CN101129823B - 一种内服治疗过敏性紫癜的中药组合物 - Google Patents
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Abstract
本发明公开了一种内服治疗过敏性紫癜的中药组合物，属中药领域。该种内服治疗过敏性紫癜的中药组合物，制成其有效成分的原料药按下述重量为：白花蛇16克，川芎12克，当归12克，生地16克，蝉蜕3克，丹参16克，丹皮12克，白茅根15克，紫草10克，生石膏3克和甘草5克。水煎服，日1剂，分2次服。本发明药物配方合理，制备方便，疗效确切，见效快，无毒副作用。经临床验证具有活血化瘀，凉血解毒的功效。
Description
技术领域
本发明涉及一种内服治疗过敏性紫癜的中药组合物，属中药领域。
背景技术
过敏性紫癜是以毛细血管炎为主的变态反应性疾病。主要表现有皮肤紫癜，胃肠症状，关节肿痛及泌尿系统症状。多见于5岁以上小儿。本病的病因尚不清楚，可能由于某种致敏原引起的变态反应所致，但直接致敏原尚不明确。起病前常有由溶血性链球菌引起的上呼吸道感染，经1～3周潜伏期后发病。此外，病毒如麻疹，流行性腮腺炎等，寄生虫如蛔虫，钩虫等，食物如鸡蛋、鱼、虾等，药物如氯霉素，水杨酸盐等，其它如虫咬、花粉等均可能成为致敏原；使体内发生自身免疫反应，以致毛细血管发生炎性改变。
该病的基本病变为毛细血管壁的炎性反应，毛细血管的通透性增加，血浆及血细胞渗出，引起水肿及出血。小动脉及小静脉也可受累，小血管的周围有中性粒细胞、单核细胞、淋巴细胞，也可有嗜酸粒细胞的浸润及不同程度的红细胞渗出，受累血管的周围还可有核的残余及肿胀的结缔组织，小血管的内膜增生，并出现透明变性及坏死，使血管腔变窄，甚至梗塞，并可见坏死性小动脉炎。皮肤及胃肠道都可见上述改变，关节腔内多见浆液及白细胞渗出，但无出血，输尿管、膀胱及尿道粘膜可有出血，并常累及肾脏，紫癜性肾炎的病理变化轻重不等。轻者为局灶性肾炎，比较多见，重者为增殖性肾炎伴新月型改变，免疫荧光检查可在肾小球上发现C3和IgG，还可见到纤维蛋白原沉积，在血管系膜上也发现有IgA。
临床上发病较急，除有发热、食欲不振、恶心，呕吐等一般症状外，主要表现有皮肤紫癜、胃肠症状、关节肿痛及泌尿系统症状。不同病例起病情况可不相同，以皮肤紫癜最多见，可单独出现，亦可同时或先后伴有关节，胃肠或泌尿系统症状。
目前对于过敏性紫癜治疗包括
(一)一般治疗有：
1、急性期应卧床休息，饮食避免蛋白，少楂半流
2、彻底清除体内感染灶，这是治疗的关键。激素治疗：一般病例无须用激素治疗，对严重血管神经性水肿、关节肿痛、胃肠道出血等可酌情应用。肾上腺皮质激素能抑制抗原-抗体反应，具有抗过敏及改善血管通透性的作用。
3、免疫抑制剂：对紫癜肾采用其他方法无效时可用免疫抑制剂，与肾上腺皮质激素合用常能提高疗效，再用药过程中要根据血象变化调整剂量。
(二)其他疗法1、抗组胺药物；2、维生素c及路丁C；3、普鲁卡因封闭疗法。
激素及西药治疗副作用较大，现在一般更倾向于中药治疗，但是目前还没有特效中药制剂。
发明内容
本发明的目的在于克服现有治疗的不足，而提供一种内服治疗过敏性紫癜的中药组合物，全部选用天然中草药，能够有效治疗过敏性紫癜。
本发明的技术方案是：该种内服治疗过敏性紫癜的中药组合物，其特征在于，制成有效成分的原料药按下述重量为：白花蛇16克，川芎12克，当归12克，生地16克，蝉蜕3克，丹参16克，丹皮12克，白茅根15克，紫草10克，生石膏3克和甘草5克。
水煎服，日1剂，分2次服。
药理作用：
白花蛇甘、咸，温；有毒。归肝经。祛风，通络，止痉。用于风湿顽痹，麻木拘挛，中风口歪，半身不遂，抽搐痉挛，破伤风，麻风疥癣，瘰疬恶疮。
川芎：气开郁，祛风燥湿，活血止痛。治风冷头痛，旋晕，胁痛腹疼，寒痹筋挛，经闭，难产，产后瘀阻块痛，痈疽疮疡。
紫草：性味性寒，味甘、咸。凉血，活血，解毒透疹。用于血热毒盛、斑疹紫黑、麻疹不透、疮疡、湿疹、水火烫伤。
当归：补血活血，调经止痛，润肠通便。用于血虚萎黄，眩晕心悸，月经不调，经闭痛经，虚寒腹痛，肠燥便秘，风湿痹痛，跌扑损伤，痈疽疮疡。
生地：清热凉血，用于血热毒盛，吐血衄血，斑疹紫黑，养阴生津，内热消渴。
蝉蜕：散风热，宣肺，定痉。治外感风热，咳嗽音哑，麻疹透发不畅，风疹瘙痒，小儿惊痫，目赤，翳障，疔疮肿毒，破伤风。
丹皮：性寒，味苦、辛。清热凉血，活血行瘀。用于温毒发斑、吐、衄、便血，骨蒸劳热，经闭痛经，痈肿疮毒，跌扑伤痛。
丹参：祛瘀止痛，活血通经，清心除烦。用于月经不调、经闭痛经、症瘕积聚、胸腹刺痛、热痹疼痛、疮疡肿痛、肝脾肿大、心绞痛。
白茅根：甘，寒。归肺、胃、膀胱经。凉血止血，清热利尿。用于血热吐血，衄血，尿血，热病烦渴，黄疸，水肿，热淋涩痛；急性肾炎水肿。
生石膏：治热病壮热不退，心烦神昏，谵语发狂，口渴咽干，肺热喘急，中暑自汗，胃火头痛、牙痛，热毒壅盛，发斑发疹，口舌生疮。
甘草：和中缓急，润肺，解毒，调和诸药。
本发明药物配方合理，制备方便，疗效确切，见效快，无毒副作用。经临床验证具有活血化瘀，凉血解毒的功效，具体临床资料如下：
1临床资料
1.1收治标准收治90例患儿均符合1990年美国风湿病协会制定的过敏性紫癜新的诊断标准：(1)可触及性紫癜；(2)发病年龄＜20岁；(3)急性腹痛；(4)组织切片显示小动脉和小静脉周围有中性粒细胞浸润。上述4条标准符合2条或以上，同时符合以下条件：(1)年龄3～13岁。(2)临床无肾损害者：无血尿及蛋白尿(尿沉渣红细胞＜5个/HP、尿蛋白阴性)。(3)血小板不少于100×109。(4)凝血系列正常(包括凝血酶原时间、INR、部分凝血活酶时间、纤维蛋白原、凝血酶时间)。(5)便常规正常、便隐血阴性。(6)不合并其他疾病。
1.2一般资料共90例，其中男59例，女31例；城市38例，农村52例；3～5岁20例，6～10岁45例，11～13岁25例；皮肤型19例，皮肤并关节型31例，皮肤并腹型21例，皮肤并关节、腹型19例；血小板(100～300)×109/L40例，(300～400)×109/L33例，400×109/L以上17例。
1.3研究方法
1.3.1分组从90例中按随机方法分为本发明药物组和对照组，本发明药物组45例，对照组45例。两组均同时给予基础治疗：口服维生素C及芦丁，有腹型及关节型给予激素治疗。
1.3.2用药本发明药物组给予日1剂，分2次服。
1.3.3随访两组患儿治疗后每两周查尿常规1次，随访时间3个月～3年。
1.3.4疗效观察初步将尿常规正常者定义为无肾脏损害，对于有肾损害者做以下临床分型：单纯血尿型(尿沉渣红细胞＜5个/HP、尿蛋白阴性)、血尿伴蛋白尿型(血尿标准同上，同时尿蛋白阳性)、血尿伴肾病综合征型(血尿标准同上，同时尿蛋白阳性，血清白蛋白低于30g/L，伴或不伴水肿及高脂血症)。
2结果
2.1治疗结果用本发明药物治疗组发生肾炎3例，占6.6％，其中单纯血尿型2例，血尿伴蛋白尿型1例；对照组发生肾炎7例，占15.5％，其中单纯血尿型3例；血尿伴蛋白尿型3例，血尿伴肾病综合征型1例。两组肾炎的发生率差异有统计学意义，0.01＜P≤0.05差异有统计学意义
2.2肝素副作用肝素组无一例发生肝素不良反应，血小板均在正常范围。
3讨论
过敏性紫癜是儿科常见的血管炎之一，由于其肾脏损害对患儿预后影响较大，所以对肾损害的预防越来越引起人们的重视。山东龙口市人民医院进一步等通过对119例过敏性紫癜患儿使用本发明药物，其中发生肾炎9例，占7.6％，而对照组109例中30例发生肾炎，占27.5％，进一步证明了本发明药物在治疗过敏性紫癜时的作用，并且未见严重不良反应。本发明人治疗的45例中无一例发现不良反应，肾炎的发生率占6.6％，而对照组肾炎发生率占15.5％。综上所述，本发明药物在预防和治疗过敏性紫癜肾炎的发生中起着较关键的作用，加之它的安全性、方便性以及经济的特点，值得临床推广应用。
典型病例：
病例一：胡某，男，14岁，患者患有双下肢紫癜伴尿血4月余。病史：2005年12月感冒后出现四肢皮疹、瘙痒不已，几天后双下肢突然出现大片疹斑，并伴有肉眼血尿，查尿蛋白(++)，红细胞满视野，白细胞5～10/高倍视野，管型0～3/低倍视野，肾功能尚正常。服本发明药物10剂后，尿蛋白即转阴，尿红细胞消失，诸症明显好转。继续服上方月余，尿检持续多次阴性。后曾调整上方养阴清热加减善后，至今未见复发，肾功能保持正常。
病例二：张某，男，11岁，患者双下肢出现大面积的紫癜三个多月了，查体温37.6℃，全身及关节、胃肠等未见异常，饮食及二便正常，诊断：下肢型过敏性紫癜。使用本发明药物治疗，八天后症状明显好转，继续服用十天后痊愈，半年后随访，未复发。
具体实施方式
例一：一种内服治疗过敏性紫癜的中药组合物，制成有效成分的原料药按下述重量为：白花蛇16克，川芎12克，当归12克，生地16克，蝉蜕3克，丹参16克，丹皮12克，白茅根15克，紫草10克，生石膏3克和甘草5克。
水煎服，日1剂，分2次服。
Claims (1)
1.一种内服治疗过敏性紫癜的中药组合物，其特征在于，制成有效成分的原料药按下述重量为：白花蛇16克，川芎12克，当归12克，生地16克，蝉蜕3克，丹参16克，丹皮12克，白茅根15克，紫草10克，生石膏3克和甘草5克。
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