CN102727725A - 一种促进术后伤口愈合的药物组合物 - Google Patents
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Abstract
本发明公开了一种促进术后伤口愈合的药物组合物，涉及中医药技术领域。该药物组合物由如下重量份的活性成分制备而成：黄芪12-16份、杜仲12-16份、当归8-12份、黄柏8-12份、葛根8-12份、血竭8-12份、牛膝15-20份、芦荟15-20份、桃仁15-20份、陈皮15-20份、苦参15-20份、苏木15-20份、金银花10-15份。本发明的药物组合物可有效促进伤口愈合，预防腹腔粘连。
Description
技术领域
本发明属于中医药技术领域，具体涉及一种促进术后伤口愈合的药物组合物。
背景技术
腹腔手术切口感染的发生率大约为3％～16％，应用抗生素预防感染的感染发生率降至3％～4％。腹腔粘连是一种常见的手术并发症，其形成与腹膜纤维蛋白的沉积和纤维蛋白溶解能力之问的失衡有关。现代西医外科学对手术造成的创伤伤口的处理方法是，对伤口灭菌、消毒，应用抗生素防止感染，缝合伤口后用医用纱布包扎的方法。缝合具有闭合伤口，促进止血及组织愈合作用，是现代外科最基本的技术，因此手工缝合是目前应用最广泛的方法。另外，现代外科不在伤口上用药，伤口的愈合是靠机体自身的组织来修复的。一般在术后2-3天，患者更换一次敷料，目的是为观察和清洁伤口。由此可见，西医对于术后伤口的愈合完全依靠患者本身的组织修复能力，伤口愈合缓慢，且增加了患者增加腹腔粘连的风险。
发明内容
本发明的目的在于提供一种促进术后伤口愈合的药物组合物。该药物组合物可有效促进伤口愈合，预防腹腔粘连。
本发明的目的是这样实现的：
一种促进术后伤口愈合的药物组合物，由如下重量份的中药材制备而成：黄芪12-16份、杜仲12-16份、当归8-12份、黄柏8-12份、葛根8-12份、血竭8-12份、牛膝15-20份、芦荟15-20份、桃仁15-20份、陈皮15-20份、苦参15-20份、苏木15-20份、金银花10-15份。
优选地，所述的一种促进术后伤口愈合的药物组合物，由如下重量份的中药材制备而成：黄芪14份、杜仲14份、当归10份、黄柏10份、葛根10份、血竭10份、牛膝18份、芦荟18份、桃仁18份、陈皮18份、苦参18份、苏木18份、金银花13份。
进一步优选地，所述的一种促进术后伤口愈合的药物组合物为口服液。
本发明涉及的中药口服液的制备方法包括如下步骤：
（1）取处方量上述中药材，洗净去杂，晾干，粉碎成颗粒；
（2）再将上述颗粒状药材加水漫过药面2cm，浸泡1-1.2h，捞出药材置多功能提取灌中加水煎煮二次，第一次加总药材8-12倍量的水，煎煮1.5-2.5h，取煎液，滤过，第二次加总药材8-10倍量的水，煎煮0.5-1.5h，取两次煎液合并，滤过，浓缩至90℃时相对密度为1.10的浓缩液；
（3）将浓缩液置0-5℃低温冷藏24h，将冷藏液加0.3%的助滤剂硅藻土，滤过，滤液再浓缩至每毫升含1-1.5g生药量，置0-5℃低温冷藏24h，将冷藏液滤过，包装即得口服液。
根据中医药史料记载，上述中药材的药理活性如下：
黄芪：具有益气固表、敛汗固脱、托疮生肌、利水消肿之功效。用于治疗气虚乏力，中气下陷，久泻脱肛，便血崩漏，表虚自汗，痈疽难溃，久溃不敛，血虚萎黄，内热消渴，慢性肾炎，蛋白尿，糖尿病等。炙黄芪益气补中，生用固表托疮。
杜仲：补肝肾，强筋骨，安胎。治腰脊酸疼，足膝痿弱，小便余沥，阴下湿痒，胎漏欲堕，胎动不安，高血压。选用杜仲科植物杜仲（Eucommia ulmoides Oliver）的干燥树皮。
当归：补血活血，调经止痛，润肠通便。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、跌扑损伤、痈疽疮疡。选用伞形科植物当归Angelica sinensis (Oliv.) Diels 的干燥根。
黄柏：清热燥湿，泻火解毒，除骨蒸清虚热。用于湿热泻痢，黄疸，带下，热淋，脚气，痿辟，骨蒸劳热，盗汗，遗精，疮疡肿毒，湿疹瘙痒。选用芸香科植物黄皮树或黄檗的干燥树皮。
葛根：解表退热，生津，透疹，升阳止泻。用于外感发热头痛、高血压颈项强痛、口渴、消渴、麻疹不透、热痢、泄泻。选用豆科植物野葛Pueraria lobata (Willd.)Ohwi的干燥根，即野葛。
血竭：内服活血散瘀，定痛，外用止血生肌，敛疮。主治：①淤血经闭、痛经，产后瘀阻。②症瘕痞块，胸腹刺痛。③跌打损伤，淤血肿痛。④外伤出血，溃疡不敛。选用百合科剑叶龙血树或柬埔寨龙血树树脂。
牛膝：补肝肾、强筋骨、活血通经、引火（血）下行、利尿通淋。主治腰膝酸痛、下肢痿软、血滞经闭、痛经、产后血瘀腹痛、症瘕、胞衣不下、热淋、血淋、跌打损伤、痈肿恶疮、咽喉肿痛。选用苋科植物牛膝的根。
芦荟：泻下；清肝；杀虫。主热结便秘；肝火头痛；目赤惊风；虫积腹痛；疥癣；痔瘘；解巴豆毒。选用洋芦荟 (巴巴多斯芦荟)。
桃仁：活血祛瘀，润肠通便，止咳平喘。用于经闭，痛经，癓瘕痞块，跌扑损伤，肠燥便秘。选用蔷薇科植物桃Prunus persica （L.） Batsch 或山桃 Prunus davidiana （Carr.）Franch.的干燥成熟种子。
陈皮：具有理气健脾，调中，燥湿，化痰的作用。主治脾胃气滞之脘腹胀满或疼痛、消化不良。湿浊阻中之胸闷腹胀、纳呆便溏。痰湿壅肺之咳嗽气喘。选用为芸香科植物橘及其栽培变种的干燥成熟果皮。
苦参：清热燥湿，杀虫，利尿。用于热痢，便血，黄疸尿闭，赤白带下，阴肿阴痒，湿疹，湿疮，皮肤瘙痒，疥癣麻风；外治滴虫性阴道炎。选用多年生落叶亚灌木植物苦参的根。
苏木：活血祛瘀，消肿定痛。主治妇人血滞经闭，痛经，产后瘀阻心腹痛，产后血晕，痈肿，跌打损伤，破伤风。选用豆科植物苏木的心材。
金银花：清热解毒。温病发热；热毒血痢；痈肿疔疮；喉痹及多种感染性疾病。选用忍冬科植物忍冬（Lonicera japonica Thunb）的干燥花蕾。
通过动物试验研究发现，本发明的中药组合物联合抗生素在切口愈合方面的效果要优于模型对照组，子宫与周围组织的粘连程度要显著轻于阳性对照组和模型对照组，这提示本发明的中药组合物可有效促进伤口愈合，预防腹腔粘连。尤其是，本发明的中药组合物加抗生素的联合用药组多呈现腹部肌层与皮肤无粘连的状态，而阳性对照组腹壁肌层与皮肤之间均呈现轻度粘连、易剥离的状态，而这种状态随着时间的延长会进一步激化，形成不易剥离的粘连。这提示本发明的中药组合物的应用具有降低术后组织粘连的作用。
具体实施方式
以下是本发明的具体实施例，对本发明的技术方案做进一步作描述，但是本发明的保护范围并不限于这些实施例。凡是不背离本发明构思的改变或等同替代均包括在本发明的保护范围之内。
实施例1中药口服液的制备
生药处方：黄芪140g、杜仲140g、当归100g、黄柏100g、葛根100g、血竭100g、牛膝180g、芦荟180g、桃仁180g、陈皮180g、苦参180g、苏木180g、金银花130g。
口服液制备方法：
（1）取处方量上述中药材，洗净去杂，晾干，粉碎成颗粒；
（2）再将上述颗粒状药材加水漫过药面2cm，浸泡1-1.2h，捞出药材置多功能提取灌中加水煎煮二次，第一次加总药材10倍量的水，煎煮2h，取煎液，滤过，第二次加总药材8倍量的水，煎煮1h，取两次煎液合并，滤过，浓缩至90℃时相对密度为1.10的浓缩液；
（3）将浓缩液置2℃低温冷藏24h，将冷藏液加0.3%的助滤剂硅藻土，滤过，滤液再浓缩至每毫升含1.5g生药量，置2℃低温冷藏24h，将冷藏液滤过，包装即得口服液。
实施例2 中药口服液的制备
生药处方：黄芪120g、杜仲160g、当归120g、黄柏100g、葛根80g、血竭80g、牛膝150g、芦荟200g、桃仁200g、陈皮180g、苦参150g、苏木150g、金银花150g。
口服液制备方法：
（1）取处方量上述中药材，洗净去杂，晾干，粉碎成颗粒；
（2）再将上述颗粒状药材加水漫过药面2cm，浸泡1-1.2h，捞出药材置多功能提取灌中加水煎煮二次，第一次加总药材12倍量的水，煎煮2h，取煎液，滤过，第二次加总药材8倍量的水，煎煮1h，取两次煎液合并，滤过，浓缩至90℃时相对密度为1.10的浓缩液；
（3）将浓缩液置2℃低温冷藏24h，将冷藏液加0.3%的助滤剂硅藻土，滤过，滤液再浓缩至每毫升含1.5g生药量，置2℃低温冷藏24h，将冷藏液滤过，包装即得口服液。
实施例3 中药口服液的制备
生药处方：黄芪150g、杜仲150g、当归80g、黄柏80g、葛根120g、血竭120g、牛膝200g、芦荟150g、桃仁150g、陈皮150g、苦参200g、苏木200g、金银花100g。
口服液制备方法：
（1）取处方量上述中药材，洗净去杂，晾干，粉碎成颗粒；
（2）再将上述颗粒状药材加水漫过药面2cm，浸泡1-1.2h，捞出药材置多功能提取灌中加水煎煮二次，第一次加总药材10倍量的水，煎煮2h，取煎液，滤过，第二次加总药材8倍量的水，煎煮1h，取两次煎液合并，滤过，浓缩至90℃时相对密度为1.10的浓缩液；
（3）将浓缩液置2℃低温冷藏24h，将冷藏液加0.3%的助滤剂硅藻土，滤过，滤液再浓缩至每毫升含1.5g生药量，置2℃低温冷藏24h，将冷藏液滤过，包装即得口服液。
实施例4 本发明中药口服液对剖腹产大鼠伤口愈合的影响
36只发情期雌性SD大鼠，随机分为如下3组：模型对照组、阳性对照组、联合用药组，每组l2只。全部大鼠受孕后，于孕2l天在10％水合氯醛麻醉下行剖宫产术。消毒后打开腹腔，暴露两侧子宫，分别在两侧子宫的中段剪0.5cm的切口，用眼科无齿镊将仔鼠及胎盘逐个取出，缝合子宫切口，将子宫还纳腹腔，分别缝合肌肉层和皮肤，涂2％碘酊后放入新换垫料盒中，垫料加厚，实验室温度保持26～27℃为大鼠保暖。术后模型对照组按l0mL/kg生理盐水灌胃给药，阳性对照组按青霉素钠16万单位/kg腹腔注射给药，联合用药组按6ml/kg灌胃本发明实施例1制备的口服液和青霉素钠16万单位/kg腹腔注射给药。时间均为7天。另组大鼠每天切口涂2％碘酊1次。各组大鼠具体按表1的方式分组并给予受试物。
表1. 实验动物分组及给药
考察各组大鼠如下指标：（1）腹部切口愈合情况；（2）腹部肌层与皮肤粘连情况(可分为无粘连、轻度粘连易剥离、轻度粘连、重度粘连4级)；（3）子宫与周围组织粘连情况(可分为无粘连、轻度粘连、重度粘连3级)。
表2腹部切口愈合情况比较
| 组别 | n | 切口愈合良好 | 切口愈合不良 | 切口裂开 |
| 模型对照组 | 12 | 0 | 8 | 2 |
| 阳性对照组 | 12 | 10 | 2 | 0 |
| 联合用药组 | 12 | 15 | 0 | 0 |
表3腹部肌层与皮肤粘连情况比较
| 组别 | n | 无粘连 | 轻度粘连易剥离 | 轻度粘连 | 重度粘连 |
| 模型对照组 | 12 | 0 | 1 | 3 | 8 |
| 阳性对照组 | 12 | 0 | 9 | 3 | 0 |
| 联合用药组 | 12 | 10 | 2 | 0 | 0 |
表4子宫与周围组织粘连情况比较
| 组别 | n | 无粘连 | 轻度粘连 | 重度粘连 |
| 模型对照组 | 12 | 0 | 3 | 9 |
| 阳性对照组 | 12 | 8 | 4 | 0 |
| 联合用药组 | 12 | 11 | 1 | 0 |
腹部切口愈合情况比较见表2。切口愈合情况组间比较，阳性对照组、联合用药组切口愈合情况显著优于模型对照组。
腹部肌层与皮肤粘连情况比较见表3。腹部肌层与皮肤粘连情况组间比较，联合用药组切口的粘连要显著轻于阳性对照组和模型对照组。
子宫与周围组织粘连情况比较见表4。子宫与周围组织粘连情况组间比较，阳性对照组、联合用药组的子宫与周围组织的粘连程度要显著低于模型对照组。
通过试验研究发现，本发明的中药组合物联合抗生素在切口愈合方面的效果要优于模型对照组，子宫与周围组织的粘连程度要显著轻于阳性对照组和模型对照组，这提示本发明的中药组合物可有效促进伤口愈合，预防腹腔粘连。尤其是，本发明的中药组合物加抗生素的联合用药组多呈现腹部肌层与皮肤无粘连的状态，而阳性对照组腹壁肌层与皮肤之间均呈现轻度粘连、易剥离的状态，而这种状态随着时间的延长会进一步激化，形成不易剥离的粘连。这提示本发明的中药组合物的应用具有降低术后组织粘连的作用。
Claims (3)
1.一种促进术后伤口愈合的药物组合物，其特征在于由如下重量份的中药材制备而成：黄芪12-16份、杜仲12-16份、当归8-12份、黄柏8-12份、葛根8-12份、血竭8-12份、牛膝15-20份、芦荟15-20份、桃仁15-20份、陈皮15-20份、苦参15-20份、苏木15-20份、金银花10-15份。
2.根据权利要求1所述的促进术后伤口愈合的药物组合物，其特征在于由如下重量份的中药材制备而成：黄芪14份、杜仲14份、当归10份、黄柏10份、葛根10份、血竭10份、牛膝18份、芦荟18份、桃仁18份、陈皮18份、苦参18份、苏木18份、金银花13份。
3.根据权利要求1或2所述的促进术后伤口愈合的药物组合物，其特征在于：所述药物组合物为口服液。
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