Background technology
Wound has been one of three big causes of the death since 20th century, simultaneously developed country's wound also be cause between twenty and fifty dead and invalid head because of, bring extreme pain to the patient, also cause enormous economic loss to society.Development along with modern medicine, especially the development of microsurgery after the sixties, improved post-traumatic survival rate dramatically, make numerous patients see hope, yet, still have many wounded can not return original work position by among the patient who saves, because the recovery of neuromuscular function remains a great problem of current medical circle after the wound, and the solution of this difficult problem not only needs a large amount of clinical positions, also relates to a series of underlying issues
As innerv effector, the atrophy degeneration inevitably takes place in skeletal muscle after losing innervation, simultaneously because neuranagenesis is very slow; often before reinnervation; the myocyte has lost regenerated material base, promptly forms irreversible amyotrophy, and its function is with irrecoverable.Therefore how Acceleration of nerve regeneration is one of key issue of functional rehabilitation after the solution wound.For this reason, Chinese scholars has been done unremitting effort.As far back as the 1950's, the foreign scholar has just found nerve growth factor (NGF), successively there is research to report the neurotrophic factor that NGF family (NGF, BDNF, NT-3, NT-4, NT-5 etc.) and the multiple source of non-NGF family (CNTF, IGF, GDNF, SDNF etc.) are different, be not quite similar, and a series of achievements in experimentation, have been obtained, yet whether can promote that clinically still there is bigger arguement in neuranagenesis, and so far breakthrough clinical progress not arranged as yet.
In recent years, Chinese medicine receives clinical increasing concern to the effect of peripheral nerve regeneration, studies show that out, Chinese medicine has preliminary curative effect to the regeneration of quickening behind the peripheral nerve injury, and its low price, toxic and side effects is little, has very huge clinical practice potentiality.Prior art related to the present invention has following list of references:
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Summary of the invention
The purpose of this invention is to provide a kind of have promote the neuromuscular regeneration compound Chinese medicinal preparation and preparation method thereof.
Compound preparation of the present invention is made by effective ingredient and pharmaceutical carrier and is promoted the regenerated compound preparation of neuromuscular, described effective ingredient is made up of following weight parts proportion raw material medicine component: Radix Codonopsis: the Radix Astragali: Radix Salviae Miltiorrhizae: the Radix Rehmanniae: Radix Angelicae Sinensis: Flos Carthami is 10: 10: 10: 10: 5: 2, surplus was adjuvant.
Described adjuvant is pharmaceutically acceptable adjuvant or complementary composition.
Chinese crude drug Radix Codonopsis involved in the present invention, the Radix Astragali, Radix Salviae Miltiorrhizae, the Radix Rehmanniae, Radix Angelicae Sinensis and Flos Carthami are recorded Chinese medicine by Chinese Pharmacopoeia one one of version in 2000, and are met the pharmacopeia prescription.
It acts on same Radix Ginseng described Radix Codonopsis, can promote the synthetic and sugar of DNA to separate, and the energy metabolism of raising and protein synthesis and invigorating primordial QI are arranged, admittedly take off promote the production of body fluid effect; The Radix Astragali has the effect of strengthening body; Radix Angelicae Sinensis has the effect that improves general metabolism; Flos Carthami, Radix Salviae Miltiorrhizae and the Radix Rehmanniae have blood circulation promoting and blood stasis dispelling, the effect that removing heat from blood nourishes blood.
Compound preparation of the present invention prepares by following method and step,
Carry out weighing according to the prescription proportioning, except that Flos Carthami, get all the other medical materials and clean, be cut into the fine grained chippings of 1~2cm after drying in the ventilation, soak with 4-10 times of water gaging and decoct 2h * 2 time behind the 12h, the water extract leaves standstill 12h after filtering, refilter once, heating is concentrated into volume required, gets Chinese medicine intermediate (the water extracted immersing paste), after the drying, airflow pulverization method is ground into micropowder 10 ~ 15 μ m; The fine powder mix homogeneously adds adjuvant or complementary composition, and mixing is made compound preparation.
Described compound preparation can be made electuary, powder, granule, pill or capsule.
The present invention has compared the short peripheral nervous growth effect of the above-mentioned Chinese medicine intermediate of distinct methods preparation, it is good that the result shows in the different preparation methoies with the water extraction drug effect, and through further pharmacology and qualitative analysis experiment, explore main effective ingredient wherein, on this basis, establish the quantitative analysis method of bioactive chemical constituent, based on water extraction, yield with polysaccharide, ferulic acid, danshensu and intermediate serves as to investigate index, uses orthogonal test method and optimizes optimised process.The preparation technology of the preferred intermediate of the present invention is wherein: with 8 times of water gaging heating and refluxing extraction 3 times, each reflux extracting time is 1 hour.
The present invention is a material with intermediate (the water extracted immersing paste), with colorimetric method for determining polyoses content in the extractum, the result is presented between 2.09~6.21%; Measure ferulic acid and content of Danshensu with the HPLC method, measurement result shows respectively between 0.050~0.092 μ g/ (mg extractum) and 0.234~0.419 μ g/ (mg extractum).
Compound preparation of the present invention has carried out pharmacological experiment, neural far-end GAP-43mRNA expressed and the synthetic influence of albumen after use in conjunction real-time quantitative RT-PCR method and immunohistochemical method observed it to peripheral nerve injury, and the Change of Ultrastructure of the corresponding sensory neuron of injured nerve is observed, the result shows, can make the GAP-43 in the earlier damage nerve express increase, the GAP-43 of these increases more can be attached to G albumino reaction site competitively, promote aixs cylinder to grow fast, help synapse and rebuild; After using herbal mixture after the Rats'Sciatic Nerve Injury, the mitochondrial swelling and degeneration degree of corresponding sensory neuron after the nerve injury, compound preparation group of the present invention is significantly better than matched group, and its satellite cell links to each other with neuron, and born of the same parents' inner cell organ is abundant; Experimental result shows; compound preparation of the present invention can promote the metabolism of body; the blood that increases damaged part supplies; help nerve and improve ischemic state; remove the myelin of degeneration; promote the division and the propagation of schwann cell; further regulate and control GAP-43 by the antidromicity signal that influences the generation of far-end target tissue; be beneficial to neural regeneration; early stage regeneration to mice and rat sciatic nerve all has obvious facilitation; corresponding sensory neuron after the injury of sciatic nerve is also had the certain protection effect, and the result confirms that compound preparation of the present invention has the pharmacological action that promotes peripheral nerve regeneration.
The present invention has carried out the zoopery of treatment peripheral nerve injury, the result shows, this compound preparation is to quickening the regeneration significant effective behind the peripheral nerve injury, and this compound preparation can further be made clinical in promoting the regenerated medicine of neuromuscular, benefits more nerve injury patient.
Obviously, according to foregoing of the present invention, ordinary skill knowledge and customary means according to this area can suitably change in the qualification that does not break away from spirit of the present invention.
The specific embodiment
Embodiment 1
Weighing Chinese crude drug Radix Codonopsis: the Radix Astragali: Radix Salviae Miltiorrhizae: the Radix Rehmanniae: Radix Angelicae Sinensis: Flos Carthami is 10: 10: 10: 10: 5: 2, claim proportioning weighing Chinese crude drug Radix Codonopsis according to the prescription weight portion: the Radix Astragali: Radix Salviae Miltiorrhizae: the Radix Rehmanniae: Radix Angelicae Sinensis: Flos Carthami is 10: 10: 10: 10: 5: 2, except that Flos Carthami, getting all the other medical materials cleans, be cut into the fine grained chippings of 1~2cm after drying in the ventilation, soak with 4-10 times of water gaging and to decoct 2h * 2 time behind the 12h, the water extract leaves standstill 12h after filtering, refilter once, heating is concentrated into volume required, get Chinese medicine intermediate (the water extracted immersing paste), after the drying, airflow pulverization method is ground into micropowder 10 ~ 15 μ m; The fine powder mix homogeneously adds adjuvant or complementary composition, and mixing is made compound preparation.
Described compound preparation can be made electuary, powder, granule, pill or capsule.
Embodiment 2
Weighing Chinese crude drug Radix Codonopsis: the Radix Astragali: Radix Salviae Miltiorrhizae: the Radix Rehmanniae: Radix Angelicae Sinensis: Flos Carthami is 10: 10: 10: 10: 5: 2, claim proportioning weighing Chinese crude drug Radix Codonopsis according to the prescription weight portion: the Radix Astragali: Radix Salviae Miltiorrhizae: the Radix Rehmanniae: Radix Angelicae Sinensis: Flos Carthami is 10: 10: 10: 10: 5: 2, except that Flos Carthami, getting all the other medical materials cleans, be cut into the fine grained chippings of 1~2cm after drying in the ventilation, soak the 12h heating and refluxing extraction 3 times with 8 times of water gagings, each reflux extracting time is 1 hour, the water extract leaves standstill 12h after filtering, refilter once, heating is concentrated into volume required, gets Chinese medicine intermediate (the water extracted immersing paste), after the drying, airflow pulverization method is ground into micropowder 10 ~ 15 μ m; The fine powder mix homogeneously adds adjuvant or complementary composition, and mixing is made compound preparation.
Described compound preparation can be made electuary, powder, granule, pill or capsule.
3 pairs of rat sciatic nerve regeneration effect experiments of embodiment
Animal: 90 of SPF level Sprague-Dawley male rats, body weight 180g~200g (available from laboratory animal portion of Fudan University).
Rat is divided into 3 groups of A, B, C at random, 30 every group.The A group is the damage matched group; The B group is preparation group of the present invention; The C group is the ginkgo flavone and lactone group.Every group is divided into 5 subgroups, 6 of each subgroups by different time points after the injury of sciatic nerve (1,2,4,6,8w) again.
Equipment and medicine:
Desk-top operating microscope and 10 times, 16 times of eyepiece (SXP-1B, Shanghai medical optical instrument factory), microsurgery instruments and 11-0, the medical eyeless suture needle line of 12-0 (Ningbo City becomes and microinstrument factory), 3-0 admires a sutures (Johson ﹠ Johnson), muscular tension transducer (SMU-PC of physiology teaching and research room of shanghai Medicine institute of Fudan University type bio signal processing system), Phasis4 helical pitch myoelectricity brings out instrument (Italian ESATO company), IMS cytological image analyses system medical image software (Shanghai Shenteng Information Technology Co., Ltd.), routine operation apparatus: self-retractor, the tip needle holder, mosquito formula operating forceps, eye scissors (Shanghai Medical Apparatus and Instruments Factory), the self-control nerve hook.0.25% penthiobarbital (Shanghai Xinya Pharmaceutical Industry Co. Ltd.), bemegride injection (morning sunlight pharmaceutical factory of The 2nd Army Medical College), 0.9% sodium chloride injection (Shanghai Long March Fu Ming pharmaceutcal corporation, Ltd), penicillin sodium powder (Shanghai pioneer pharmaceutcal corporation, Ltd).
Method:
Animal makes intraperitoneal injection of anesthesia with 0.25% penthiobarbital (0.1ml/kg).Make the RG angular cut under the aseptic condition, appear right sciatic nerves, cut off sciatic nerve apart from piriformis lower edge 0.8cm place, under operating microscope, sew up immediately, close otch with 11-0 noinvasive nylon needlework in the buttocks spatium intermusculare.Postoperative A organizes and gives normal saline 1ml filling stomach every day, the B group gives EGb50 (Xingling Sci. ﹠ Tech. Pharmaceutical Co., Ltd., Shanghai) to be provided, lot number 2004105) 200mgkg-1d-1 is diluted to 1ml with normal saline and irritates stomach, the C group gives preparation concentrated solution 1ml of the present invention and irritates stomach, respectively at the row regeneration distance of sensory nerve detection of 1 week of postoperative, use electrophysiology, histology and functional examination assessment sciatic nerve regeneration and functional rehabilitation situations in 2,4,6,8 weeks of postoperative.
Observation index:
1. the sciatic nerve function index (sciatic functional index, SFI):
Self-control rat foot walking case, the long 90cm of passage, wide 15cm, high 15cm.The passage near-end is placed a Mus case, long 20cm, and wide 15cm, high 15cm, one-sided opening the door placed continuous recording paper (20cm is wide) at the bottom of the case.Tried the two metapedes of Mus and dip in carbon ink, put into the walking tank inlet, Mus stays 4~5 footmarks in every side in the far-end crawling process, and choosing experiment parapodum (E) and normal parapodum (N) footmark are measured following three variablees.(1) (podogramlength PL), refers to the footmark longest distance to footmark length, and promptly heel is to the distance of toe.(2) the toes width (width betweenthe first and fifth toes, TW), i.e. the distance of first toe to the, five toe lines.Toes distance (3) (inter-toesdistance, IT), i.e. the distance of second toe to the, four toe lines.Above-mentioned three variable substitution Bain formula are calculated SFI, are normal value with SFI 0, and-100 is neural dialysis index fully.
SFI=-38.3(EPL-NPL)/NPL+109.5(ETS-NTS)/NTS+13.3(EIT-NIT)/NIT-8.8。
2. regeneration distance of sensory nerve (Pinch test)
Postoperative the 7th day, the anesthesia back exposes right sciatic nerves, under operating microscope with microsurgery forceps from anastomotic stoma far-end 2cm to the every interval 0.5mm of near-end apart from the clamp sciatic nerve, till muscle of back occurring and shrinking, be the regenerated distance of sensory nerve to the distance (being accurate to mm) of anastomotic stoma with this point of vernier caliper measurement.
3. electric physiological detection
With Italian Phasis myoelectric apparatus test.With bipolar electrode as stimulating electrode place the neural anastomosis mouth near, far-end 5mm place stimulates (side of not performing the operation stimulating electrode places opposite position respectively), is recording electrode with the core needle electrode, the insertion triceps surae.Near, the far-end that excites nerve writes down it and brings out current potential, according to its incubation period and stimulation point distance trying to achieve motor nerve conduction velocity.Electricity irritation and recording parameters: square wave: persistent period 0.1ms, stimulus intensity 0.3mA, stimulus frequency 1Hz, scanning speed 2ms/D.Keep neural moistening with warm saline in the whole operation process, avoid stimulating electrode contact muscular tissue on every side.
A) the triceps surae maximum is brought out current potential wave amplitude (MAP) recovery rate: will damage side (right side) and compare (R/L * 100%) with offside (left side) maximum amplitude and draw recovery rate (%).
B) motor nerve conduction velocity (MNCV) recovery rate: will damage side (right side) and compare (R/L * 100%) with offside (left side) motor nerve conduction velocity and draw recovery rate (%).
4. muscular tension is measured
Adopt SMU-PC type bio signal processing system (physiology teaching and research room of shanghai Medicine institute of Fudan University) to measure the single contractility and the tetanic contractility of triceps surae.With the fixing knee joint of No. 12 syringe needles, ligation is also cut off triceps surae far-end tendon.By the 1-0 silk thread its broken ends of fractured bone is connected on the tonotransducer, output lead links to each other with the twice physiograph, with the excite nerve near-end of anastomotic stoma of special silver wire electrode, adjust the optimal length of muscle, behind single stimulation of stimulation work with voltage 5V, the wide 0.2ms of ripple, frequency 1HZ, single contractility of record muscle.With the stimulation of voltage 5V, the wide 0.2ms of ripple, frequency 50HZ, stimulate and write down its tetanic contractility.Room temperature remains on 180C~250C in the operating process, and warm saline keeps neuromuscular moistening.
A) maximum single muscular contraction force recovery rate: get single stimulated muscle and shrink maximum amplitude (P-P value), relatively draw recovery rate (%) with strong side.
B) maximum tetanic contractility recovery rate: at stimulus frequency is to continue under the 50HZ to stimulate, and writes down maximum tetanic contractility, relatively draws recovery rate (%) with strong side.
5. the triceps surae weight in wet base is measured
After having surveyed muscular tension, put to death rat, be close to surface of bone and take out the both sides triceps surae, reject surperficial connective tissue, after filter paper blots surperficial blood, promptly be engraved on the electronic analytical balance (R200D, 1,/10 ten thousand, Germany) weigh.And and self be good for side triceps surae weight in wet base and relatively obtain recovery rate (%).
6. the myelinated nerve fiber percent of pass (Pass ratio, PR)
The neural anastomosis mouth is drawn materials with 3mm far away with nearly 2mm, gets respectively to be about one section nerve of 2mm, 10% formalin fixed, paraffin embedding, section, Toluidine blue staining.Gained section is got 1 every 3, connects and gets 5.Medical image software with IMS cytological image analyses system carries out distance end myelinated nerve fiber counting, obtains far-end myelinated nerve fiber percent of pass (%).
7. triceps surae myocyte sectional area recovery rate
Get bilateral triceps surae middle part muscle specimen, routine paraffin wax section, the thick 5 μ m of sheet, HE dyeing.20 muscle fibers in 5 visuals field are got in 5 of each specimen sections at random, measure myocyte's sectional area with IMS cell image processing system, and experimental side and strong pleural muscle cell sectional area are made comparisons, and draw myocyte's sectional area recovery rate (%).
Adopt SPSS11.0 statistics software to carry out statistical procedures, every group of sample adopts mean and standard deviation to calculate, with (x ± s) expression, one factor analysis of variance carries out statistical test, and P<0.05 is for there being statistical significance.
Result's demonstration,
Sciatic nerve function index (SFI): B, C group each time point SFI after surgery all obviously is better than the A group, and difference has statistical significance (P<0.01).Preparation group of the present invention is compared difference not statistically significant (P>0.05) with the ginkgo flavone and lactone group.
Regeneration distance of sensory nerve (Pinch test): in 1 week of postoperative, B, C group regeneration distance of sensory nerve is obviously greater than the A group, and its difference has statistical significance (P<0.01).Difference not statistically significant (P>0.05) between B, the C group.
Electricity physiological detection: B, C group after surgery 2,4,6,8 week each time point motor nerve conduction velocity and bring out current potential wave amplitude recovery rate and all be better than A group (P<0.01).2,4 weeks of postoperative, the difference not statistically significant (P>0.05) between B, the C group.In 6,8 weeks of postoperative, the B group is better than C group (P<0.05).
Simple 2 week of muscular tension: A group postoperative, 2 simple muscular tension of rat experiment side were not drawn.The recovery rate that B, C organize the simple muscular tension of each time point triceps surae all is better than the A group, and difference has statistical significance (P<0.01).In 2 weeks of postoperative, B organizes simple muscular tension recovery rate and is better than C group (P<0.05), 4,6,8 weeks of postoperative, the difference not statistically significant (P>0.05) between B, the C group.
Tetanic contractility: B, C organize the recovery rate of the tetanic contractility of each time point triceps surae, compare with the A group, and both differences have statistical significance (P<0.01).Difference not statistically significant (P>0.05) between B, the C group.
Muscle weight in wet base recovery rate: B, the C group triceps surae muscle weight in wet base recovery rate of 2,4,6,8 all each time points after surgery all is better than the A group, and difference has statistical significance (P<0.01).Difference not statistically significant (P>0.05) between B, the C group.
Myocyte's sectional area: postoperative 2,4,6,8 all A group triceps surae myocyte sectional area recovery rates all are starkly lower than B, C group, and difference has statistical significance (P<0.01).Difference not statistically significant (P>0.05) between B, the C group.
The myelinated nerve fiber counting: B, C organize each time point myelinated nerve fiber percent of pass and all obviously are better than the A group, and difference has statistical significance (P<0.01).2,4,6 weeks of postoperative, B group myelinated nerve fiber percent of pass and C group difference not statistically significant (P>0.05), in 8 weeks of postoperative, the C group is better than B group (P<0.05).
Experimental result proves that nerve injury has the regenerated practical function of the neuromuscular of promotion to compound formulation of the present invention to sunderland V degree.