CN101780257B - 一种治疗类风湿性关节炎的中药 - Google Patents
一种治疗类风湿性关节炎的中药 Download PDFInfo
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Abstract
本发明公开了一种治疗类风湿性关节炎的中药,其特征在于:它由以下重量配比的中药原料组成:防风3-5%,炮附子3-5%,炮山甲2-4%,淫羊藿3-5%,续断4-6%,姜黄3-5%,熟地黄6-8.2%,补骨脂4-6%,骨碎补3-5%,制马钱子0.3-0.5%,全蝎2-4%,白芷3-5%,肉桂2-4%,白芍4-6%,赤芍4-6%,土鳖虫3-5%,灸麻黄1-3%,连翘5-7%,牛膝5-7%,黄柏1-3%,苍术2-4%,寻骨风3-5%,透骨草11-14%。该治疗类风湿性关节炎的中药,能明显缓解临床症状和体征,降低了ESR和RF滴度,同时在治疗过程中,未发生医源性血管、神经损伤事故,也未见因药物引起的不良反应,安全可靠,副作用小、疗程短、效果好,治疗费用低,极大的缓解了患者的痛苦。
Description
技术领域
本发明涉及一种治疗关节炎的中药,具体地说是一种治疗类风湿性关节炎的中药。
背景技术
类风湿性关节炎又称类风湿(RA),是一种病因尚未明了的慢性全身性炎症性疾病,以慢性、对称性、多滑膜关节炎和关节外病变为主要临床表现,属于自身免疫炎症性疾病。该病好发于手、腕、足等小关节,反复发作,呈对称性分布。早期有关节红、肿、热、痛和功能障碍,晚期关节可出现不同程度的僵硬、畸形,并伴有骨和骨骼肌的萎缩,极易致残,根据统计数据,未经治疗的患者两年的致残率约为50%。目前,西医的临床治疗多以非甾体类抗炎药、免疫抑制剂、糖皮质激素等为主,但这些药物副作用大,患者多难以坚持治疗。传统医学认为,类风湿性关节炎属于中医的“痹症”范畴,认为其病因病机为感受风、寒、湿邪,痹阻经络,气血运行不畅,致肌肉、筋骨、关节肿痛、麻木、关节畸形,但目前还没有行之有效的中药可以达到理想的治疗效果。
发明内容
本发明的目的在于提供一种副作用小、疗程短、效果好,治疗费用低的治疗类风湿性关节炎的中药。
为了达到以上目的,本发明所采用的技术方案是:该一种治疗类风湿性关节炎的中药,其特征在于:它由以下重量配比的中药原料组成:防风3-5%,炮附子3-5%,炮山甲2-4%,淫羊藿3-5%,续断4-6%,姜黄3-5%,熟地黄6-8.2%,补骨脂4-6%,骨碎补3-5%,制马钱子0.3-0.5%,全蝎2-4%,白芷3-5%,肉桂 2-4%,白芍4-6%,赤芍4-6%,土鳖虫3-5%,炙麻黄1-3%,连翘5-7%,牛膝5-7%,黄柏1-3%,苍术2-4%,寻骨风3-5%,透骨草11-14%。
本发明所述的中药原料最佳重量配比组成为:防风10g,炮附子10g,炮山甲6g,淫羊藿9g,续断12g,姜黄10g,熟地黄18g,补骨脂12g,骨碎补10g,制马钱子1g,全蝎6g,白芷10g,肉桂6g,白芍12g,赤芍12g,土鳖虫10g,炙麻黄6,连翘15g,牛膝15g,黄柏6g,苍术6g,寻骨风10g,透骨草30g。服用方法:将上述中药原料进行水煎服,每日一剂,分早、晚二次服用,14天一个疗程,服用前必须加热至沸腾方可服用。停药7天,继续下一个疗程的服药,期间,必须检查肝肾功能,以免发生马钱子中毒现象。连服个疗程。本发明配合小宽针松解治疗同时进行,效果更好。
本发明的药理:类风湿性关节炎当属于中医学中“痹症”、“尪痹”、“历节”等范畴,是由人体营卫失调,风、寒、湿、热邪侵入机体,流注经脉,留于关节、肌肉、筋骨,进而阻塞经络,使气血运行不畅,经脉阻滞,不通则痛;经络闭阻,则关节肿胀,病久成瘀,而致血停为瘀、湿凝为痰,痰瘀互结则关节畸形;闭阻日久,经久不愈伤及正气,累及肝、脾、肾等脏腑。该病本在肝、脾、肾,标在经络、筋肉、关节,病性虚实夹杂。治疗应以祛瘀通络、清热宣痹为主则,兼顾补阴血、益肝肾,固本培元。方中土鳖虫、姜黄、炮山甲、制马钱子、牛膝祛瘀通络为君药;防风、白芷温散风寒、胜湿祛风止痛,苍术、寻骨风、透骨草祛风湿、通经络;黄柏清湿热、泻虚火,连翘清热解毒散结,以上六味清热解表宣痹,协助君药疏通痹塞经络为臣药;炮附子、肉桂回阳救逆、温中散寒止痛;全蝎镇惊熄风;熟地、白芍、赤芍补血行血;淫羊藿、补骨脂、骨碎补、续断补肝肾、续筋骨、通经络、祛风湿,为佐药;炙甘草调和诸药为使药。全方合用,具有祛瘀通络、清热解表宣痹、补阴血、益肝肾,固 本培元之功效。
防风:辛、甘,微温。归膀胱、肺、脾经。功用主治:祛风解表,胜湿止痛,止痉,止痒。主治外感风寒,偏正头痛,风湿痹痛,腹痛泄泻,肠风下血,破伤风,小儿惊风,风疹瘙痒,疮疡初起。
炮附子:辛、甘,热,有毒。归心、肾、脾经。功用主治:回阳救逆,散寒除湿。主治阴盛格阳,大汗亡阳,吐泻厥逆,心腹冷痛,冷痢,脚气水肿,风寒湿痹,阴疽疮漏及一切沉寒痼冷之疾。
炮山甲:咸,微寒,归肝、胃经。功用主治:活血通经,下乳,消痈。主治血瘀经闭,癥瘕,风湿痹痛,乳汁不下,痈肿,瘰疬。
淫羊藿:辛、甘,温。归肾、肝经。功用主治:补肾壮阳,强筋健骨,祛风除湿。主治阳痿遗精,虚冷不育,尿频失禁,肾虚喘咳,腰膝酸软,风湿痹痛,半身不遂,四肢不仁。
续断:苦、辛,微温。归肝、肾经。功用主治:补肝肾,强筋骨,调血脉,止崩漏。主治腰背酸痛,肢节痿痹,跌扑创伤,损筋折骨,胎动漏红,血崩,遗精,带下,痈疽疮肿。
姜黄:苦、辛,温。归脾、肝经。功用主治:破血行气,通经止痛。主治血瘀气滞诸证,胸腹胁痛,妇女痛经,闭经,产后瘀滞腹痛,风湿痹痛,跌打损伤,痈肿,诸疮癣初生时痛痒。
熟地黄:甘,温。归肝、肾经。功用主治:补血滋阴,益精填髓。主治血虚萎黄,眩晕心悸,月经不调,崩漏不止,肝肾阴亏,潮热盗汗,遗精阳痿,不孕不育,腰膝酸软,耳鸣耳聋,头目昏花,须发早白,消渴,便秘,肾虚喘促。
补骨脂:辛、苦,温。归肾、脾经。功用主治:补肾助阳,固精缩尿,暖 脾止泻。主治虚寒腰痛,阳痿滑精,遗尿,尿频,久泻,虚喘,白癜风,斑秃,银屑病。
骨碎补:苦,温。归肝、肾经。功用主治:补肾强骨,活血止痛。主治肾虚腰痛,足膝痿弱,耳鸣耳聋,牙痛,久泄,遗尿,跌打骨折及斑秃。
制马钱子:苦,寒,大毒。归肝、脾经。功用主治:通络止痛,散结解毒。主治风湿痹痛,肌肤麻木,肢体瘫痪,跌打损伤,痈疽疮毒,喉痹,牙痛,疠风,顽癣,恶性肿瘤疼痛。
白芷:辛,温。归肺、脾、胃经。功用主治:祛风除湿,通窍止痛,消肿排脓。主治感冒头痛,眉棱骨痛,牙痛,鼻塞,鼻渊,湿盛久泻,赤白带下,痈疽疮疡。
肉桂:辛、甘,热。归肾、脾、心、肝经。功用主治:补火助阳,散寒止痛,温经通脉。主治肾阳不足,命门火衰之畏寒肢冷,腰膝疫软,阳痿遗精,小便不利或频数,短气喘促,浮肿尿少诸证;命门火衰,火不归元,戴阳、格阳,及上热下寒,面赤足冷,头晕耳鸣,口舌糜烂;脾肾虚寒,腕腹冷痛,食减便溏;肾虚腰痛;寒湿痹痛;寒疝疼痛;宫冷不孕,痛经经闭,产后瘀滞腹痛;阴疽流注,或虚寒痈疡脓成不溃,或溃后不敛。
白芍:苦、酸,微寒。归肝、脾经。功用主治:养血和营,缓急止痛,敛阴平肝。主治血虚寒热,脘腹疼痛,胁痛,肢体痉挛疼痛,痛经,月经不调,崩漏,自汗,盗汗,下痢泄泻,头痛眩晕。
赤芍:苦,微寒。归肝、脾经。功用主治:清热凉血,活血祛瘀。主治温毒发斑,吐血衄血,肠风下血,目赤肿痛,痈肿疮疡,闭经,痛经,崩带淋浊,瘀滞胁痛,疝瘕积聚,跌扑损伤。
土鳖虫:咸,寒;有小毒。归肝经。功用主治:破瘀血,续筋骨。用于筋骨折伤,瘀血经闭,症瘕痞块。
炙麻黄:辛、微苦,温。归肺、膀胱经。功用主治:发汗解表,宣肺平喘,利水消肿。主治风寒表实证,咳嗽气喘,风水,小便不利,风湿痹痛,肌肤不仁,风疹瘙痒,阴疽痰核。
连翘:苦,微寒。归肺、心、胆经。功用主治:清热解毒,消肿散结。主治风热感冒,温病,热淋尿闭,痈疽,肿毒,瘰疬,瘿瘤,喉痹。
牛膝:苦、酸,平。归肝、肾经。功用主治:补肝肾,强筋骨,活血通经,引血下行,利尿通淋。主治腰膝疫痛,下肢痿软。血滞经闭,痛经,产后血瘀腹痛,癥瘕,胞衣不下,热淋,血淋,跌打损伤,痈肿恶疮,咽喉肿痛。
黄柏:苦,寒。归肾、膀胱、大肠经。功用主治:清热燥湿,泻火解毒。主治湿热痢疾、泄泻、黄疸,梦遗、淋浊、带下,骨蒸劳热,痿躄,以及口舌生疮,目赤肿痛,痈疽疮毒,皮肤湿疹。
寻骨风:辛、苦,平。归肝经。功用主治:祛风除湿,通络止痛。主治风湿痹痛,肢体麻木,筋骨拘挛,脘腹疼痛,睾丸肿痛,跌打伤痛,乳痈。
透骨草:辛,温。归肝、肾经。功用主治:祛风除湿,舒筋活血,散瘀消肿,解毒止痛。主治风湿痹痛,筋骨挛缩,寒湿脚气,腰部扭伤,瘫痪,闭经,阴囊湿疹,疮疖肿毒。
诊断标准:ARA 1987年6月第51届ARA会议修订的标准:
早起关节僵硬至少1小时(≥6周);
3个以上关节肿胀(≤6周);
手关节或掌指关节或近端指间关节肿胀(≤6周);
对称性肿胀;
手的X线改变;
皮下结节;
类风湿因子。
如具备4项以上指标即可确诊。
疗效判断标准:
近期控制:经治疗后受累关节肿痛消失,关节功能改善或恢复正常,RF、ESR恢复正常,且停药后可维持3个月以上。
显效:受累关节肿痛明显好转或消失,ESR、RF滴度降低,或ESR、RF已恢复正常,但关节肿痛尚未消失。
有效:经治疗后受累关节疼痛或肿痛有好转。
无效:经治疗5个疗程(整个治疗过程105天以上),受累关节肿痛无好转。
临床治疗共100例,近期控制31例,近期控制率为31%,显效34例,显效率为34%,有效31例,总有效率96%。
本发明的有益效果在于:能明显缓解临床症状和体征,降低了ESR和RF滴度,同时在治疗过程中,未发生医源性血管、神经损伤事故,也未见因药物引起的不良反应,安全可靠,副作用小、疗程短、效果好,治疗费用低,极大的缓解了患者的痛苦。
具体实施方式
实施例1
一种治疗类风湿性关节炎的中药,由以下重量的中药原料药组成:防风10g,炮附子10g,炮山甲6g,淫羊藿9g,续断12g,姜黄10g,熟地黄18g,补骨脂12g,骨碎补10g,制马钱子1g,全蝎6g,白芷10g,肉桂6g,白芍12g,赤芍12g,土鳖虫10g,炙麻黄6,连翘15g,牛膝15g,黄柏6g,苍术6g,寻骨风10g,透骨草30g。
用本实施例临床治疗共50例,近期控制17例,近期控制率为34%,显效17例,显效率为34%,有效14例,总有效率96%。
典型病例
患者赵xx,男,42岁,莱芜市莱城区人,农民。因长期在南方打工住地潮湿,出现全身多处关节痛,尤其以手指发凉,皮肤苍白无血色,时有麻木。四肢大小关节均肿大变形,关节局部发热,酸胀,有灼热。夜间疼痛加重,怕风,有时出现呈游走性痛,四肢末端发凉,气短倦怠,双臂不能向外伸展抬高,双肘仅能伸展120度。各指间关节间隙明显变窄,双侧骶髂关节融合,腕、膝、踝关节及足趾关节,均呈对称性疼痛。化验:血沉42mm/h,RF阳性,X线示:骨质稀疏明显,诊断为“类风湿性关节炎I期”,采用本发明治疗,水煎服,每天1剂,分2次服用。同时对肿痛关节处给予小宽针松解治疗,取关节两侧的关节囊肿胀疼痛最明显处定点,选3-5处施术,20天后行第二次松解术,总共5次松解治疗,上述症状逐渐减轻,面色红润,关节活动自如,两臂可上举过头,肘关节伸展明显改善。治疗半年后临床症状基本控制,随访1年未复发。
实施例2
一种治疗类风湿性关节炎的中药,由以下重量的中药原料药组成:防风11g,炮附子9g,炮山甲7g,淫羊藿10g,续断11g,姜黄10g,熟地黄17g,补骨脂 13g,骨碎补9g,制马钱子1g,全蝎6g,白芷11g,肉桂6g,白芍11g,赤芍13g,土鳖虫9g,炙麻黄7g,连翘14g,牛膝15g,黄柏7g,苍术7g,寻骨风17g,透骨草27g。
用本实施例临床治疗共50例,近期控制14例,近期控制率为28%,显效17例,显效率为34%,有效17例,总有效率96%。
典型病例
患者李x,女,15岁,2006年9月2日就诊。患者面色苍白,四肢关节刺痛,晨起十指、手腕关节僵硬1小时左右,双手中指、右膝关节肿胀,右肘、双膝关节疼痛,右前臂不能伸直、内旋伴肌肉萎缩,双膝只能屈曲100度左右,行走时左下肢呈拖步态。胃纳尚可,大便干结,偶有心慌,舌红、苔薄,脉细数。实验室检查:抗“0”815u、ESR 58mm/h、RF强阳性,X线示:骨质稀疏明显,诊断为类风湿性关节炎。中医辨证为尪痹(湿热郁结)。采用本发明治疗,水煎服,每天1剂,分2次服用。同时对疼痛关节处给予小宽针松解治疗,每次松解3-5个治疗点,松解术方法同上。小宽针治疗后立刻止痛,关节活动有所恢复,治疗3个月后上述症状逐渐减轻,面色红润,活动自如,两臂可上举过头,肘关节伸展明显改善。5个月后临床症状基本控制,复查:抗“0”588u、RF弱阳性。6个月后复查,抗“0”476u,患者已无晨僵,右膝外侧稍有发热,无肿痛,右肘关节比以前灵活,可稍微内旋,双膝关节屈伸稍有不利,但无疼痛,精神状态良好,面色红润,无不适。
Claims (2)
1.一种治疗类风湿性关节炎的中药,其特征在于:它由以下重量配比的中药原料组成:防风3-5%,炮附子3-5%,炮山甲2-4%,淫羊藿3-5%,续断4-6%,姜黄3-5%,熟地黄6-8.2%,补骨脂4-6%,骨碎补3-5%,制马钱子0.3-0.5%,全蝎2-4%,白芷3-5%,肉桂2-4%,白芍4-6%,赤芍4-6%,土鳖虫3-5%,炙麻黄1-3%,连翘5-7%,牛膝5-7%,黄柏1-3%,苍术2-4%,寻骨风3-5%,透骨草11-14%。
2.根据权利要求1所述的一种治疗类风湿性关节炎的中药,其特征在于:它由以下重量中药原料组成:防风10g,炮附子10g,炮山甲6g,淫羊藿9g,续断12g,姜黄10g,熟地黄18g,补骨脂12g,骨碎补10g,制马钱子1g,全蝎6g,白芷10g,肉桂6g,白芍12g,赤芍12g,土鳖虫10g,炙麻黄6 g,连翘15g,牛膝15g,黄柏6g,苍术6g,寻骨风10g,透骨草30g。
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