Background technology: now, the incidence rate of xerophthalmia increases year by year.Xerophthalmia is meant because the tear film that causes unusually of the amount of tear or matter is unstable and the eye surface damage, thereby causes a class disease of ophthalmic uncomfortable symptom.The investigation of the U.S. shows in 65~84 years old crowd, have 14.6%, and promptly 4,300,000 population is suffered from xerophthalmia.Though do not have clear and definite xerophthalmia Epidemiological study result so far in China, based on the sanitary condition and the ambient condition of China, its sickness rate may be higher than the U.S..Main method to this type of persons suffering from ocular disorders treatment is: 1. replenish tear, promptly the replacement therapy of tear composition comprises the application of artificial tears and oneself serum; 2. preserve tear, as wear wet room mirror, row lacrimal passage thromboembolism etc.
For obstinate xerophthalmia, the lacrimal passage thromboembolism is still present best method clinically.To be tear be expelled to the anatomical passageway of nasal cavity from the eye table to lacrimal passage, by it is blocked, more kept the tear of self and played the effect of treatment at the eye table.The method of initial sealing lacrimal passage is to use hot lacrimal point to burn, and this method is simple and effective, but can cause cicatrix, and pain is arranged, and is simultaneously irreversible.Occurred being used to block the lacrimal duct embolus of lacrimal passage in recent years, behind the implantation lacrimal passage, its mechanical blockage effect has reduced the discharge of tear, now is used for clinical mainly contain two kinds (all originating from the U.S.): permanent type and degradable type.The former is made by silica gel, and after the implantation, the effect of lacrimal passage thromboembolism is permanent; The latter makes for collagen, implants back regular period degradable and makes lacrimal passage logical again, is mainly used in short term tests treatment and seasonal xerophthalmia.The appearance of lacrimal duct embolus makes the lacrimal passage Embolization become reversible operation, can take out at any time.Existing lacrimal duct embolus is import, costs an arm and a leg complicated process of preparation, it is raw material that the degradation-type embolus mostly is animal collagen, implant back slippage easily, and degradation cycle lacks (an about week), the generation of complication such as local inflammation after certain implantation, parcel is arranged in addition.Therefore, develop a kind of novel degradable lacrimal passage plug and preparation method thereof is home and abroad new problem anxious to be solved always.
Summary of the invention:
In order to solve the problem of above-mentioned existence, the present invention a kind of novel degradation-type lacrimal duct embolus is provided, the lacrimal passage embolotherapy, the severe dry eye patients that are mainly used in the moderate dry eye patients are implanted the preceding experimental treatment of permanent embolus and the treatment of seasonal xerophthalmia, can be written into medicine in the embolus, reduce local inflammation, parcel complication, and implantation after rehydration can expand, reduce the generation of embolus slippage situation, the preparation method of embolus is simple, cost is lower, more easily realize a kind of novel degradable lacrimal passage plug of industrialization and preparation method thereof.
The object of the present invention is achieved like this: a kind of novel degradable lacrimal passage plug and preparation method thereof, described lacrimal duct embolus is the preparation raw material with the sodium alginate, the composition of finished product comprises alginic acid, chitosan and calcium alginate, and its weight ratio is an alginic acid: chitosan: calcium alginate is 1: 0.1: 0.3~1: 1: 0.7; Lacrimal duct embolus can be written into antiinflammatory and antibacterials, its weight ratio is an alginic acid: chitosan: calcium alginate: medicine 1: 0.1: 0.3: 0.005~1: 1: 0.7: 0.3, described medicine is dexamethasone, a hydrocortisone in the anti-inflammatory drug, one or more combination of gentamycin, tobramycin in the antibiotics; The alginic acid of lacrimal duct embolus, calcium alginate molecular weight are 20~650,000, and the chitosan molecule amount is 15~550,000, and deacetylation is 70~95%; Its physical form of lacrimal duct embolus is long 1.0~2.5mm, and diameter 0.2~1.0mm's is cylindrical, and suction back volume is inflatable to be original 2.0~2.5 times; The preparation method of degradable lacrimal passage plug is as follows: (1) adopt molecular weight be 20~650,000 biologys absorbable sodium alginate be dissolved in normal saline, obtain the high viscosity solution that concentration is 3~10wt%, solution centrifugal or vacuumize degassing bubble is obtained preparing stock solution, with the air pressure of 0.2~0.8Mpa it is pressed into the CaCl that concentration is 5~10wt% gradually with special compression pump
2In the solution; Leave standstill the alginic acid one calcium alginate filament that obtained successive diameter 0.5~2.0mm in 30 minutes; Filament is washed, placing deacetylation then is that 70~95% concentration is that the aqueous solution of 0.5~3.5wt% chitosan and 0.5~5wt% spirit of vinegar soaks and modifies, and to alginic acid: chitosan: the calcium alginate weight ratio is that take out 1: 0.1: 0.3~1: 1: 0.7 back; Filament with washing of 75% alcoholic solution and gradient dehydration, is used the freeze dryer lyophilizing then, obtain the filament that diameter is 0.2~1.0mm, being cut to length is 1.0~2.5mm, the cylinder of diameter 0.2~1.0mm, and cobalt 60 sterilizations, envelope is standby; The preparation method of degradable lacrimal passage plug, wherein concentration is can add antiinflammatory and the antibacterials that concentration is 0.1~10wt% in the aqueous solution of 0.5~3.5wt% chitosan and 0.5~5wt% spirit of vinegar, so that be written into relative medicine in the product; The preparation method of degradable lacrimal passage plug, wherein concentration is can add antiinflammatory and the antibacterials that concentration is 0.1~10wt% in the high viscosity sodium alginate soln of 3~10wt%, so that be written into relative medicine in the product.
Main points of the present invention are its product and preparation method.Its preparation principle is, the composition of degradable lacrimal passage plug of the present invention is alginic acid, chitosan, calcium alginate, all have natural component at nature, studies show that in a large number they all have effects such as certain antiinflammatory, hemostasis, anti-cicatrix, have excellent biological compatibility, in vivo degradable, no antigen, not having harmful catabolite, can make its slow release behind the adding medicine in it, is medicine good slow release carrier.Embolus is implanted the back degradation cycle and can be controlled: primary amino radicals a large amount of on a large amount of carboxyls and the chitosan molecule chain formation polyelectrolyte that can mutually combine is arranged on the alginic acid strand, make the amino ionizing of chitosan simultaneously, thereby the antibiosis that has improved alginic acid and salt thereof and chitosan is managed brinish water solublity, make it absorb cycle stretch-out, so control the embolus that the content of chitosan in the raw material just can obtain good different degradation cycles.
A kind of novel degradable lacrimal passage plug and preparation method thereof compared with prior art, have novel science, processing technology lacrimal passage embolotherapy, severe dry eye patients superior, that be used for the moderate dry eye patients and implant the experimental treatment before the permanent embolus and the treatment of seasonal xerophthalmia, can be written into medicine in the embolus, reduce local inflammation, parcel complication, and implantation after rehydration can expand, reduce the generation of embolus slippage situation, the preparation method of embolus is simple, cost is lower, more easily realize advantage such as industrialization, will be widely used in the medical industry.
The specific embodiment:
Below in conjunction with embodiment the present invention is further described in detail:
The object of the present invention is achieved like this: a kind of novel degradable lacrimal passage plug and preparation method thereof, described lacrimal duct embolus is the preparation raw material with the sodium alginate, the composition of finished product comprises alginic acid, chitosan and calcium alginate, and its weight ratio is an alginic acid: chitosan: calcium alginate is 1: 0.1: 0.3~1: 1: 0.7; Lacrimal duct embolus can be written into antiinflammatory and antibacterials, its weight ratio is an alginic acid: chitosan: calcium alginate: medicine 1: 0.1: 0.3: 0.005~1: 1: 0.7: 0.3, described medicine is dexamethasone, a hydrocortisone in the anti-inflammatory drug, one or more combination of gentamycin, tobramycin in the antibiotics; The alginic acid of lacrimal duct embolus, calcium alginate molecular weight are 20~650,000, and the chitosan molecule amount is 15~550,000, and deacetylation is 70~95%; Its physical form of lacrimal duct embolus is long 1.0~2.5mm, and diameter 0.2~1.0mm's is cylindrical, and suction back volume is inflatable to be original 2.0~2.5 times; The preparation method of degradable lacrimal passage plug is as follows: (1) adopt molecular weight be 20~650,000 biologys absorbable sodium alginate be dissolved in normal saline, obtain the high viscosity solution that concentration is 3~10wt%, solution centrifugal or vacuumize degassing bubble is obtained preparing stock solution, with the air pressure of 0.2~0.8Mpa it is pressed into the CaCl that concentration is 5~10wt% gradually with special compression pump
2In the solution; Leave standstill the alginic acid-calcium alginate filament that obtained successive diameter 0.5~2.0mm in 30 minutes; Filament is washed, placing deacetylation then is that 70~95% concentration is that the aqueous solution of 0.5~3.5wt% chitosan and 0.5~5wt% spirit of vinegar soaks and modifies, and to alginic acid: chitosan: the calcium alginate weight ratio is that take out 1: 0.1: 0.3~1: 1: 0.7 back; Filament with washing of 75% alcoholic solution and gradient dehydration, is used the freeze dryer lyophilizing then, obtain the filament that diameter is 0.2~1.0mm, being cut to length is 1.0~2.5mm, the cylinder of diameter 0.2~1.0mm, and cobalt 60 sterilizations, envelope is standby; The preparation method of degradable lacrimal passage plug, wherein concentration is can add antiinflammatory and the antibacterials that concentration is 0.1~10wt% in the aqueous solution of 0.5~3.5wt% chitosan and 0.5~5wt% spirit of vinegar, so that be written into relative medicine in the product; The preparation method of degradable lacrimal passage plug, wherein concentration is can add antiinflammatory and the antibacterials that concentration is 0.1~10wt% in the high viscosity sodium alginate soln of 3~10wt%, so that be written into relative medicine in the product.
Embodiment one, adopting molecular weight is 500,000, and biology, absorbable sodium alginate was dissolved in tri-distilled water, obtained the high viscosity solution that concentration is 5wt%, the solution centrifugal deaeration is obtained preparing stock solution, be pressed into the CaCl that concentration is 5wt% gradually with the air pressure of 0.6Mpa with special compression pump
2In the solution; Leave standstill the alginic acid-calcium alginate filament that obtained successive diameter 1.5mm in 30 minutes.With filament washing, place then deacetylation be 75% concentration be the aqueous solution of 1.5wt% chitosan and 2wt% spirit of vinegar soak modify 30 minutes must alginic acid-chitin-alginic acid calcium filament.Filament is dewatered with the washing of 75wt% alcoholic solution and with the Different concentrations of alcohol solution gradient, and with the filament that obtains freeze dryer lyophilizing, cutting into length is 1.5mm, the cylinder of diameter 0.4mm, and cobalt 60 sterilizations, envelope is standby.
Embodiment two, adopting molecular weight is 350,000, biology, absorbable sodium alginate was dissolved in the tri-distilled water that contains the 2wt% dexamethasone injection, compound concentration is the high viscosity solution of 4wt%, the solution centrifugal deaeration is obtained preparing stock solution, be pressed into the CaCl that concentration is 6wt% gradually with the air pressure of 0.8Mpa with special compression pump
2In the solution; Leave standstill the sodium alginate-calcium alginate filament that obtained successive diameter 1.5mm in 30 minutes.Wash filament with tri-distilled water, placing deacetylation then is that 82% concentration is that the aqueous solution of 1wt% chitosan and 2wt% spirit of vinegar soaks, and leaves standstill chemical treatment in 20 minutes and gets alginic acid-chitin-alginic acid calcium filament.Filament is dewatered with 75wt% washing with alcohol and gradient, and with the filament that obtains freeze dryer lyophilizing, cutting into length is 1.0mm, the filament of diameter 0.3mm, and cobalt 60 sterilizations, envelope is standby.
Embodiment three, adopting molecular weight is 450,000, absorbable sodium alginate was dissolved in the aqueous solution that contains the 1.5wt% gentamycin and obtained the high viscosity solution that concentration is 5wt% biology, the solution vacuumizing and defoaming is obtained preparing stock solution, be pressed into the CaCl that concentration is 9wt% gradually with the air pressure of 0.3Mpa with special compression pump
2In the solution; Leave standstill the alginic acid-calcium alginate filament that obtained successive diameter 2.0mm in 30 minutes.Filament is washed with tri-distilled water, and placing deacetylation then is that 85% concentration is that the aqueous solution of 2.5wt% chitosan and 2.5wt% spirit of vinegar soaks, and leaves standstill chemical treatment in 20 minutes and gets alginic acid-chitin-alginic acid calcium filament.Filament is dewatered with washing of 75% alcoholic solution and gradient, and with the filament that obtains freeze dryer lyophilizing, cutting into length is 1.5mm, the filament of diameter 1.0mm, and cobalt 60 sterilizations, envelope is standby.
Embodiment four, adopting molecular weight is 550,000, biology, absorbable sodium alginate was dissolved in the tri-distilled water that contains 1.5% tobramycin, obtain the high viscosity solution that concentration is 6wt%, the solution centrifugal deaeration is obtained preparing stock solution, be pressed into the CaCl that concentration is 8wt% gradually with the air pressure of 0.6Mpa with special compression pump
2In the solution; Leave standstill the alginic acid-calcium alginate filament that obtained successive diameter 2.5mm in 20 minutes.Filament is washed with tri-distilled water, and placing deacetylation then is that 85% concentration is that the aqueous solution of 3wt% chitosan and 3wt% spirit of vinegar soaks, and leaves standstill chemical treatment in 15 minutes and gets alginic acid-chitin-alginic acid calcium filament.Filament is dewatered with washing of 75% alcoholic solution and gradient, and with the filament that obtains freeze dryer lyophilizing, cutting into length is 2.0mm, the filament of diameter 0.5mm, and cobalt 60 sterilizations, envelope is standby.
Embodiment five, adopting molecular weight is 600,000, absorbable sodium alginate was dissolved in and contained the 2wt% dexamethasone injection biology, in the tri-distilled water of 20,000 U gentamycins, obtain the high viscosity solution that concentration is 7wt%, the solution centrifugal deaeration is obtained preparing stock solution, be pressed into the CaCl that concentration is 9wt% gradually with the air pressure of 0.3Mpa with special compression pump
2In the solution; Leave standstill the sodium alginate-calcium alginate filament that obtained successive diameter 1.5mm in 10 minutes.With filament washing, placing deacetylation then is that 95% concentration is that the aqueous solution of 2.5wt% chitosan and 2wt% spirit of vinegar soaks, and leaves standstill chemical treatment in 15 minutes and gets alginic acid-chitin-alginic acid calcium filament.Filament is dewatered with washing of 75% alcoholic solution and gradient, and with the filament that obtains freeze dryer lyophilizing, cutting into length is 1.0mm, the filament of diameter 1.0mm, and cobalt 60 sterilizations, envelope is standby.
Embodiment six, adopting molecular weight is 650,000, absorbable sodium alginate was dissolved in and contained the 2wt% dexamethasone injection biology, in the 1.5wt% gentamycin tri-distilled water, obtain the high viscosity solution that concentration is 8wt%, the solution centrifugal deaeration is obtained homogenate, be pressed into the CaCl that concentration is 10wt% gradually with the air pressure of 0.8Mpa with special compression pump
2In the solution; Leave standstill the sodium alginate-calcium alginate filament that obtained successive diameter 1.5mm in 30 minutes.With filament washing, placing deacetylation then is that 95% concentration is that the aqueous solution of 3wt% chitosan and 2wt% spirit of vinegar soaks, and leaves standstill chemical treatment in 20 minutes and gets alginic acid-chitin-alginic acid calcium filament.Filament is dewatered with washing of 75% alcoholic solution and gradient, and with the filament that obtains freeze dryer lyophilizing, cutting into length is 1.5mm, the filament of diameter 0.7mm, and cobalt 60 sterilizations, envelope is standby.
Below the present invention is further described in detail: the embolus of above each embodiment preparation, physical form is small cylinder, and length is 1.0~2.5mm, and diameter is the cylindrical of 0.2~1.0mm, to be fit to the implantation of different thicknesses lacrimal passage.Environment is observed lacrimal duct embolus of the present invention in the simulation human body lacrimal passage: the lacrimal duct embolus that the appeal method makes is inserted in the small test tube, add and contain in the normal saline of lysozyme (concentration is 1.7mg/ml), put into 37 ℃ of water baths, change liquid every day and observe its variation.The result: expansion rate is about 200~250% after the lacrimal duct embolus rehydration.The finished product embolus that embodiment 1 ~ 6 makes all can be degraded in 3 months fully, and its degradation cycle is different because of the concentration of chitosan dilute acetic acid solution, and the big more degradation cycle of its concentration is long more.Detect the normal saline of medicine carrying lacrimal duct embolus with high performance liquid chromatograph and change clothes liquid discovery, the existence that all can measure medicine when embolus is not degraded fully.Show after, need not take out and just can make lacrimal passage logical again, because of antiinflammatory, the anti-cicatrix of effect of chitosan self and the medicine that is loaded with the incidence rate of local inflammation and propagation parcel is reduced in addition from melting with lacrimal duct embolus implant into body lacrimal passage of the present invention.
The clinical report of a kind of novel degradable lacrimal passage plug and preparation method thereof: in selecting to be diagnosed as, patient's 60 examples of severe xerophthalmia, be divided into two groups by randomly assigne, each 30 example of artificial tears's treatment group and lacrimal duct embolus treatment group.Artificial tears's treatment group gives hyaluronate sodium medicament for the eyes day four eye dripping treatments, and lacrimal duct embolus treatment group descends lacrimal point to implant the treatment of preparation lacrimal duct embolus.Followed up a case by regular visits to for 2 weeks, to carrying out lacrimal secretion amount, breakup time of tear film and cornea fluorescent staining scoring carrying out record before and after the treatment.
After two weeks, two groups of patient's eyes are done and are waited malaise symptoms that in various degree improvement is all arranged.After application SPSS13.0 software analysis treated for 2 weeks, the variation of each check result.Use pairing T check analysis, the lacrimal secretion amount before and after using artificial tear group and the treatment of lacrimal duct embolus treatment group does not all have significant difference (p>0.05), illustrates that two kinds of treatments all can not increase patient's lacrimal secretion (table 1).Breakup time of tear film all prolongs before and after two groups of treatments, use pairing T check analysis, significant difference (p<0.05) is arranged before and after two groups of patient treatments, and the result uses T check analysis in groups after two groups of medications, significant difference (p<0.05) is also arranged, and visible lacrimal duct embolus treatment group prolongs breakup time of tear film and obviously is better than using the artificial tears to organize (table 2).Use pairing rank test analysis, fluorescent staining is clearly better before and after two groups of treatments, significant difference (p<0.05) is arranged, 2 week two groups of fluorescent staining results in back use rank test analysis in groups, there was no significant difference (p>0.05), explanation is for the treatment of this group dry eye patients corneal epithelium pathological changes, and lacrimal duct embolus has similar effect (table 3) with the artificial tears.
Table 1Schirmer result of the test (mm)
Table 2 breakup time of tear film (BUT) result (second)
Table 3 fluorescent staining result
The clinic trial preliminary conclusion: the lacrimal duct embolus that adopts the method for the invention to prepare is applied to clinical, and therapeutic effect is satisfied, does not find severe complication.