CN102210782B - Compound traditional Chinese medicine for treating glucocorticoid dependence and application thereof - Google Patents
Compound traditional Chinese medicine for treating glucocorticoid dependence and application thereof Download PDFInfo
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Abstract
The invention discloses a compound traditional Chinese medicine for treating glucocorticoid dependence and application thereof. The traditional Chinese medicine comprises the following components in percentage by weight: 11.76-26.67% of herba epimedii, 3.12-9.38% of antler gelatin, 6.25-13.33% of morinda officinalis, 6.25-13.33% of semen psoraleae, 13.33-25.02% of radix astragali, 4.44-18.75% of cornel, 4.45-18.75% of Chinese wolfberry, 3.12-9.37% of the root of Chinese thorowax, 2.95-9.09% of cortex magnoliae officinalis and 3.12-8.83% of radix glycyrrhizae preparata. The compound traditional Chinese medicine disclosed by the invention is applied to diseases needing a large dosage of hormone for a long time and can be used in a time period after the hormone is withdrawn to be maintained and stopped, not only a hormone withdrawal symptom can be relieved, but also hormone dependence can be also modified, and the recurrence of the disease can be reduced; the compound traditional Chinese medicine has the effects of nourishing and warming kidney-yang and promoting adrenal cortex functions and is a clinically safe and effective pure Chinese medicine composition; in addition, the compound traditional Chinese medicine can be applied to preparing a medicament for treating the glucocorticoid dependence.
Description
Technical field
The present invention relates to a kind of herbal mixture that is used for the treatment of glucocorticoid dependence, be specifically related to panimmunity or autoimmune relevant disease (such as systemic lupus erythematosus (sle), idiopathic thrombocytopenia, primary nephrotic syndrome, bronchial asthma etc.) because Chinese medicine composition heavy dose of, the length glucocorticoid dependence that hormone therapy the causes course for the treatment of.
Background technology
The immunity such as systemic lupus erythematosus (sle), idiopathic thrombocytopenic purpura, primary nephrotic syndrome, bronchial asthma or autoimmune disease often need adopt heavy dose, long course for the treatment of glucocorticoid treatment, reduce to subsequently maintenance dose, until drug withdrawal.Hypoadrenocorticism sample symptom can appear in the decrement process or behind the inactive hormone, the lighter shows as lethargy, weak, loss of appetite, joint and myalgia, severe one heating can occur, feels sick, vomiting, hypotension etc., even the protopathy recurrence occurs or increase the weight of (rebound phenomenon).Glucocorticoid dependence is exactly to hormone-sensitive, alleviate after the medication, but repetition person more than 2 times is recurred in decrement or drug withdrawal in 1 month.The treatment that the recurrent hormone relies on is adopted take hormone as main treatment more, sometimes routine adds with the immunosuppressant curative effect still dissatisfied, wide because side effect is large, even can be forced to therapy discontinued, so the treatment that hormone relies on makes the clinicist quite feel thorny, there is no so far effective therapeutic scheme always.
Chinese medicine all is summed up as " poison of drug " with the cause of disease of glucocorticoid dependence, thinks hormone analog in pure positive excessive fire medicine, and a large amount of long terms consume the cloudy liquid of human body in human body, easily cause the card of hyperactivity of fire caused by deficiency of YIN; Yet be accompanied by the decrement of hormone because supporing yang reaction force attenuation, in addition delay with the passing of time, the card of the kidney yang virtual loss such as coldness of the body and aversion to cold, cold extremities loose stool namely appears in deficiency of YIN affecting YANG, visible glucocorticoid dependence and insufficiency of kidney-YANG have close internal relation.Modern study shows that long-term, high-dose application glucocorticoid can cause that HPA (HPA) axle suppresses, causing atrophy of adrenal gland, may be the short easily major reason of recurrence of disease-free period and can not recover normal level in hormone decrement to maintenance phase.As seen pathogenesis and the endogenous hypoadrenocorticism of hormone dependence are closely related.So be necessary that the person seeks a kind of method that can stimulate and improve the Pituitary Adrenal function to using the hormone heavy dose of, the long course for the treatment of.Western medicine still lacks interchangeable medicine and the method that can stimulate and improve the hpa axis function at present, traditional Chinese medical science warming and recuperating the kidney-YANG method can promote adrenocortical secretory function, can obviously improve to remove and subtract and the success rate of inactive hormone, this is the distinctive feature of Chinese medicine primary disease.So from Chinese medicine, seek appropriate method treatment primary disease, alleviate or eliminates hormone to the toxic and side effects of human body until the disengaging hormone is very necessary.
Therefore, need to be for the deficiencies in the prior art and defective, a kind of herbal mixture for the treatment of the internal medicine glucocorticoid dependence is provided, make it have warming and recuperating the kidney-YANG, promote the effect of adrenal cortex function, and pure Chinese medicinal preparation safely and effectively, keep treatment stage and the hormone initial stage of stopping using at hormone and use and to alleviate hormone and withdraw symptomes complice, can improve again hormone and rely on, reduce the relapse rate of disease.
Summary of the invention
In view of this, purpose of the present invention provides a kind of herbal mixture for the treatment of glucocorticoid dependence, be applied to the need heavy dose and grow the diseases such as the systemic lupus erythematosus (sle) of course of therapy, idiopathic thrombocytopenic purpura, primary nephrotic syndrome, bronchial asthma, keep treatment stage and the inactive initial stage use of hormone at hormone, both can alleviate hormone and withdraw symptomes complice, can improve again hormone relies on, reduce the relapse rate of disease, has warming and recuperating the kidney-YANG, improve the effect of adrenal cortex function, be pure Chinese medicinal preparation safely and effectively.
The present invention treats the herbal mixture of glucocorticoid dependence, and Chinese medicine comprises following component by mass percentage: Herba Epimedii 11.76～26.67%, Colla cornus cervi 3.12～9.38%, Radix Morindae Officinalis 6.25～13.33%, Fructus Psoraleae 6.25～13.33%, the Radix Astragali 13.33～25.02%, Fructus Corni 4.44～18.75%, Fructus Lycii 4.45～18.75%, Radix Bupleuri 3.12～9.37%, Cortex Magnoliae Officinalis 2.95～9.09%, Radix Glycyrrhizae Preparata 3.12～8.83%.
Further, Chinese medicine comprises following component by mass percentage: Herba Epimedii 11.76～18.18%, Colla cornus cervi 6.06～9.38%, Radix Morindae Officinalis 9.09～13.33%, Fructus Psoraleae 8.82～13.33%, the Radix Astragali 18.18～25.02%, Fructus Corni 8.83～18.75%, Fructus Lycii 8.82～18.75%, Radix Bupleuri 6.07～9.37%, Cortex Magnoliae Officinalis 6.25～9.09%, Radix Glycyrrhizae Preparata 6.06～8.83%.
Further, Chinese medicine comprises following component by mass percentage: Herba Epimedii 18.18%, Colla cornus cervi 6.06%, Radix Morindae Officinalis 9.09%, Fructus Psoraleae 9.09%, the Radix Astragali 18.18%, Fructus Corni 9.09%, Fructus Lycii 9.09%, Radix Bupleuri 6.07%, Cortex Magnoliae Officinalis 9.09%, Radix Glycyrrhizae Preparata 6.06%.
Can add the Chinese medicine that one or more are used for improving or treating accompanied symptoms when further, this herbal mixture uses;
Further, this herbal mixture can add the pharmaceutical carrier that medical science can accept and makes preparation.
The invention also discloses a kind of application of herbal mixture in the medicine of preparation treatment glucocorticoid dependence that hormone relies on for the treatment of.
Beneficial effect of the present invention: the present invention treats the Chinese medicine that hormone relies on, be applied to the low dose of glucocorticoid of the diseases such as systemic lupus erythematosus, idiopathic thrombocytopenic purpura, primary nephrotic syndrome, bronchial asthma and keep treatment phase and inactive initial stage of hormone, both can alleviate hormone and withdraw symptomes complice, can be conducive to again removing of hormone and subtract and stop using, reduce the relapse rate of disease; Have warming and recuperating the kidney-YANG, promote the effect of adrenal cortex function, be pure Chinese medicinal preparation safely and effectively.
The present invention is directed to the basic pathogenesis that hormone relies on, take into full account the drug matching principle, Colla cornus cervi, Herba Epimedii help kidney yang in the side, and warm gate of vitality's fire is monarch drug altogether; Fructus Psoraleae, Radix Morindae Officinalis warming and recuperating the kidney-YANG, gas are beginning of YANG, the end of qi derived from yang, get Radix Astragali warming with drugs of thick nature take supporing yang altogether as ministerial drug; The moon of Fructus Corni, Fructus Lycii nourish liver and kidney is beneficial to treating YANG within YIN, and suppresses the dry property of warming YANG medicine, and Radix Bupleuri rises the liter of few positive aid yang qi and sends out, and the Cortex Magnoliae Officinalis the chest stuffiness relieving of regulating the flow of vital energy is adjuvant drug altogether in case tonic is jammed; The Radix Glycyrrhizae Preparata coordinating the actions of various ingredients in a prescription is for making medicine; Give prominence to the key points, make a distinction between the important and the lesser one in full side, all medicines share the effect of playing altogether warming and recuperating the kidney-YANG; Use herbal mixture of the present invention in low dose of hormone maintenance phase and the hormone initial stage of stopping using clinically, can improve hormone and rely on, reduce the relapse rate of disease; Zoopery also proves that the present invention can improve adrenocortical secretory function.
The specific embodiment
The present invention treats the embodiment of the herbal mixture of glucocorticoid dependence:
Embodiment one
The Chinese medicine of present embodiment comprises following component by mass percentage: Herba Epimedii 12.51%, Colla cornus cervi 3.12%, Radix Morindae Officinalis 6.25%, Fructus Psoraleae 6.25%, the Radix Astragali 18.75%, Fructus Corni 18.75%, Fructus Lycii 18.75%, Radix Bupleuri 3.12%, Cortex Magnoliae Officinalis 6.25%, Radix Glycyrrhizae Preparata 6.25%.
Embodiment two
The Chinese medicine of present embodiment comprises following component by mass percentage: Herba Epimedii 18.18%, Colla cornus cervi 6.06%, Radix Morindae Officinalis 9.09%, Fructus Psoraleae 9.09%, the Radix Astragali 18.18%, Fructus Corni 9.09%, Fructus Lycii 9.09%, Radix Bupleuri 6.07%, Cortex Magnoliae Officinalis 9.09%, Radix Glycyrrhizae Preparata 6.06%.
Embodiment three
The Chinese medicine of present embodiment comprises following component by mass percentage: Herba Epimedii 26.67%, Colla cornus cervi 6.67%, Radix Morindae Officinalis 13.33%, Fructus Psoraleae 13.33%, the Radix Astragali 13.33%, Fructus Corni 4.44%, Fructus Lycii 4.45%, Radix Bupleuri 4.44%, Cortex Magnoliae Officinalis 6.67%, Radix Glycyrrhizae Preparata 6.67%.
Embodiment four
The Chinese medicine of present embodiment comprises following component by mass percentage: Herba Epimedii 12.50%, Colla cornus cervi 9.38%, Radix Morindae Officinalis 9.37%, Fructus Psoraleae 9.37%, the Radix Astragali 25.02%, Fructus Corni 9.37%, Fructus Lycii 9.37%, Radix Bupleuri 9.37%, Cortex Magnoliae Officinalis 3.13%, Radix Glycyrrhizae Preparata 3.12%.
Embodiment five
The Chinese medicine of present embodiment comprises following component by mass percentage: Herba Epimedii 11.76%, Colla cornus cervi 8.83%, Radix Morindae Officinalis 8.82%, Fructus Psoraleae 8.82%, the Radix Astragali 23.52%, Fructus Corni 8.83%, Fructus Lycii 8.82%, Radix Bupleuri 8.82%, Cortex Magnoliae Officinalis 2.95%, Radix Glycyrrhizae Preparata 8.83%.
The Chinese medicine composition of above embodiment when using, mixes rear with being decocted in water for oral dose by Chinese medicine composition; During decoction, in the situation that does not affect this Chinese medicine composition effect, can add the Chinese medicine that one or more are used for improving or treating accompanied symptoms (side effect), for example: the aobvious author of yang deficiency adds Radix Aconiti Lateralis Preparata, Cortex Cinnamomi; Heavier Radix Codonopsis, the Rhizoma Atractylodis Macrocephalae of adding of the deficiency of vital energy; Nauseating person adds the Rhizoma Pinelliae, Pericarpium Citri Reticulatae; The blood stasis person adds Radix Salviae Miltiorrhizae, Radix Paeoniae Rubra; The thermal image person that holds concurrently adds the Radix Rehmanniae, Cortex Moutan, Herba Artemisiae Annuae; Articular muscle is felt sorry with Radix Gentianae Macrophyllae, Caulis Lonicerae; The inappetence person adds the Rhizoma Atractylodis Macrocephalae, Poria etc.
This Chinese medicine can add the pharmaceutical carrier that medical science can accept and make preparation; Such as by forms such as the agent of pharmaceutical carrier granulation, oral liquid, tablet, capsule, pills, adopt existing commercial process all can realize.
The invention also discloses this Chinese medicine composition and can take the method for any prior art, and add any other composition, for the preparation of the medicine at the treatment glucocorticoid dependence, such as in the medicine process for the preparation of the treatment glucocorticoid dependence, this herbal mixture is as wherein a kind of composition interpolation; Glucocorticoid dependence refers to use the hormone that causes in the process of the diseases such as hormone therapy systemic lupus erythematosus (sle), idiopathic thrombocytopenic purpura, primary nephrotic syndrome, bronchial asthma and relies on.
Below be Chinese medicine composition clinical research situation of the present invention, show the effect of the present invention in the glucocorticoid dependence treatment:
Glucocorticoid dependence patient 80 examples (systemic lupus erythematosus (sle), idiopathic thrombocytopenia, primary nephrotic syndrome, each 20 example of bronchial asthma), divide at random treatment group 40 examples by the disease kind patient, matched group 40 examples, be every group every kind disease 10 examples, male 12 examples in the treatment group, women 28 examples; 18～62 years old age, average (35.8 ± 13.7) year, the course of disease 1.5～7.4 years, average 26.5 months.Male 13 examples in the matched group, women 27 examples; 16～61 years old age, average (37.8 ± 10.7) year, the course of disease 1.8～7.6 years, average 28.2 months; 2 groups of there are no significant aspect sex, age, course of disease differences (P＞0.05) have comparability.
Diagnostic criteria:
(1) Disease Diagnosis Standard
Systemic lupus erythematosus diagnosis standard: 1) buccal section erythra; 2) plate-like erythema: 3) photosensitivity; 4) oral ulcer; 5) not aggressive arthritis; 6) oromeningitis; 7) kidney damage; 8) nerve is got involved; 9) blood system is got involved; 10) crucial immunological abnormality (anti-ds-DNA antibody increases, or anti-Sm antibody is positive, or anti-phospholipid antibody is positive); 11) antinuclear antibody is positive.At least meet the diagnosable SLE of being of above 4 persons.
The diagnostic criteria of idiopathic thrombocytopenia: 1. repeatedly laboratory examination platelet count reduces.2. spleen does not increase or slightly increases.3. the bone marrow examination megalokaryocyte increases or normally, dysmaturity is arranged.4. should possess any point in following 5: the I. Prednisone Therapy is effective; II. cut the spleen treatment effectively; III.PAIgG increases; IV.PAC
3Increase; V. life-span determination of blood platelet shortens.5. get rid of Secondary cases.
Primary nephrotic syndrome diagnostic criteria: 1. High-grade Proteinuria (urine protein is greater than 3.5g/d); 2. hypoproteinemia (particularly low albumin disease, plasma albumin is less than 30g/L); 3. obvious edema; 4. hyperlipemia (blood cholesterol is higher than 7.8mmol/L).Wherein 1. 2. two be indispensable.And get rid of the Secondary cases nephrotic syndrome that lupus erythematosus, diabetes and other reasons cause.
The bronchial asthma diagnostic criteria: 1. repeatedly outbreak pant, out of breath, uncomfortable in chest or cough, many with to contact allergen, cold air, physics, chemical irritation and viral upper respiratory tract infection, motion etc. relevant.At two lung audibles and be dispersed in or diffusivity, take expiratory phase as main wheezing sound, expiratory phase prolongs when 2. showing effect.3. above-mentioned symptom and sign can be alleviated or spontaneous remission through treatment.4. except other diseases causedly pant, out of breath, uncomfortable in chest and cough.5. its atypical clinical manifestations person's (as without obviously panting or sign) should possess with the next item down test positive: I. brinchial provocation test or the motion activated test positive at least; II. Bronchodilation Test positive [one second forced expiratory volume (FEV
1) increase 〉=12%, and FEV
1Increase absolute value 〉=200ml]; III. aberration rate in the maximal expiratory flow (PEF) day 〉=20%.Meet 1-4 bar or 4,5 persons, can be diagnosed as bronchial asthma.
(2) hormone relies on diagnostic criteria
To hormone-sensitive, alleviate after the medication, but repetition person more than 2 times is recurred in decrement or drug withdrawal in 1 month.
Inclusive criteria:
1) meets above-mentioned diagnostic criteria;
2) between 15～65 years old age.
Exclusion standard:
1) age is below 15 years old or over-65s;
2) gestation or women breast-feeding their children;
3) other Complicated with Severe disease and psychotics such as severe infection.
Therapeutic Method
(1) matched group scheme
1. lupus erythematosus and Therapy of Nephrotic Syndrome method: the matched group prednisone is by the standard method course for the treatment of, every day, 1mg/kg was oral, decrement 5mg weekly after 8 weeks, continue 6 months to 0.5mg/kg dosage (next day 1mg/kg), then after reducing to gradually maintenance dose (next day 0.5mg/kg) and keeping for 3～4 weeks, by subtract weekly 2.5mg gradually decrement to drug withdrawal.
2. idiopathic thrombocytopenic purpura therapeutic scheme: every daily dose is 1mg/kg/d, and generally at 2～3 all internal hemorrhage doing well,improvings, platelet count raises.After the alleviation, then decrement 5mg weekly reduces to maintenance dose (next day 0.5mg/kg) gradually.After keeping for 3～4 weeks, by subtract weekly 2.5mg gradually decrement to drug withdrawal.
3. asthma in acute attack stage gives methylprednisolone 40～80mg/d quiet on the Comprehensive Treatment basis, 3～5d, and prednisone 0.5mg/kg/d after the remission, decrement 5mg weekly then reduces to maintenance dose (next day 0.5mg/kg) gradually; After keeping for 3～4 weeks, by subtract weekly 2.5mg gradually decrement to drug withdrawal.
(2) treatment group scheme
The same matched group of hormone therapy, hormone reduce to maintenance dose (next day 0.5mg/kg) and add Chinese medicine decoction of the present invention, until 4 weeks after the drug withdrawal, the whole course for the treatment of in about 14 weeks.Carry out the suitable flavor that adds according to clinical symptoms (accompanied symptoms) and treat, aobvious author adds Radix Aconiti Lateralis Preparata, Cortex Cinnamomi such as yang deficiency; Heavier Radix Codonopsis, the Rhizoma Atractylodis Macrocephalae of adding of the deficiency of vital energy; Nauseating person adds the Rhizoma Pinelliae, Pericarpium Citri Reticulatae; The blood stasis person adds Radix Salviae Miltiorrhizae, Radix Paeoniae Rubra; The thermal image person that holds concurrently adds the Radix Rehmanniae, Cortex Moutan, Herba Artemisiae Annuae; Articular muscle is felt sorry with Radix Gentianae Macrophyllae, Caulis Lonicerae; The inappetence person adds the Rhizoma Atractylodis Macrocephalae, Poria etc.
The efficacy determination index
(1) observes hypoadrenocorticism sample symptom during hormonal withdrawal, comprise lethargy, weak, loss of appetite, joint and myalgia, fear of cold, feel sick, the symptoms such as vomiting, hypotension.
(2) get the 9am peripheral blood during hormonal withdrawal and detect Determination of cortisol, estimate adrenal function.
(3) observe in the hormone decrement process and the number of times of drug withdrawal palindromia in March.
Two groups of Clinical efficacy comparisons
In hypoadrenocorticism sample symptom, lethargy, weak, fear of cold improve and reach remarkable meaning (p＜0.01), loss of appetite, the improvement of feeling sick also reach statistical significance (p＜0.05), and remaining three symptoms also have reduction in various degree, specifically see the following form.
Two groups of hypoadrenocorticism sample symptom incidence rates compare (%)
| Clinical symptoms | Matched group | Treatment group |
| 1. lethargy | 70％ | 40％ ▲ |
| 2. weak | 77.5％ | 42.5％ ▲ |
| 3. loss of appetite | 45％ | 20％ △ |
| 4. joint and myalgia | 31％ | 17.5％ |
| 5. fear of cold | 40％ | 5％ ▲ |
| 6. feel sick | 37.5％ | 15％ △ |
| 7. vomiting | 20％ | 12.5％ |
| 8. hypotension | 27.5％ | 10％ |
Annotate: through χ
2Check is compared with matched group
△P＜0.05,
▲P＜0.01.
The present invention treats the first two group serum cortisol does not have difference (p＞0.05), and treatment group is after the present invention's treatment, and hydrocortisone obviously improves (p＜0.01) than matched group, and concrete outcome sees the following form.
Two groups of serum cortisol compare (nmol/L)
| Group | Matched group | Treatment group |
| Before the treatment | 216.11±71.76 | 209.21±57.96 |
| After the treatment | 211.97±70.66 | 343.62±86.11 ▲ |
Annotate: through the T check,
▲Compare p＜0.01 with matched group.
Palindromia in March situation after hormone decrement and the drug withdrawal.Matched group recurs 38 examples, and relapse rate 95%, treatment group recur 25 examples, and relapse rate 62.5% is (through χ
2Check is compared P＜0.01 with matched group); The prescription relapse rate of embodiment one is that the prescription relapse rate of 87.5%, embodiment two is that the prescription relapse rate of 25%, embodiment three is that the prescription relapse rate of 37.5%, embodiment four is that the prescription relapse rate of 75%, embodiment five is 87.5% in the treatment group.Embodiment two, three prescription obviously are better than embodiment one, four, five, and its former because embodiment one, four, five the kidney warming pharmaceutical quantities are less, and its effect that should occur is not enough, so final optimization pass is embodiment two.In above-mentioned pharmacodynamic study, do not find medicine toxic side effect of the present invention simultaneously.
The result shows: Chinese medicine compound of the present invention can reduce glucocorticoid dependence patient Hormone Withdrawal except symptom, improves adrenal cortex function, reduces the relapse rate of disease.
Medical record is given an example:
Example 1. Lee, woman, 41 years old, workman.Because oral ulcer increased the weight of to accompany arthralgia January in 2 years.The patient found in local hospital chemical examination before 2 years: ESR:38mm/h, and urine protein (+), ANA (+), dsDNA (+) examines and is systemic lupus erythematosus (sle) (SLE).Press the prednisone standard care, lupus can be alleviated fully, but hormone reduces to 10～15mg/d, and (3 times) are arranged during the state of an illness repeatedly, all can alleviate behind the adjustment hormone dosage.Patient's hormone decrement is sought Chinese traditional treatment to 20mg/d for assisting Hormone Withdrawal to subtract at present, and the patient felt obviously weak, indigestion and loss of appetite, abdominal distention in nearly 1 month, soreness of waist pain, and puffiness of face, light red tongue have the indentation tongue light white, deep-slow pulse.Examine and be systemic lupus erythematosus (sle), hormone dependence.The traditional Chinese medical science belongs to syndrome of deficiency of kidney-YANG, give embodiment one treatment, Herba Epimedii 12.51%, Colla cornus cervi 3.12%, Radix Morindae Officinalis 6.25%, Fructus Psoraleae 6.25%, the Radix Astragali 18.75%, Fructus Corni 18.75%, Fructus Lycii 18.75%, Radix Bupleuri 3.12%, Cortex Magnoliae Officinalis 6.25%, Radix Glycyrrhizae Preparata 6.25%, during suitably add and subtract according to the variation of accompanied symptoms.After simultaneously hormone is kept around the 15mg/d, remove and subtract by subtracting weekly 2.5mg, in continual cure January after hormone is stopped using, in partner treatment process of the present invention, various hormones are withdrawn symptom and are obviously alleviated.Following up a case by regular visits to the half a year disease does not recur.
Example 2. Wang, man, 23 years old, the patient is because of facial area and 6 years companions of two lower limbs edema fatigue and weakness, 1 all going to a doctor, the patient fell ill before 5 years and is diagnosed as primary nephrotic syndrome in local hospital through coherence check, and give the hormone standard treatment and all can alleviate fully, but whenever 2～4 weeks recurrence after drug withdrawal, 4 times repeatedly, patient's hormone decrement dare not decrement because fearing palindromia to 15mg/d after this recurrence, sees a doctor in the traditional Chinese medical science in order to prevent palindromia, it is dark and gloomy to examine the meeting color quarter, slight fear of cold, spiritlessness and weakness, poor appetite, gastral cavity is vexed, feeling thirst but no desire to drink, the urine amount is few, and stool still can, pale tongue with thin fur is greasy in vain, deep-thready pulse.Be diagnosed as nephrotic syndrome, hormone relies on.Give embodiment two treatments, Herba Epimedii 18.18%, Colla cornus cervi 6.06%, Radix Morindae Officinalis 9.09%, Fructus Psoraleae 9.09%, the Radix Astragali 18.18%, Fructus Corni 9.09%, Fructus Lycii 9.09%, Radix Bupleuri 6.07%, Cortex Magnoliae Officinalis 9.09%, Radix Glycyrrhizae Preparata 6.06% are are suitably added and subtracted according to change of illness state during the treatment.Simultaneously the 15mg/d hormone dosage is kept January, Tapered slowly then, and in Chinese medicine continual cure January after the hormonal withdrawal, various condition of illness eradicating efficacies are obvious, follow up a case by regular visits to the patient and do not recur June.
Example 3. Zhangs, woman, 25 years old, workman.Because anti-skin purpura was seen a doctor in 7 years.Unknown cause skin purpura appearred in the patient before 7 years, wear through bone to be diagnosed as " chronic idiopathic thrombocytopenic purpura ".Take the Drug therapys such as prednisone, leucogen, remission, rear because whenever after hormone dosage reduces to 0.25mg/kg, recurring, be in hospital 5 times once thereafter.Be diagnosed as chronic idiopathic thrombocytopenic purpura, hormone relies on.Oral three weeks of prednisone 50mg/d before medical, check platelet count 9.4 ten thousand/mm
3, clinical symptom remission, hormone be decrement 5mg weekly.Existing patient feels dizzy, fatigue and weak, extremity are cold, loss of appetite, nocturia, diarrhea with loose stool, pale tongue, deep-thready pulse, Chinese medical discrimination are deficiency of spleen-YANG and kidneyYANG, when reducing to maintenance dose (next day 0.5mg/kg), give embodiment three treatments, Herba Epimedii 26.67%, Colla cornus cervi 6.67%, Radix Morindae Officinalis 13.33%, Fructus Psoraleae 13.33%, the Radix Astragali 13.33%, Fructus Corni 4.44%, Fructus Lycii 4.45%, Radix Bupleuri 4.44%, Cortex Magnoliae Officinalis 6.67%, Radix Glycyrrhizae Preparata 6.67%.After keeping for 3～4 weeks, decrement is to drug withdrawal gradually by subtracting weekly 2.5mg, and various clinical symptoms obviously alleviate, and Chinese medicine continual cure January, follows up a case by regular visits to 1 year disease and does not recur.
Example more than 4. certain, woman, 32 years old.January is sent out in recurrent cough, asthma uncomfortable in chest more than 15 years again.10 years causes of patient's private prosecution are suffered from cold and cough occurred, asthma uncomfortable in chest, and wheezing due to retention of sputum in the throat, moving then more so, can not put down sleeping when panting.Be diagnosed as bronchial asthma through inspections such as pulmonary functions, early stage patient can be through β
2Receptor stimulating agent, glucocorticoid aerosol are alleviated, the various aerosols alleviations of the each outbreak of patient are poor before 5 years, often need oral or quiet afterwards alleviation in 3～5 days of heavy dose of hormone, after the patient begins to occur heavy dose of hormone alleviation before 2 years, in a short time (January in) recurrence after the drug withdrawal, this is medical be the 4th time repeatedly.Patient's hormone reduces to (0.25mg/d) when medical, keeps and treats February, and symptoms of asthma is obviously alleviated, owing to worry the side effect of hormone, the patient asks therapy of combining Chinese and Western medicine.Diagnosis bronchial asthma, hormone relies on.The traditional Chinese medical science gives embodiment four treatments three months, Herba Epimedii 12.50%, Colla cornus cervi 9.38%, Radix Morindae Officinalis 9.37%, Fructus Psoraleae 9.37%, the Radix Astragali 25.02%, Fructus Corni 9.37%, Fructus Lycii 9.37%, Radix Bupleuri 9.37%, Cortex Magnoliae Officinalis 3.13%, Radix Glycyrrhizae Preparata 3.12%.Hormone is successfully removed, and do not recur March.
Example 5. Huangs, male, 28 years old.The patient puffiness of the eyes occurs after catching a cold before 8 years, in the local hospital hospitalization, be diagnosed as primary nephrotic syndrome, take more than the prednisone treatment JIUYUE, and remission, albumen is turned out cloudy and is left hospital, continue taking prednisone drug withdrawal after half a year.The tired recurrence of cause in 3 years 2 times is alleviated through hormone therapy, and nearly 3 years Patients on Recurrences repeatedly all recur in 4 weeks after hormonal withdrawal at every turn, now adopt hormone to keep treatment, daystart decoction being taken at a draught next day of 30mg.Be diagnosed as primary nephrotic syndrome, hormone relies on.Examine quarter and see eyelid, the little swelling of lower limb, complexion is white all of a sudden, and the soreness of waist is weak, light red tongue white and thin fur, deep-thready pulse.Chinese medical discrimination is deficiency of spleen-YANG and kidneyYANG, give embodiment five treatments, Herba Epimedii 11.76%, Colla cornus cervi 8.83%, Radix Morindae Officinalis 8.82%, Fructus Psoraleae 8.82%, the Radix Astragali 23.52%, Fructus Corni 8.83%, Fructus Lycii 8.82%, Radix Bupleuri 8.82%, Cortex Magnoliae Officinalis 2.95%, Radix Glycyrrhizae Preparata 8.83%, and suitably add and subtract according to symptom variation.Hormone is removed routinely and is subtracted, and do not recur June after the drug withdrawal, and can normally participate in general work.
Chinese medicine compound promotes the animal experiment study of adrenal function restitution in 17-hydroxy-11-dehydrocorticosterone decrement process: adopt heavy dose of 17-hydroxy-11-dehydrocorticosterone rat model, simulate clinical hormone decrement, to low dose of process, give Chinese medicine compound of the present invention in the hormone decrement, estimate the intervention effect that the present invention relies on hormone from adrenal cortex function.Mainly by the present invention the proportioning medicine of embodiment two is decocted with water 3 times in proportion, collecting decoction, simmer down to 2g crude drug/ml is used for rat experiment.
Experimental technique: male SD rat, 45, body weight 250～270g, be divided at random normal group (15), model group (15), treatment group (15), except normal group, all adopt dexamethasone 0.75mg/kg modeling 7 days, decrement is dexamethasone 0.5mg/kg modeling 7 days subsequently, decrement is dexamethasone 0.25mg/kg modeling 7 days again, treatment group is calculated according to Mus and people's dose,equivalent, press 30.75g/Kg dosage, gave gavage on the 15th day from modeling, until 25 days, normal group, model group give normal saline.Model group, treatment group, normal group were collected the 24h urine in the 21st, 25 day, adopted ELISA to detect the content of 24h urine 17-OHCS.The result shows, 17-OHCS concentration treatment group when no matter hormone is stopped using (21 days) or naturally in the recovery (25 days) apparently higher than model group, specifically see the following form.
The content of three groups of rat 24h urine 17-OHCS is (μ mol/L) relatively
| Group | 21 days | 25 days |
| Normal group | 23.68±8.64 | 25.46±9.25 |
| Model group | 8.06±3.35 | 11.42±4.94 △ |
| Treatment group | 10.81±4.87 | 15.86±6.71 △ |
Annotate: through the T check,
△Compare P＜0.05 with matched group.
The result shows: Chinese medicine compound has the restitution that promotes adrenal cortex function in the hormone decrement process, is conducive to improve hormone and relies on.
This shows, the present invention has following characteristics: 1. the adrenal gland that heavy dose of hormone that links closely causes suppresses, Hormone Withdrawal subtract and adrenal functional rehabilitation of drug withdrawal initial stage slow, disease easily recur the basic pathogenesis that relies on of the hormone that forms, advocate take warming and recuperating the kidney-YANG as the main principles of formulating prescriptions.2. not only the generation that Hormone Withdrawal subtracts symptom can be alleviated on the treatment indication, the relapse rate of disease can also be significantly reduced.3. the present invention is not suitable for heavy dose of hormone therapy phase mainly for low dose of hormone maintenance phase.4. the present invention is for to be comprised of pure Chinese medicine ingredients, and toxic and side effects is low.
Explanation is at last, above embodiment is only unrestricted in order to technical scheme of the present invention to be described, although with reference to preferred embodiment the present invention is had been described in detail, those of ordinary skill in the art is to be understood that, can make amendment or be equal to replacement technical scheme of the present invention, and not breaking away from aim and the scope of technical solution of the present invention, it all should be encompassed in the middle of the claim scope of the present invention.
Claims (5)
1. herbal mixture for the treatment of glucocorticoid dependence, it is characterized in that: Chinese medicine comprises following component by mass percentage: Herba Epimedii 11.76～26.67%, Colla cornus cervi 3.12～9.38%, Radix Morindae Officinalis 6.25～13.33%, Fructus Psoraleae 6.25～13.33%, the Radix Astragali 13.33～25.02%, Fructus Corni 4.44～18.75%, Fructus Lycii 4.45～18.75%, Radix Bupleuri 3.12～9.37%, Cortex Magnoliae Officinalis 2.95～9.09%, Radix Glycyrrhizae Preparata 3.12～8.83%.
2. the herbal mixture for the treatment of glucocorticoid dependence according to claim 1, it is characterized in that: Chinese medicine comprises following component by mass percentage: Herba Epimedii 11.76～18.18%, Colla cornus cervi 6.06～9.38%, Radix Morindae Officinalis 9.09～13.33%, Fructus Psoraleae 8.82～13.33%, the Radix Astragali 18.18～25.02%, Fructus Corni 8.83～18.75%, Fructus Lycii 8.82～18.75%, Radix Bupleuri 6.07～9.37%, Cortex Magnoliae Officinalis 6.25～9.09%, Radix Glycyrrhizae Preparata 6.06～8.83%.
3. the herbal mixture for the treatment of glucocorticoid dependence according to claim 2, it is characterized in that: Chinese medicine comprises following component by mass percentage: Herba Epimedii 18.18%, Colla cornus cervi 6.06%, Radix Morindae Officinalis 9.09%, Fructus Psoraleae 9.09%, the Radix Astragali 18.18%, Fructus Corni 9.09%, Fructus Lycii 9.09%, Radix Bupleuri 6.07%, Cortex Magnoliae Officinalis 9.09%, Radix Glycyrrhizae Preparata 6.06%.
4. according to claim 1 to the herbal mixture of the described treatment glucocorticoid dependence of 3 arbitrary claim, it is characterized in that: the preparation that the pharmaceutical carrier that this herbal mixture adding medical science can be accepted is made.
5. the application of the herbal mixture of the described treatment glucocorticoid dependence of the arbitrary claim of claims 1 to 3 in the medicine of preparation treatment glucocorticoid dependence.
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| 吴沛田.慢性肾炎蛋白尿中医辨证应注意什么.《中医杂志》.2007,第48卷(第03期),279-280. * |
| 李贤.多发性硬化症应用激素后的中医辨治.《广西中医药》.2002,第25卷(第06期),32-33. * |
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