CN102764342B - 治疗褥疮、糖尿病伤口、烫伤的药膏 - Google Patents
治疗褥疮、糖尿病伤口、烫伤的药膏 Download PDFInfo
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Abstract
本发明实施例公开了一种治疗褥疮、糖尿病伤口、烫伤的药膏,包括以下重量比配方:磺胺结晶:1.5%~6.5%,磺胺嘧啶:1.5%~6.5%,氧化锌:2.0%~10.0%,鱼肝油:0.4%~4.0%,消旋山莨菪碱:0.1%~3.0%,冰片:0.02%~1.4%,紫花地丁:5.0%~30.0%,以及余量的医用凡士林。采用本发明,可增强对患者伤处的组织渗透性,减少本发明的药膏的水分蒸发,延长药物在伤处的作用时间,并抑灭患处细菌,明显改善局部微循环,避免毛细血管血液灌流时断时续现象,促进患处痊愈。
Description
技术领域
本发明涉及一种药膏,尤其涉及一种治疗褥疮、糖尿病伤口、烫伤的专用药膏。
背景技术
褥疮、糖尿病足主要均属缺血性坏死形成的,常合并化脓性感染。局部微循环未改善或感染控制不住时,坏死组织越来越多,造成面积大且深之溃疡,后来常烂至见骨。溃烂严重者常是致死的主因。有的患者虽经清创、挖肉补疮、截肢(趾)、植皮等手术,但术后仍有部分人未能恢复,要么是补贴的新组织、表皮不成活,要么是截肢(趾)后创面难以愈合,继续坏死,不得以再次、多次截肢。此期病人体质已十分虚弱,经不起再次手术,多次并至高位截肢致死者屡有发生。
前者系压迫性缺血性坏死,后者则主要是属微循环障碍,糖尿病患者后期或血糖长期居高不下,容易引起全身动脉、毛细管脱水硬化,导致血管壁通透性下降,血管内径缩小,加上其他因素,逐渐引起多器官损害,后期常伴有心、肝、肾、脑、眼底不同程度的病变,微循环障碍表现在其足部就较突出,不少患者因跌、撞伤足部而引起伤处局限性出血而致皮肤紫癜,使原可勉强维持的局部微循环在外在的压力下失代偿,因而不可避免地发生缺血性坏死。特别是有些伤处并无破损,后来发展为溃疡多属由里向外溃破的,一旦溃破皮肤后,细菌感染接踵而来,导致化脓。
而目前医院里虽屡屡用高效、广谱、新型的抗生素仍未能控制继续感染、甚至有直接往溃疡处浇、淋、撒此类抗生素液、粉或胰岛素的,最终还是不能抑制继续坏死。究其因,局部毛细血管接连烂断,其局部微循环更趋衰竭,所使用的药物也难以由此缺损的血管网运抵目的地。
发明内容
本发明实施例所要解决的技术问题在于,提供一种用于治疗褥疮、糖尿病、伤口、烫伤药膏。可增强组织渗透,减少水分蒸发,并抑灭患处细菌,明显改善局部微循环,促进患处痊愈。
为了解决上述技术问题,本发明实施例提供了一种治疗褥疮、糖尿病伤口、烫伤的药膏,包括以下重量比配方:磺胺结晶:1.5%~6.5%,磺胺嘧啶:1.5%~6.5%,氧化锌:2.0%~10.0%,鱼肝油:0.4%~4.0%,消旋山莨菪碱:0.1%~3.0%,冰片:0.02%~1.4%,紫花地丁:5.0%~30.0%,以及余量的医用凡士林。
进一步地,所述配方重量比为:磺胺结晶:2.9%~3.5%,磺胺嘧啶:2.9%~3.5%,氧化锌:5.1%~5.7%,鱼肝油:0.95%~1.25%,消旋山莨菪碱:0.3%~0.5%,冰片:0.09%~0.11%,紫花地丁:11.5%~13.5%,以及余量的医用凡士林。
更进一步地,所述配方重量比为:磺胺结晶:3.2%,磺胺嘧啶:3.2%,氧化锌:5.4%,鱼肝油:1.1%,消旋山莨菪碱:0.4%,冰片:0.1%,紫花地丁:12.5%,以及余量的医用凡士林。
相应地,本发明实施例还提供了一种制作上述药膏的方法,包括以下步骤:
步骤1:将采集到了紫花地丁洗净晒干后切断,碾成粉后再次晒干;
步骤2;计算出所需制作的药膏的总量,根据总量计算出各种配方的加入量;
步骤3:将步骤1里所计算出重量的紫花地丁与冰片进行充分混合,并与根据总量计算出重量的医用凡士林充分搅拌,并过碾膏机初步碾成膏;
步骤4:将步骤1所计算出重量的磺胺结晶碾成粉后与上述重量的磺胺嘧啶、氧化锌充分混合后加入上述重量的鱼肝油,再次充分混合;
步骤5:将步骤1里所计算出重量的消旋山莨菪碱与上步骤3所得到的膏体进行充分混合。
实施本发明实施例,具有如下有益效果:对于褥疮与糖尿病伤口,本发明可增强对患者伤处的组织渗透性,减少本发明的药膏的水分蒸发,延长药物在伤处的作用时间,并抑灭患处细菌,明显改善局部微循环,避免毛细血管血液灌流时断时续现象,促进患处痊愈;对于烫伤,本发明能够抑制患处细菌生长繁殖,改善局部微循环,促进皮下组织和皮肤的再生。
具体实施方式
为使本发明的目的、技术方案和优点更加清楚,下面将对本发明作进一步地详细描述。
本发明治疗褥疮、糖尿病伤口的药膏其配方以改善患者伤处的局部微循环,重组血管网为目的,通过长期实践探索,以下配方可解决现有技术中治疗褥疮、糖尿病伤口药物的不足,其配方重量比为:磺胺结晶:1.5%~6.5%,磺胺嘧啶:1.5%~6.5%,氧化锌:2.0%~10.0%,鱼肝油:0.4%~4.0%,消旋山莨菪碱:0.1%~3.0%,冰片:0.02%~1.4%,紫花地丁:5.0%~30.0%,以及余量的医用凡士林。
下面将对各配方的疗效与相互作用进行说明。
磺胺结晶:是指磺胺在体内沉淀,磺胺药抗菌范围广,对大多数革兰氏阳性菌和革兰氏阴性菌均有抑制作用。对磺胺药高度敏感的病原菌有:链球菌、肺炎球菌、沙门氏菌、化脓棒状杆菌、大肠杆菌等;次敏感菌有:葡萄球菌、变形杆菌、巴氏杆菌、产气荚膜梭菌、肺炎杆菌、炭疽杆菌、绿脓杆菌、李氏杆菌、痢疾杆菌等。磺胺类药对某些放线菌、衣原体和某些原虫如球虫、阿米巴原虫、弓形虫也有较好的作用。
磺胺嘧啶:具有广谱及较强抗菌活性,对革兰阳性及阴性菌均有抑制作用,可用于脑膜炎双球菌、肺炎球菌、淋球菌、溶血链球菌感染的治疗,能通过血脑屏障进入脑脊液,曾被用于治疗流行性脑膜炎的首选药。抗菌机制是通过与对氨基苯甲酸(PABA)竞争细菌的二氢叶酸合成酶,导致细菌体内叶酸合成受阻而使细菌的生长、繁殖受挫。该品属中效磺胺,对非产酶金葡菌、化脓性链球菌、肺炎链球菌、大肠埃希菌、克雷伯菌属、沙门菌属、志贺菌属等肠杆菌科细菌、淋球菌、脑膜炎球菌、流感嗜血杆菌具有抗菌作用,此外在体外对沙眼衣原体、星形奴卡菌、疟原虫和弓形虫也有抗微生物活性。
氧化锌:用于收敛外用药、促进创面愈合,起消炎、保护作用。
鱼肝油:对慢性溃疡、X线皮炎、皮肤干裂有效。
消旋山莨菪碱:临床用于:1、抗休克,取代阿托品用于暴发型流行性脑脊髓炎,中毒性痢疾和其他感染性休克;2、解痉,用于解除内脏平滑肌痉挛所致的绞痛;3、有机磷农药中毒的治疗;4、血管性疾病、脑血栓、脑血管痉挛、血管神经性头痛、血栓闭塞性脉管炎等;5、治疗牛皮癣有效率达80%;6、其他如眩晕病(包括梅尼埃病,痊愈率达97%)、各种神经痛等。
冰片:内服芳香开窍,主要用于神昏、痉厥诸症,有类似麝香的开窍之醒脑功效;外用散热止痛,用于各种疮疡疥癣及喉症、眼疾等,有防腐散热止痛的功效,多作外用。
紫花地丁:清热解毒、而以疗疮毒为其特长,可用于痈疽发背、疔毒等热毒之症,亦治麻疹热毒。“主治一切痈疽发背,疔肿瘰疬,无名肿毒,恶疮。”(《本草纲目》)
医用凡士林:润滑剂、用作软膏基质、不亲水,涂抹在皮肤上可以保持皮肤湿润,使伤口部位的皮肤组织保持最佳状态,加速了皮肤自身的修复能力。
磺胺结晶与磺胺嘧啶属广谱抗菌药,虽目前许多临床常见病原菌对该二类药物耐药,但作为外用抗菌药物,其疗效仍较好,这是因为内服经代谢后,由于微细血管中的血药浓度太低,遇到耐药菌株能起抑制或杀灭作用,但在作外用药用,由于没有或极少经体内代谢,药物在局部仍处高浓度时,对抑菌仍有明显效果,故在对付耐药菌株时,在内服往往失效或微效时,外用仍可起显著的功效,两者合用功效更佳,但由于两者已属生产几十年的老药,功效不如前,故用冰片、紫花地丁增强其抗菌功效,对他们两者耐药的菌株未必对这两者产生耐药,冰片、紫花地丁两种中药乃联合用药,协同用药,单独和协同应用时对无名肿毒、恶疮有效,加上前述二种磺胺类药后,抗菌功效大大增强,起了事半功倍的作用。
氧化锌、鱼肝油有促进伤口愈合作用,鱼肝油有营养品之称,协同使用后更能促进伤处愈合,且在临床中未见有拮抗,在治疗中,为了对付药物的副作用,使用拮抗药也是常见的,上述药物使用禁忌对磺胺类药物过敏者禁用,由于外用,对于甲状腺肿及功能减退的不良反应均偶有发生。
实施例1:
药方总量:100g,其中,磺胺结晶:3.2g,磺胺嘧啶:3.2g,氧化锌:5.4g,鱼肝油:1.1g,消旋山莨菪碱:0.4g,冰片:0.1g,紫花地丁:12.5g,医用凡士林:74.1g。
实施例2:
药方总量:100g,其中,磺胺结晶:1.5g,磺胺嘧啶:1.5g,氧化锌:2.0g,鱼肝油:0.4g,消旋山莨菪碱:0.1g,冰片:0.02g,紫花地丁:5.0g,医用凡士林:89.48g。
实施例3:
药方总量:100g,其中,磺胺结晶:6.5g,磺胺嘧啶:6.5g,氧化锌:10g,鱼肝油:4.0g,消旋山莨菪碱:3.0g,冰片:1.4g,紫花地丁:30g,医用凡士林:38.6g。
实施例4:
药方总量:100g,其中,磺胺结晶:3.5g,磺胺嘧啶:2.9g,氧化锌:5.1g,鱼肝油:0.95g,消旋山莨菪碱:0.5g,冰片:0.09g,紫花地丁:13.5g,医用凡士林:73.46g。
实施例5:
药方总量:100g,其中,磺胺结晶:2.9g,磺胺嘧啶:3.5g,氧化锌:5.7g,鱼肝油:1.25g,消旋山莨菪碱:0.3g,冰片:0.11g,紫花地丁:11.5g,医用凡士林:74.74g。
以上各实施例的配方的特点是采用中西药结合,西药成份的磺胺结晶、磺胺嘧啶、消旋山莨菪碱三者配合起到快速杀菌抗菌功效,中药成份的紫花地丁具有治疗种疮毒的特性,且不易挥发,药效作用时间长,配用医用凡士林使得西药成份不易挥发且能将中药成份的药效得到最佳的发挥,有效的成份得以渗透入皮肤,再配合冰片、鱼肝油使得伤口的局部微循环得以改善,促进皮下组织再生,最终使患处得以快速愈合。
本发明治疗褥疮、糖尿病伤口、烫伤药膏的制备方法如下:
步骤1、将采集到的紫花地丁洗净晒干后切断,并碾成粉,再次进行晒干。
步骤2、计算出制作药物的总重量根据计算各种药物的加入量,将紫花地丁和冰片按配比与医用凡士林充分混合后,充分搅拌,用碾膏机碾过,如遇医用凡士林比较软,加入中药混合粉量可适当增加,而医用凡士林比较硬时,则反之,采用较软医用凡士林更佳,以利于中药混合粉可高比例地投入。
步骤3、将上述初步碾成膏后称其重量,然后再加入适当量的医用凡士林作为预备配制,将它们计算出总量后再按比例计算出磺胺结晶、磺胺嘧啶、氧化锌、鱼肝油、各自应加入的重量,并将磺胺结晶碾粉后与磺胺嘧啶、氧化锌充分混合和搅拌,然后加入计算出重量的鱼肝油,经与预备配制好的膏体充分搅拌后过碾膏机。
步骤4、将上述已计好消旋山莨菪碱与上述膏体再次充分混合搅拌后再次过碾膏机,即可制成本发明的治疗褥疮、糖尿病伤口、烫伤的药膏。
需要进行说明的是,磺胺结晶、磺胺嘧啶、氧化锌、鱼肝油的组分一般比较固定,而冰片、紫花丁、医用凡士林之量则根据药物的纯度适当地变动,增减后对疗效不发生影响。
本发明已在临床上初见成效,其使用特点为:敷膏后四至五天内,伴有数量不等的脓水流出,味及臭,与此同时,溃疡四周逐渐转为暗红色,七至八天后,患处部分底部可见到新鲜、红色的肉芽组织,此期流出脓水也逐渐减少。肉芽组织也相应增多增大。所谓“不破不立”,坏死组织不溶解掉,新生之肉芽也无地方生长。溃疡深度不超过1cm者,经外敷发明的药膏二个月左右可愈合,若超过1cm者,外敷本发明药膏时间必须相应延长。
以下结合发明人的临床试验实例进行说明:
应用实例1:患者甲,女,86岁,因年迈体衰,外卧病在床而发生褥疮,无糖尿病史,其褥疮面呈椭圆形、漏斗型疮底,最深处约6cm左右,采用本发明的实施例1配比的药膏约三个月左右而痊愈,在本例中紫花地丁配合磺胺结晶、磺胺嘧啶起主要作用,使得褥疮得已快速痊愈。
应用实例2:患者乙,女,42岁,有糖尿病史,患脑栓塞至半身瘫痪,又被开水烫伤,经常规药物治疗十余天仍无好转,采用本发明的实施例2配比的药膏外敷约十来天而愈,其中主要原因是利用了医用凡士林的不亲水特性,保持皮肤湿润,使得杀菌类药物的磺胺结晶与磺胺嘧啶等的常时药效得以发挥,其中西药成份起快速杀菌作用,并利用医用凡士林使伤口与空气隔绝,防止药效挥发,促进烫伤伤口得以迅速恢复。
应用实例3:患者丙,男,84岁,原查出有糖尿病,入住医院后,护士因其手足静脉管径太小,改为足部静脉注射,不慎感染,造成糖尿病足,且溃疡深至筋骨,且常规药物久治而不愈,改用本发明的实施例3配比的药膏外敷约三个月而愈,本实施例中是主要是中西结合,其西药成份起快速杀菌作用,中药成份持续作用的药效长,并利用医用凡士林使伤口与空气隔绝,防止药效挥发,使得患处快速恢复。
以上所述是本发明的优选实施方式,应当指出,对于本技术领域的普通技术人员来说,在不脱离本发明原理的前提下,还可以做出若干改进和润饰,这些改进和润饰也视为本发明的保护范围。
Claims (4)
1.一种治疗褥疮、糖尿病伤口、烫伤的药膏,其特征在于,包括以下重量比配方:磺胺结晶:1.5%~6.5%,磺胺嘧啶:1.5%~6.5%,氧化锌:2.0%~10.0%,鱼肝油:0.4%~4.0%,消旋山莨菪碱:0.1%~3.0%,冰片:0.02%~1.4%,紫花地丁:5.0%~30.0%,以及余量的医用凡士林。
2.根据权利要求1所述的治疗褥疮、糖尿病伤口、烫伤的药膏,其特征在于,所述配方重量比为:磺胺结晶:2.9%~3.5%,磺胺嘧啶:2.9%~3.5%,氧化锌:5.1%~5.7%,鱼肝油:0.95%~1.25%,消旋山莨菪碱:0.3%~0.5%,冰片:0.09%~0.11%,紫花地丁:11.5%~13.5%,以及余量的医用凡士林。
3.根据权利要求2所述的治疗褥疮、糖尿病伤口、烫伤的药膏,其特征在于,所述配方重量比为:磺胺结晶:3.2%,磺胺嘧啶:3.2%,氧化锌:5.4%,鱼肝油:1.1%,消旋山莨菪碱:0.4%,冰片:0.1%,紫花地丁:12.5%,以及余量的医用凡士林。
4.一种制作如权利要求1所述的治疗褥疮、糖尿病伤口、烫伤的药膏的方法,其特征在于,包括以下步骤:
步骤1:将采集到了紫花地丁洗净晒干后切断,碾成粉后再次晒干;
步骤2;计算出所需制作的药膏的总量,根据总量计算出各种配方的加入量;
步骤3:将步骤1里所计算出重量的紫花地丁与冰片进行充分混合,并与根据总量计算出重量的医用凡士林充分搅拌,并过碾膏机初步碾成膏;
步骤4:将步骤1所计算出重量的磺胺结晶碾成粉后与上述重量的磺胺嘧啶、氧化锌充分混合后加入上述重量的鱼肝油,再次充分混合;
步骤5:将步骤1里所计算出重量的消旋山莨菪碱与上步骤3所得到的膏体进行充分混合。
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