericum L. species, their medicinal effects shown in the studies, their use among the public and their interactions with drugs. Keywords: Hypericum; St John’s wort; herb-drug interactions. III İçindekiler Önsöz ............................................................................................................................ I Özet ............................................................................................................................. II Abstract .................................................................................................................... III Tablo Listesi .............................................................................................................. IX Şekil Listesi ............................................................................................................... IX Resim Listesi ............................................................................................................. IX Kısaltmalar ................................................................................................................ X 1. Giriş ......................................................................................................................... 1 1.1. Halk Arasında Kullanımı ................................................................................... 2 1.2. Kantaron Yağının Hazırlanması ....................................................................... 4 2. Genel Bilgiler .......................................................................................................... 5 2.1. Coğrafi Yayılışı .................................................................................................... 5 2.2. Hypericum Cinsinin Sistematikteki Yeri ........................................................... 5 2.3. Hypericum Türlerinin Genel Özellikleri ........................................................... 6 2.4. Biyoaktif Bileşenleri ............................................................................................ 7 2.4.1.Naftodiantronlar ............................................................................................... 8 2.4.1.1. Hiperisin ......................................................................................................... 8 2.4.2. Floroglusinoller ................................................................................................ 9 2.4.3. Flavonol Glikozitleri ...................................................................................... 10 2.4.4. Biflavonlar ...................................................................................................... 11 2.4.5. Fenilpropanlar ................................................................................................ 12 2.4.6. Proantosiyanidinler ........................................................................................ 13 2.4.7. Uçucu Yağlar .................................................................................................. 13 2.5. Gebelik ve Emzirme Döneminde Kullanım .................................................... 14 2.6. Toksikoloji ......................................................................................................... 15 IV 3. Gereç ve Yöntem .................................................................................................. 15 4. Bulgular ................................................................................................................. 15 4.1. Hypericum Türlerinin Biyolojik Aktiviteleri ve Tıbbi Kullanımları ............ 15 4.1.1. Antioksidan Aktivite ...................................................................................... 15 4.1.2. Antibakteriyel Aktivite .................................................................................. 18 4.1.3. Antifungal Aktivite ........................................................................................ 21 4.1.4. Antiviral Aktivite ........................................................................................... 23 4.1.5. Antihelmintik Aktivite ................................................................................... 25 4.1.6. Antikanser Etki .............................................................................................. 26 4.1.7. Yara İyileştirici Etki ...................................................................................... 28 4.1.8. Antidepresan Etki .......................................................................................... 31 4.1.9. Anksiyolitik Etki ............................................................................................ 34 4.1.10. Mevsimsel Duygulanım Bozukluğunda Kullanım .................................... 35 4.2. İlaçlarla Etkileşim ............................................................................................. 38 4.2.1. Bitkisel Ürün-İlaç Etkileşiminin Genel Mekanizması ................................ 39 4.2.1.1.
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