CN102580021B - 用于原发性肾小球肾炎的鳖黄青白汤 - Google Patents
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Abstract
本发明涉及一种药物配方领域，具体地说是一种用于原发性肾小球肾炎的鳖黄青白汤，其技术特征是，采用鳖甲、黄芪、黄柏、青蒿、白茅根、白薇、桑白皮、山茱萸、知母、干姜、肉苁蓉、肉桂、茯苓、泽泻、当归、远志、牡丹皮为原料药，先将鳖甲捣碎，青蒿单包，将余下的15味原料药加水浸泡，鳖甲单独浸泡水中，先将鳖甲用武火煮沸，然后加入其余15味原料药煮沸，再加入单包的青蒿，文火煎熬，煎熬后去渣得滤液，原料药组成以重量百分比计为：鳖甲9～12％，黄芪6～9％，黄柏5～7％，青蒿5～7％，白茅根6～8％，白薇4～6％，桑白皮4～7％，山茱萸4～7％，知母5～7％，干姜3～5％，肉苁蓉2～4％，肉桂2～3％，茯苓6～8％，泽泻3～5％，当归4～6％，远志3～6％，牡丹皮4～6％。
Description
技术领域
本发明涉及一种中成药制剂，具体地说是一种用于原发性肾小球肾炎的鳖黄青白汤。
背景技术
众所周知，原发性肾小球肾炎是发生于人体肾脏的自身免疫性疾病，分有急性、急进性、慢性等类型。其临床表现主要为血尿、蛋白尿、水肿、高血压等，病变主要累及双肾肾小球，它占肾小球病中的大多数。是我国引起慢性肾衰竭最主要的原因。目前临床治疗本病主要以休息和对症治疗为主，慢性肾炎的治疗以防止或延缓肾功能进行性恶化，改善或缓解临床症状及防治严重合并症为主要目的，而不以消除尿红细胞或轻微尿蛋白为目标，给患者带来了极大的痛苦及经济负担。
发明内容
本发明所要解决的技术问题是为了克服现有技术的不足，提供一种用于原发性肾小球肾炎的鳖黄青白汤，治疗原发性肾小球肾炎疗效高、无毒副作用，具有疏风利水、通阳化湿、分利温热、健脾温肾之功效，适用于急性、急进性、慢性等类型。
本发明解决上述技术问题采用的技术方案是：一种用于原发性肾小球肾炎的鳖黄青白汤，其技术特征是，采用鳖甲、黄芪、黄柏、青蒿、白茅根、白薇、桑白皮、山茱萸、知母、干姜、肉苁蓉、肉桂、茯苓、泽泻、当归、远志、牡丹皮为原料药，先将鳖甲捣碎，青蒿单包，将余下的15味原料药加水浸泡，鳖甲单独浸泡水中，先将鳖甲用武火煮沸，然后加入其余15味原料药煮沸，再加入单包的青蒿，文火煎熬，煎熬后去渣得滤液，原料药组成以重量百分比计为：鳖甲9～12％，黄芪6～9％，黄柏5～7％，青蒿5～7％，白茅根6～8％，白薇4～6％，桑白皮4～7％，山茱萸4～7％，知母5～7％，干姜3～5％，肉苁蓉2～4％，肉桂2～3％，茯苓6～8％，泽泻3～5％，当归4～6％，远志3～6％，牡丹皮4～6％。
本发明的有益效果是，治疗原发性肾小球肾病疗效高，无毒副作用，具有疏风利水，通阳化湿，分利温热，健脾温肾之功效，适用于急性、急进性、慢性等类型。
具体实施方式
下面结合实施例对本发明作进一步的描述：
实施例1：
采用鳖甲、黄芪、黄柏、青蒿、白茅根、白薇、桑白皮、山茱萸、知母、干姜、肉苁蓉、肉桂、茯苓、泽泻、当归、远志、牡丹皮为原料药制备而成，其组分(重量％)每副为鳖甲10、黄芪8、黄柏6、青蒿6、白茅根8、白薇5、桑白皮5、山茱萸6、知母7、干姜5、肉苁蓉4、肉桂2、茯苓8、泽泻5、当归5、远志5、牡丹皮5。取上述17味原料药总重量191克，先将鳖甲捣碎，青蒿单包，其余的15味原料药加水900～1000ml，鳖甲单独浸泡200ml水中，均浸泡4～5小时，先将鳖甲用武火煮沸，加入其余的15味原料药煮沸，再加入单包的青蒿，用文火煎熬至60～80分钟左右，去渣得滤液150ml，药渣再加水300～400ml，煎熬30分钟，去渣得滤液50ml，共得200ml左右药汤，即制得鳖黄青白汤。装入无菌玻璃瓶内，密封瓶盖备用，每日一剂分两次口服，每次空腹服100ml。口服鳖黄青白汤的同时，再配合应用附子12g，牡蛎25g，补骨脂12g，芒硝3g，将前三味原料加水600ml煎煮成200ml，再溶芒硝于其中，待冷却后保留灌肠，每日1次。口服鳖黄青白汤3个月为一疗程，第一疗程配合应用上述方法灌肠，第二、三疗程单服鳖黄青白汤，一般应用3个疗程，每疗程中间休息5天。
本发明主药鳖甲，化学成分含动物胶、白蛋白、碘、维生素D等。性味咸、微寒，归肝、肾经。具有滋阳潜阳，软坚散结、退热、除蒸等功效，用于阳虚发热、劳热、骨蒸、虚风内动、经闭等。黄芪性味甘、温、归肺、脾经。具有补气固表、利尿脱毒、排脓、敛疱生肌的功效，用于气虚乏力、食少便溏、中气下陷、欠泻脱肛、便血崩漏、表虚自汗、气虚水肿、痈疽难溃、久溃不敛、血虚痿黄、内热消渴、慢性肾炎蛋白尿、糖尿病。黄柏性味苦、寒，归肾、膀胱经，具有清热燥湿，泻长除蒸、解毒疗疱的功效，用于湿热、泻痢、黄疸、带下、热淋、脚气、骨蒸劳热、盗汗等。青蒿性味苦、辛、寒，归肝、胆经，具有清热解暑、除蒸、截疟的功效，用于暑邪发热、阴虚发热、夜热早凉、骨蒸劳热、疟疾寒热、湿热黄疸。白茅根性味甘、寒，归肺、胃、膀胱经，具有凉血止血、清热利尿的功效。用于血热吐血、尿血、热病烦渴、黄疸、水肿，热淋涩痛、急性肾炎水肿。白薇性味苦、咸、寒，归胃、肝、肾经，具有清热凉血、利尿通淋、解毒疗疱的功效。用于湿邪伤营发热、骨蒸劳热、产后血虚发热、热淋、血淋、痈疽肿毒。桑白皮性味甘、寒，归肺经，具有泻肺平喘、利水消肿的功效，用于肺热喘咳、水肿胀满尿少、面目肌肤浮肿。山茱萸性味酸、涩、微温，归肝、肾经。具有补益肝肾、涩精固脱的功效，用于眩晕耳鸣、腰膝酸痛、阳痿遗精、遗尿尿频、崩漏带下、大汗虚脱、内热消渴。知母性味苦、甘、寒，归肺、胃、肾经，具有清热泻火、生津润燥的功效，用于外感热病、高热烦渴、肺热燥咳、骨蒸潮热、内热消渴、肠燥便秘。干姜性味辛、热，归脾、胃、肾、心、肺经。具有温中散寒、回阳通脉、燥湿消痰的功效，用于腕腹冷痛、呕吐泄泻、肢冷脉微、痰饮喘咳。肉苁蓉性味甘、咸、温，归肾、大肠经。具有补肾阳、益精血、润肠通便的功效，用于阳痿不孕，腰膝酸软、筋骨无力、肠燥便秘。肉桂性味辛、甘、大热、归肾、心、肝经。具有补火助阳、引火归源、散寒止痛、活血通经的功效，用于阳痿、宫冷、腰膝冷痛、肾虚作喘、阳虚眩晕、目赤咽痛、心腹冷痛、虚寒吐泻、寒疝、奔豚、经闭、痛经。茯苓性味甘、淡平、归心、肺、脾、肾经。具有利水渗湿、健脾宁心的功效，用于水肿尿少、痰饮眩悸、脾虚食少、便溏泄泻、心神不安、惊悸失眠。泽泻性味甘、寒，归肾、膀胱经，具有利小便，清湿热的功效，用于小便不利，水肿胀满、泄泻尿少、痰饮眩晕、热淋涩痛、高血脂。当归性味甘、辛、温，归肝、心、脾经。具有补血、活血，调经止痛，润肠通便的功效，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、跌打损伤、痈疽疱疡。远志性味苦、辛、温，归心、肾、肺经。具有安神益智、祛痰、消肿的功效，用于心肾不交引起的失眠多梦、健忘惊悸、神志恍惚、咳痰不爽、疱疡肿毒、乳房肿痛。牡丹皮性味苦、辛、微寒，归心、肝、肾经。具有清热凉血、活血化瘀的功效，用于温毒发斑、吐血、夜热早凉、无汗骨蒸、经闭痛经、痈肿疱毒、跌打伤痛。17味中草药巧妙组方，药物相须配伍，以增强性能、功效相同或近似药物疗效；相使配伍，辅药可以提高主要的功效；相偎配伍，使一种药物的毒副作用被另一种药物所抑制，使其毒副作用减轻或消失。药物相互协调作用，共奏原发性肾小球肾炎之特效。
本发明各原料还可按下表所列比例(重量百分比)混合的实施例来实现。其加工工艺与实施例1相同。
下面结合我院，即山东省威海市文登中心医院进行的临床预试验对本发明作进一步、详细地描述：
1.病例选择：所选病例为原发性肾小球肾炎患者，其诊断均符合陆再英、钟南山主编的《内科学》第七版诊断标准。其中男42例，女21例；年龄16～67岁之间；其中急性肾小球肾炎36例，急进性肾小球肾炎12例，慢性肾小球肾炎15例，病程5天到6个月。
2.疗程方法：每日一剂分2次口服，每次空腹服100ml，口服鳖黄青白汤的第一个疗程，再配合应用附子12g，牡蛎25g，补骨脂12g，芒硝3g，将前三味原料药加水600ml，煎煮成200ml，再溶芒硝于其中，待冷却后保留灌肠，每日一次。口服鳖黄青白汤3个月为一疗程，应用3个疗程，每疗程中间休息5天。第二、三疗程单服鳖黄青白汤，不配合灌肠。
3疗程评价：根据上海市卫生局《上海市中医病症诊疗常规》制定：痊愈：水肿等症状与体征完全消失，尿蛋白持续阴性或24小时尿蛋白持续＜0.2g，高倍镜下尿红细胞消失，肾功能正常。显效：水肿等症状与体征基本消失，24小时尿蛋白持续减少5％以上，高倍镜下尿红素细胞不超过3-5个，肾功能基本正常。有效：水肿等症状与体征明显减轻，24小时尿蛋白持续减少5％-4％以上，高倍镜下尿红细胞不超过5-8个，肾功能有改善。无效：水肿等症状体征及尿蛋白、尿红细胞、肾功能等治疗前后无变化。痊愈、显效、有效为总有效率。
4.治疗结果：使用本发明治疗63例原发性肾小球肾炎患者，按照疗效评价标准进行治疗效果评价：痊愈26例、显效23例、有效5例、无效9例，总有效率为85.7％。
Claims (1)
1.一种用于原发性肾小球肾炎的鳖黄青白汤，其技术特征是：采用鳖甲、黄芪、黄柏、青蒿、白茅根、白薇、桑白皮、山茱萸、知母、干姜、肉苁蓉、肉桂、茯苓、泽泻、当归、远志、牡丹皮为原料药，先将鳖甲捣碎，青蒿单包，将余下的15味原料药加水浸泡，鳖甲单独浸泡水中，先将鳖甲用武火煮沸，然后加入其余15味原料药煮沸，再加入单包的青蒿，文火煎熬，煎熬后去渣得滤液，原料药组成以重量百分比计为：鳖甲9～12％，黄芪6～9％，黄柏5～7％，青蒿5～7％，白茅根6～8％，白薇4～6％，桑白皮4～7％，山茱萸4～7％，知母5～7％，干姜3～5％，肉苁蓉2～4％，肉桂2～3％，茯苓6～8％，泽泻3～5％，当归4～6％，远志3～6％，牡丹皮4～6％。
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