CN103285100A - Externally-applied Chinese medicinal composition for treating metastatic cancer-induced bone pain - Google Patents

Externally-applied Chinese medicinal composition for treating metastatic cancer-induced bone pain Download PDF

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CN103285100A
CN103285100A CN2013101485236A CN201310148523A CN103285100A CN 103285100 A CN103285100 A CN 103285100A CN 2013101485236 A CN2013101485236 A CN 2013101485236A CN 201310148523 A CN201310148523 A CN 201310148523A CN 103285100 A CN103285100 A CN 103285100A
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pain
chinese medicinal
medicinal composition
treatment
externally
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CN103285100B (en
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俞超芹
翟东霞
韩洁
白玲玲
张丹英
俞瑾
王针织
孙帅
周丽虹
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Second Military Medical University SMMU
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Abstract

The invention relates to an externally-applied Chinese medicinal composition for treating metastatic cancer-induced bone pain, and the Chinese medicinal composition is characterized by being prepared by the following Chinese medicine raw materials in parts by weight: 50-100 parts of rheum officinale and 200-400 parts of mirabilite. The externally-applied Chinese medicinal composition is aimed at metastatic cancer-induced bone pain, by taking pain-relieving, heat-clearing and stagnation-eliminating as a principle of treatment, and by verification through the clinical application of many years and pharmacological studies, the externally-applied Chinese medicinal composition can help to obviously improve the clinical symptom of the metastatic cancer-induced bone pain, and has advantages of definite therapeutic effect, no toxic and side effects, low cost and convenient application.

Description

A kind of external medicine composition for the treatment of the carcinous osteodynia of transitivity
Technical field
The invention belongs to pharmaceutical field, relate to a kind of external medicine composition for the treatment of the carcinous osteodynia of transitivity; In addition, the invention still further relates to the medical usage of this Chinese medicine composition.
Background technology
The sickness rate of cancer pain at late stage is up to 75%-90%, and wherein shifting the osteodynia that causes by neoplastic bone is that (metastatic cancer-induced bone pain CIBP) accounts for 40% to the carcinous osteodynia of transitivity.It is the modal transfer of late malignant tumour that bone shifts, and can betide any tumor, wherein sees so that breast carcinoma, pulmonary carcinoma, carcinoma of prostate particularly more.Yet, the internal organs transfer does not take place as yet if bone shifts the patient, life span may be longer relatively, the patient will continue to face serious bone pain, the torment of limitation of activity for a long time, also will face the threat of severe complication danger such as pathologisch Bruch, nerve root compression, spinal cord infringement, hypercalcemia take place at any time for a long time, and cause viability decline, anxiety-depression, overall quality of life to descend.At present, the treatment of WHO three step analgesias is the cancer pain drug treatment of international extensive use, but often there are toxic and side effects such as gastrointestinal reaction, drug resistance and addiction, simultaneously, CIBP is a kind of chronic pain syndrome of complexity, the pathogenesis complexity, its clinical manifestation and mechanism all are different from traditional inflammatory pain or neuropathic pain, the patient is difficult to obtain abundant analgesia usually, compare more thorny with the cancer pain at other positions, therefore, CIBP has a strong impact on the life quality of tumor patient, is one of types of pain of the most difficult alleviation in the pain field.
The treatment of CIBP mainly contains whole body therapeutic and topical therapeutic two aspects at present, and whole body therapeutic comprises analgesic, chemotherapy, bone resorption inhibitor class Drug therapy and close bone radiosiotope internal radiation radiotherapy; Topical therapeutic comprises appeasing property external exposure radiotherapy, bone surgery treatment etc.The whole bag of tricks has its pluses and minuses and indication.Though wherein three ladder medicine analgesia therapies are rapid-action, only be symptomatic treatment, curative effect lasting time is short, prolonged application, untoward reaction is many, easily drug resistance, addiction is arranged; Systemic chemotherapy shifts the patient to bone certain effect really, but curative effect depends on that tumor cell is to the sensitivity of chemotherapy regimen, and generally speaking, the difficult osseous tissue barrier that sees through of most of cancer therapy drugs, and the osteoclasia reparation is slower, and the short time is difficult to take effect. the untoward reaction that the while chemotherapy is brought has also influenced patient's life quality to a certain extent; Parent's bone radiosiotope internal-radiation therapy can reduce bone and shift bone destruction, the dissolving that causes, for eliminating or alleviating the had an intense pain certain curative effect of whole body popularity bone due to shifting, can suppress simultaneously the development of bone metastasis, but the bone marrow depression incidence rate is higher, recovers slower; Bone resorption inhibitor class medicine (diphosphonate) main pharmacological is for suppressing osteoclast activity, analgesic effect is good, shift the caused bone pain except can effectively controlling neoplastic bone, can also alleviate a series of complication that osteolytic lesion causes, be that the clinical treatment bone shifts the active drug of generally acknowledging at present, but expensive, it is bad that its side effect can cause bone calcification, osteomalacia and gastrointestinal complication.Appeasing property external exposure radiotherapy is a kind of effective topical therapeutic means, but the cancer patient for extensive bone transfer, curative effect is no longer brought into play in local radiotherapy, and whole body radiotherapy can bring such as severe complications such as nausea and vomiting, severe bone marrow depression, radioactivity visceral organ injuries.Because CIBP is a chronic seriousness disease that mechanism is complicated, symptom is obstinate, curative effect is not good enough, therefore, searching determined curative effect, little, easy to use, the cheap medicine of side effect are the striving directions of domestic and international pain field and tumor area.
The overall strategy of CIBP treatment is alleviating pain, and the quality of making the life better is the Comprehensive Treatment of main target.The therapeutic scheme that generally adopts at present the long-term oral combination diphosphonate of three step analgesia medicines regularly to use clinically, obtain satisfied result, but have the xerostomia expensive, that opium kind analgesics brings, constipation, feel sick, vomiting, problem such as weak, and continue to use the drug resistance and the potential addiction risk that cause and be difficult to eliminate.
Summary of the invention
The purpose of this invention is to provide a kind of external medicine composition for the treatment of the carcinous osteodynia of transitivity.
To achieve these goals, technical scheme of the present invention is as follows: a kind of external medicine composition for the treatment of the carcinous osteodynia of transitivity is characterized in that adopting the preparation of following weight Chinese medicinal raw materials: Radix Et Rhizoma Rhei 50-100 weight portion, Natrii Sulfas 200-400 weight portion.
Preparation of drug combination of the present invention there is no special feature, adopts the conventional preparation method in this area to be prepared into that said common exterior-applied formulation gets final product on the pharmaceutics, and its dosage form is mainly powder, can certainly be made into other common dosage forms.
Chinese medicine pharmaceutical composition of the present invention is raw materials used inexpensive, prepares easyly, easy to use, and through clinical application for many years and pharmacological research, to shift caused pain, numbness, limb activity unfavorable to alleviating bone, has curative effect preferably.In view of the carcinous osteodynia morbidity of transitivity crowd enormous amount, clinical at present simple pain management effect is not good enough, and compound Chinese medicinal preparation provided by the invention has a good application prospect.
The specific embodiment
The carcinous osteodynia of transitivity is the modern medicine name of disease, metastatic bone cancer belong in the TCM Document " osteoma ' ', " osteomyelitis ", " bone fistula skin ulcer ", " bone tumor ' ', category such as " rheumatism involving the bone ".As " the surgery central administrative unit " day: " if impairment caused by overstrain kidney water, can not flourish bone and be tumor osteoma husband tumor person by name, stay also.Stagnate with airsetting, all injured because of internal organs, QI and blood and separated ".
About the pathomechanism of this sick traditional Chinese medical science, mainly contain following 3 points: 1. qi depression to blood stasis expectorant coagulates.Because formation and the development of cancerous protuberance, condense and do not loose or more poly-more big, hinder the normal operation of QI and blood, stagnate in certain position, the swelling of the flesh natural fibre line of meat, channels is forced to and causes pain.2. the poison knot is invaded film evil network.Because cancer poison knot stagnates, hollow heart is lost outward, injures the flesh natural fibre line of meat, internal organs, meridians, channels pressurized and cause pain.3. the anemia venation is not sought.Because the in-fighting of cancerous protuberance, healthy energy is not gradually propped up, and anemia can not be sought and be moistened in internal organs and meridians, makes channels be in the contracture state of cervical carcinoma with cachexia and causes pain.So pain has two aspects of deficiency and excess, i.e. " stagnation of QI and blood may bring about pain " and " not Rong Ze pain ".Before treatment by Chinese herbs CIBP, need assess position, character, degree and the patient's of inquiry pain mental and physical equally to pain.And use the traditional Chinese medical science prestige, hear, ask, cut comprehensive analysis of the data gained by the four methods of diagnosis and diagnose, adopt dialectical combine to discuss with differential diagnosis of diseases control.According to " stagnation of QI and blood may bring about pain " and theories of Chinese medical science such as " not Rong Ze pains ", pain is carried out determination for the treatment of based on pathogenesis obtained through differentiation of symptoms and signs.
There are some researches show: Natrii Sulfas main component Na2SO410H2O, account for 96%-98%, have pain relieving, antiinflammatory, stimulation enterokinesia and improve the effect of local blood circulation; Strengthen hypertrophy phenomenon and the phagocytic function of reticuloendothelial system, to transfer body resistance against diseases, to strengthen antiinflammatory action; In addition, it can provide a kind of high environment that oozes, can be by the effect of osmotic pressure, and antiinflammatory eliminating dampness by diuresis, absorptive tissue sepage.
At bone, the pyretic toxicity stasis of blood is become trouble mutually, based on the heat clearing away removing obstruction for relieving pain, takes into account blood stasis dispelling with the carcinous Itai-itai diseases of transitivity position in the present invention.Adopt the Therapeutic Principle of heat clearing away removing obstruction for relieving pain.Radix Et Rhizoma Rhei, Natrii Sulfas are clinical conventional Chinese medicine, the many records relevant for the card of " obstructed ", " not flourish " due to the two medicines treatment stasis of blood, expectorant, heat, the poison of successive dynasties medical book, " blood stasis under the Radix Et Rhizoma Rhei master; blood closes cold and heat, broken addiction abdominal mass is gathered, and cleanses the intestines and stomach; push away Chen Zhixin; tonneau water paddy, relieving dyspepsia in the accent, peace and the five internal organs as Shennong's Herbal." Compendium of Material Medica: " Radix Et Rhizoma Rhei cures mainly the hectic fever delirium, jaundice, all burn." " medicine justice ": " the Radix Et Rhizoma Rhei abnormal smells from the patient is deep, and it is descending to land vertically, and walks and does not keep, and has to cut to close the power of forcing the way to, so number general.Specialize in trusted subordinate's distension, the accumulation of heat of breast stomach, it is real to gather expectorant, the constipation blood stasis." the Natrii Sulfas bitter in the mouth is salty, cold in nature, nontoxic, function heat and toxic materials clearing away, moistening for dryness and softening hard mass, clearing heat for detumescence.For oral administration get it and rush down the purgation merit; The usefulness of its hard masses softening and resolving, detumescence is got in external application: the bitter energy of its property dampness, cold can purging heat; The salty energy of its property hard masses softening and resolving, the diuretic of promoting blood circulation, promoting blood circulation to remove blood stasis.
Because CIBP patient belongs to malignant tumor late period more, often experienced receive and distribute art or chemotherapy repeatedly, radiotherapy after, healthy energy is empty, anti-sending an expedition against not, the taste absorption function weakens, and simultaneously pain is as more violent, and often receive, sleep, emotion had a strong impact on by stomach for the patient, sometimes oral medicine poor effect, this moment, external therapy of Chinese herb had more advantage.External treatment of Chinese medicine is the important component part of motherland's medical science, and clear Wu Shi machine is mentioned in " theory is boiled literary composition ": " reason of external treatment, the i.e. reason for the treatment of by oral administration of medicines: the medicine of external treatment, the i.e. medicine for the treatment of by oral administration of medicines.Different person, a method ear! The medical knowledge property of medicine does not have two, changes and rule is magical." external treatment is the direct administration of body surface, generation effect after skin or mucous membrane surface directly absorb, cancerous pain is still a kind of topical manifestations of general disease, so there is card to debate, has method to follow; And painful area is close to body surface more, and external application can make the efficacy of a drug sick institute that goes directly, and pain relieving is rapid, and can avoid oral too many levels deactivation and the side effect that brings for oral administration that runs into that absorb through digestive tract.With mouth medication relatively, have reach the same goal by different routes, play the same tune on different musical instruments wonderful, be particularly suitable for critical patient or can not the oral administration person in late period.
The present invention is directed to symptom and the pathogenesis of the carcinous osteodynia of transitivity, adopt the Therapeutic Principle of heat clearing away removing obstruction for relieving pain, adopt the mode of external simultaneously.Proportioning raw materials is that the inventor is in conjunction with the theory of Chinese medical science dialectical prescription, and use through long-term clinical practice and a large amount of cases and to grope to draw, the usage ratio of each component all has better curative effect in following ranges, following column weight amount Chinese medicinal raw materials preparation, (every pair of Chinese medicine): Radix Et Rhizoma Rhei 50-100 restrains (± 10%), and Natrii Sulfas 200-400 restrains (± 10%).Using method is external application, once a day, and each 2 ~ 3 hours.
The preparation of compositions powder and the specific embodiment of using method are as follows:
Press Radix Et Rhizoma Rhei 50 ± 5 grams, the ratio of Natrii Sulfas 300 ± 30 gram weight parts will be crushed into powder behind 2 kinds of pharmaceutical dryings, crosses 100 mesh sieves, and behind the mixing, the double-deck cloth bag of packing into (being about 30cm, wide about 20cm) evenly spreads out, and the most obvious place of osteodynia is also fixing.Deposited bag once outside 12 hours need to change.
Press Radix Et Rhizoma Rhei 100 ± 10 grams, the ratio of Natrii Sulfas 200 ± 20 gram weight parts will be crushed into powder behind 2 kinds of pharmaceutical dryings, crosses 100 mesh sieves, and behind the mixing, the double-deck cloth bag of packing into (being about 30cm, wide about 20cm) evenly spreads out, and the most obvious place of osteodynia is also fixing.Deposited bag once outside 12 hours need to change.
Press Radix Et Rhizoma Rhei 80 ± 8 grams, the ratio of Natrii Sulfas 400 ± 40 gram weight parts will be crushed into powder behind 2 kinds of pharmaceutical dryings, crosses 100 mesh sieves, and behind the mixing, the double-deck cloth bag of packing into (being about 30cm, wide about 20cm) evenly spreads out, and the most obvious place of osteodynia is also fixing.Deposited bag once outside 12 hours need to change.
Press Radix Et Rhizoma Rhei 100 ± 10 grams, the ratio of Natrii Sulfas 300 ± 30 gram weight parts will be crushed into powder behind 2 kinds of pharmaceutical dryings, crosses 100 mesh sieves, and behind the mixing, the double-deck cloth bag of packing into (being about 30cm, wide about 20cm) evenly spreads out, and the most obvious place of osteodynia is also fixing.Deposited bag once outside 12 hours need to change.
Press Radix Et Rhizoma Rhei 50 ± 5 grams, the ratio of Natrii Sulfas 200 ± 20 gram weight parts will be crushed into powder behind 2 kinds of pharmaceutical dryings, crosses 100 mesh sieves, and behind the mixing, the double-deck cloth bag of packing into (being about 30cm, wide about 20cm) evenly spreads out, and the most obvious place of osteodynia is also fixing.Deposited bag once outside 12 hours need to change.
This compound Chinese medicinal preparation has obtained clinical efficacy preferably in clinical practical application, to alleviating osteodynia, improve signs such as acroparesthesia, edema, improve the quality of life of late tumor patient, and prolong aspect life cycle, obtained clinical effectiveness preferably.For considering of medical ethics, in clinical observation, do not set up the placebo group, by the 30 routine patients that meet diagnostic criteria have been carried out observation of curative effect, the result is as follows.Clinical total effects: 30 routine patients all treat two courses for the treatment of above (be 14 days each course for the treatment of), and the mean treatment time is 3.8 months.After treatment, pain is obviously alleviated (scoring below 2 minutes) person's 5 examples, pain relief (scoring 3-5 branch) person's 10 examples, effectively (2 fens person's 11 examples of the more preceding reduction of pain scores, invalid 4 examples, total effective rate 86.7%, inefficiency 13.3%.
In clinical practice, we find two kinds according to the range size of painful area, and at Radix Et Rhizoma Rhei 50-100 weight portion, in the scope of Natrii Sulfas 200-400 weight portion, the treatment curative effect all has statistical significance (P<0.05).When drug weight ratio Radix Et Rhizoma Rhei: better to the remission effect of pain during Natrii Sulfas=1:4, have remarkable significant difference (P<0.01).Under this ratio, when the medicine amount of getting is Radix Et Rhizoma Rhei 50 ± 5 gram, during Natrii Sulfas 200 ± 20 grams, effect is particularly outstanding, and is the most obvious to the remission effect of pain.Use and the difference that is used in combination in order to explore two kinds of medicine lists, other has 10 routine qualified patients to be divided into 2 groups at random, every group of 5 people, one group single with Radix Et Rhizoma Rhei 50 weight portions, one group of single Natrii Sulfas 200 weight portion of using is taked the preparation method same with compound preparation, is crushed into powder after the drying respectively, cross 100 mesh sieves, behind the mixing, the double-deck cloth bag of packing into (being about 30cm, wide about 20cm), evenly spread out, the most obvious place of osteodynia is also fixing.Deposited bag once outside 12 hours need to change, the pain relief rate is single to be 18% with the Radix Et Rhizoma Rhei group, single is 24% with the Natrii Sulfas group, and undesirable to the effect that disappears of local soft tissue swelling, no matter is that total effective rate or simultaneous phenomenon improvement rate are well below the complex group of common use Radix Et Rhizoma Rhei Natrii Sulfas.
Below for several examples of clinical practice:
Example 1
Journey, woman, in March, 1962 birth, Shanghai people.Medical Record number: 552323.Because " leiomyosarcoma of uterus postoperative 5 years, hepatic metastases 2 years, lumbar vertebra transferase 12 week " goes to a doctor.Patient in May, 2011 lumbar vertebra MRI points out multiple transfer companion part pathologisch Bruch, and on June 23rd, 2011 occurred waist suddenly and has an intense pain, and marked 8 fens, and two lower limb can't be movable, and defecation can not be explained by oneself.Have a medical check-up: 0 grade of bilateral lower-limb muscular strength, 0 grade of muscular tension, the following superficial sensibility in bilateral knee joint is gone down, pain sensation sensitivity, and bilateral knee reflection, Achilles tendon reflex disappear.Conventional suiting the medicine to the illness supported to handle, and simultaneously in waist external application compound Chinese medicinal preparation of the present invention, Radix Et Rhizoma Rhei 100 grams, continue 2 hours, continuous 14 days at 400 every days of Natrii Sulfas 1 time.Pain symptom obviously alleviates, and marks 4 fens.Have a medical check-up: 2 grades of bilateral lower-limb muscular strengths, 2 grades of muscular tension, the following superficial sensibility in bilateral knee joint is gone down, pain sensation sensitivity, and bilateral knee reflection, Achilles tendon reflex exist.Use compound Chinese medicinal preparation waist of the present invention external application after leaving hospital always, continue 2 hours every day 1 time, followed up a case by regular visits to 1 year half, symptom continues to take a turn for the better, still existence, and pain scores 1-2 branch at present, and life is simply taken care of oneself.
Example 2
Tight certain, woman, birth in May nineteen fifty-seven, Shanghai people, Medical Record number: 654349.Because " find two breast carcinomas 2 years 5 months, the breast lumbar vertebra extensively shifted companion's pain 1 year " goes to a doctor.In February, 2012, vertebra MRI pointed out vertebra (breast T3-T12, waist L1-L4) many vertebral bodys and the extensive metastatic tumor of adnexa, part vertebral body pathologisch Bruch.Have a medical check-up: pain scores 6 minutes, 3 grades of bilateral lower-limb muscular strengths, 4 grades of muscular tension, two lower limb are felt feel deeply, superficial sensibility is normal, and bilateral knee reflection, Achilles tendon reflex exist.Breast waist external application compound Chinese medicinal preparation of the present invention, Radix Et Rhizoma Rhei 100 grams, Natrii Sulfas 400 grams, every day 1 time, each 2 hours, external was 6 months continuously, makes regular check on, do not see disease progression, have a medical check-up at present: pain scores 2 minutes, 4 grades of bilateral lower-limb muscular strengths, 4 grades of muscular tension, two lower limb are felt feel deeply, superficial sensibility is normal, and bilateral knee reflection, Achilles tendon reflex exist.
Embodiment 3
Lee, woman, people from Yanji.November nineteen fifty-nine birth, Medical Record number: 787645.Because " carcinoma of endometrium postoperative 5 years is surplus, flank pain companion left lower extremity pain March " is admitted to hospital.2012 08 month lumbar vertebra MRI: lumbar vertebra L3-L4 vertebral body, L4 left side pedicle of vertebral arch bone shift.Have a medical check-up: pain scores 7 minutes, 2 grades of left lower extremity muscular strengths, 2 grades of muscular tension, 3 grades of right lower extremity muscular strengths, 3 grades of muscular tension, two lower limb are felt feel deeply, superficial sensibility is normal, and bilateral knee reflection, Achilles tendon reflex exist.Waist external application compound Chinese medicinal preparation of the present invention, Radix Et Rhizoma Rhei 50 grams, Natrii Sulfas 200 grams, every day 1 time, each 2 hours, external was had a medical check-up after 6 days continuously: pain scores 3 minutes, 4 grades of bilateral lower-limb muscular strengths, 4 grades of muscular tension, two lower limb are felt feel deeply, superficial sensibility is normal, and bilateral knee reflection, Achilles tendon reflex exist.Follow up a case by regular visits to after leaving hospital, at present stable disease.

Claims (4)

1. an external medicine composition for the treatment of the carcinous osteodynia of transitivity is characterized in that adopting the preparation of following weight Chinese medicinal raw materials: Radix Et Rhizoma Rhei 50-100 weight portion, Natrii Sulfas 200-400 weight portion.
2. according to the external medicine composition of the carcinous osteodynia of the described treatment transitivity of claim 1, it is characterized in that its dosage form is powder.
3. according to the external medicine composition of the carcinous osteodynia of the described treatment transitivity of claim 1, it is characterized in that every pair of Chinese medicine amount of getting: Radix Et Rhizoma Rhei 50 ± 5 grams, Natrii Sulfas 200 ± 20 grams.
4. the external medicine composition of the carcinous osteodynia for the treatment of transitivity as claimed in claim 1 is characterized in that the application of this external medicine composition on the carcinous osteodynia for the treatment of transitivity.
CN201310148523.6A 2013-04-26 2013-04-26 A kind of external medicine composition for the treatment of transitivity Cancer pain Active CN103285100B (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104873900A (en) * 2015-06-03 2015-09-02 王淑美 New drug for treating cancer pain by external application
CN106309585A (en) * 2015-07-01 2017-01-11 上海中医药大学附属龙华医院 Traditional Chinese medicinal composition with effect of relieving ostealgia of tumor patient, and application of traditional Chinese medicinal composition in pain-easing

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
任东芳: "联合应用大黄、芒硝对下腹部切口脂肪液化疗效观察", 《淮海医药》 *
宋勤等: "大黄、芒硝外敷预防二次剖宫产术后切口愈合不良的疗效观察", 《现代实用医学》 *

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104873900A (en) * 2015-06-03 2015-09-02 王淑美 New drug for treating cancer pain by external application
CN106309585A (en) * 2015-07-01 2017-01-11 上海中医药大学附属龙华医院 Traditional Chinese medicinal composition with effect of relieving ostealgia of tumor patient, and application of traditional Chinese medicinal composition in pain-easing
CN106309585B (en) * 2015-07-01 2019-09-27 上海中医药大学附属龙华医院 A kind of Chinese medicine composition improving tumor patient ostalgia and its application in analgesia

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