CN103405554B - A kind of medicine for the preoperative bowel relieving of abdominal operation - Google Patents

A kind of medicine for the preoperative bowel relieving of abdominal operation Download PDF

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CN103405554B
CN103405554B CN201310360149.6A CN201310360149A CN103405554B CN 103405554 B CN103405554 B CN 103405554B CN 201310360149 A CN201310360149 A CN 201310360149A CN 103405554 B CN103405554 B CN 103405554B
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radix
preoperative
medicine
abdominal operation
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CN103405554A (en
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苏红军
曲少贤
王娟
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Abstract

The invention discloses a kind of medicine for the preoperative bowel relieving of abdominal operation, to solve the preoperative treatment problem of abdominal operation.It is characterized in that being prepared from by the crude drug of following weight proportion: Conyza canadensis (L.) Cronq., Fructus cinnamomi immaturus, Radix Ranunculi Ternati, Caulis Trachelospermi, Herba Sarcandrae, Radix Adenophorae (Radix Glehniae), Radix Dipsaci, Pericarpium Citri Reticulatae, Flos Helianthi, Turbo cornutus Solander, Folium Salicis Babylonicae moss, magnesium sulfate.Clinical trial certificate the present invention has the good feature of intestine cleaning effect for abdominal operation is preoperative, clinic application, popularization.

Description

A kind of medicine for the preoperative bowel relieving of abdominal operation
Technical field
The present invention relates to drug world, be specifically related to a kind of medicine for the preoperative bowel relieving of abdominal operation.
Background technology
Before abdominal operation, INTESTINAL CLEANSING comprises stimulates enterokinesia, softening and remove feces, gets rid of enteral pneumatosis, prevents patient from increasing opportunities for contamination because anaesthetizing rear Sphincter ani chalasia and can not controlling defecation; Minimizing enteral pneumatosis fills and has feces and affects operation technique simultaneously.Clinical practice confirms, can also alleviate Post operation abdominal distention discomfort by Oral Rhubarb, Natrii Sulfas, Radix Glycyrrhizae mixing water decocting liquid intestinal tract cleaning.Traditional method is that art proxima luce (prox. luc) enters without slag liquid food, preoperative late oral purgative (as: mannitol), and art uses 0.2% suds cleansing enema once morning again.There is following defect in this kind of INTESTINAL CLEANSING mode: 1. mannitol is a kind of hyperosmotic dehydration agent, and intestinal stimulates strong, has a significant effect to patient's emotion, sleep state; 2. the Traditional Method last coloclysis time is art 6am in morning, and 8am enters operating room, and period does not have time enough thoroughly emptying by intestinal, easily pollutes in art; 3. beneficial effect can not be produced to post-operative recovery.
At present, also report is had to use Chinese medicine preparation to carry out preoperative bowel relieving, as oral above-mentioned Radix Et Rhizoma Rhei, Natrii Sulfas, Radix Glycyrrhizae mixing water decocting liquid, but medicine great majority used are all the purgatives medicine things such as Radix Et Rhizoma Rhei, take rear zest strong, patient's emotion, sleep state are had a significant effect, and Semen Platycladi etc. cathartic medicine is wayward rushes down the lower time.So lack now one to be applicable to preoperative bowel relieving, rush down effectively lower and can not sleep be affected again, the medicine of beneficial effect can be produced for post-operative recovery.
Summary of the invention
Technical assignment of the present invention is for above the deficiencies in the prior art, provides a kind of curative effect certainly and the little medicine for the preoperative bowel relieving of abdominal operation of side effect.
The technical scheme that the present invention solves its technical problem is: a kind of medicine for the preoperative bowel relieving of abdominal operation, it is characterized in that being prepared from by the crude drug of following weight proportion: Conyza canadensis (L.) Cronq. 10 ~ 30 parts, Fructus cinnamomi immaturus 6 ~ 12 parts, Radix Ranunculi Ternati 3 ~ 10 parts, Caulis Trachelospermi 6 ~ 12 parts, Herba Sarcandrae 3 ~ 10 parts, Radix Adenophorae (Radix Glehniae) 6 ~ 12 parts, Radix Dipsaci 6 ~ 12 parts, Pericarpium Citri Reticulatae 6 ~ 12 parts, Flos Helianthi 6 ~ 12 parts, Turbo cornutus Solander 1 ~ 5 part, Folium Salicis Babylonicae moss 3 ~ 10 parts, 10 ~ 25 parts, magnesium sulfate.
Chinese medicine of the present invention is prepared from by the raw material of following optimum weight part proportioning: Conyza canadensis (L.) Cronq. 20 parts, Fructus cinnamomi immaturus 10 parts, Radix Ranunculi Ternati 6 parts, Caulis Trachelospermi 10 parts, Herba Sarcandrae 6 parts, Radix Adenophorae (Radix Glehniae) 10 parts, Radix Dipsaci 10 parts, Pericarpium Citri Reticulatae 10 parts, Flos Helianthi 10 parts, Turbo cornutus Solander 2 parts, Folium Salicis Babylonicae moss 6 parts, 20 parts, magnesium sulfate.
Wherein said: Conyza canadensis (L.) Cronq., is Compositae Herba Erigerontis aceris platymiscium Conyza canadensis (L.) Cronq. Erigeron canadensis L., is used as medicine with herb or fresh leaf.Property mildly bitter flavor, pungent, cool.Merit can clearing away heat-damp and promoting diuresis, dissipating blood stasis for subsidence of swelling.
Fructus cinnamomi immaturus, the tender fruit of the children for canella Cortex Cinnamomi.Gas fragrance, taste is micro-sweet.Nature and flavor Wen Xingan, returns stomach warp.Merit can warming spleen and stomach for dispelling cold.
Radix Ranunculi Ternati is the dried root of ranunculaceae plant Seynuns Kugelann Ranunculus ternatus Thunb..Nature and flavor sweet, acrid, warm.Return liver, lung meridian.Merit can eliminating stagnation, detumescence.
Caulis Trachelospermi is the dry zone leaf rattan of apocynaceae plant trachelospermum jasminoide Trachelospermum jasminoides (Lindl.) Lem..Hardship, is slightly cold.GUIXIN, liver, kidney channel.Merit can dispelling wind and removing obstruction in the collateral, and removing heat from blood is subsided a swelling.
Herba Sarcandrae is the dry Herb of Chloranthaceae plant plait Corallium Japonicum Kishinouye Sarcandra glabra (Thunb.) Nakai.Bitter, pungent, flat.GUIXIN, Liver Channel.Merit can clearing away heat and cooling blood, speckle removing of invigorating blood circulation, dispelling wind and removing obstruction in the collateral.
Radix Adenophorae (Radix Glehniae) is the dry root of Campanulaceae adenophora tetraphylla Adenophora tetraphylla (Thunb.) Fisch. or Radix Adenophorae (Radix Glehniae) Adenophora stricta Miq..Nature and flavor are sweet, are slightly cold.Attach to the lung and stomach meridians.Merit can nourishing YIN and clearing away lung-heat, reduces phlegm, QI invigorating.
Radix Dipsaci is the dry root of Dipsacaceae herbaceos perennial Radix Dipsaci Himalayan Teasel Root.Bitter in the mouth is pungent; Slightly warm in nature.Return liver, kidney channel.Merit can invigorating the liver and kidney; Bone and muscle strengthening; Blood circulation regulating; Continuous injured; Only metrorrhagia.
Pericarpium Citri Reticulatae is the dry mature skin of rutaceae orange Citrus reticulata Blanco and variety thereof.Nature and flavor are bitter, pungent, temperature.Return lung, spleen channel.Merit can regulating qi-flowing for strengthening spleen, drying dampness to eliminate phlegm.
Flos Helianthi is the flower of feverfew Helianthi Helianthus annuus L..Taste is micro-sweet; Property is put down.Merit can be dispeled the wind; Suppressing the hyperactive liver; Dampness removing.
Turbo cornutus Solander, covers operculum for Mollusca Turbinidae Turbo cornulus Turbo cornutus Solander.Salty in the mouth; Property is put down.Return kidney channel.Merit can clearing away damp-heat; Remove phlegm-fire; Separate sore.Taste is micro-sweet; Property is put down.Merit can be dispeled the wind; Suppressing the hyperactive liver; Dampness removing.
Folium Salicis Babylonicae moss is Amblystegiaceae Folium Salicis Babylonicae moss Amblystegium serpens(Hedw.) plant of B.S.G..Nature and flavor are puckery; Flat.Merit can astringing to arrest bleeding.
Composition principle: abdominal operation is preoperative will carry out intestinal process, namely bowel relieving.Traditional method is that art proxima luce (prox. luc) enters without slag liquid food, preoperative late oral purgative (as: mannitol or Chinese medicine cathartic prescription), and art morning, 0.2% suds (or normal saline) cleansing enema was once again.There is following defect in this kind of INTESTINAL CLEANSING mode: 1. mannitol or Chinese medicine cathartic prescription, and intestinal stimulates strong, has a significant effect to patient's emotion, sleep state; 2. the Traditional Method last coloclysis time is art 6am in morning, and 8am enters operating room, and period does not have time enough thoroughly emptying by intestinal, easily pollutes in art; 3. beneficial effect can not be produced to post-operative recovery.We are cathartic with magnesium sulfate, coordinate the medicine of fugitive stable enterokinesia, and the reaction sensitivity that suitable reduction intestinal contents stimulates intestinal, lax intestinal smooth.Like this, the magnesium sulfate entering intestinal on the one hand not easily absorbs at intestinal, forms hyperosmotic state, completes catharsis effect; On the other hand the medicine of fugitive stable enterokinesia relaxes intestinal smooth, alleviates awareness of defecation, to ensure Sleeping.Meanwhile, other pharmaceutical components in we complete invigorate blood circulation, eliminate the phlegm, the effect of eliminating stagnation, dredging collateral, promote abdominal operation post-operative recovery.
Compared with prior art, the present invention has following characteristics.
1, Conyza canadensis (L.) Cronq. and Fructus cinnamomi immaturus coordinate for monarch drug, inventor studies discovery: the mixing water decocting liquid of Conyza canadensis (L.) Cronq. and Fructus cinnamomi immaturus is wriggled without obvious inhibitory action to isolated mouse ileum, but when gastrointestinal smooth muscle is in the excitatory state under magnesium sulfate stimulation, there is remarkable relexation.Its mechanism of action may be relevant to the smooth muscle relaxation of Conyza canadensis (L.) Cronq. total flavones water soluble part, but this kind of effect coordinates can only come into force for the intestinal wall smooth muscle under excited state with Fructus cinnamomi immaturus.Under this dosage, the pharmacological action time of Conyza canadensis (L.) Cronq. is 8 ~ 10 hours, namely takes medicine night, can alleviate the awareness of defecation under magnesium sulfate stimulation, and ensure suitable sleep, after art drug effect in morning is lost, can complete the effect of cleaning intestinal.
2, Radix Ranunculi Ternati mass dissipating and swelling eliminating, Caulis Trachelospermi dredging collateral reducing swelling and alleviating pain, alleviates the discomfort that postoperative pelvic cavity excitation causes.
3, Radix Adenophorae (Radix Glehniae) boosting qi and nourishing yin, Radix Dipsaci nourishing the liver and kidney, Pericarpium Citri Reticulatae invigorating the spleen and benefiting QI diuretic, the postoperative function of intestinal canal that is conducive to recovers, and shortens fasting time, is conducive to early recovery.
4, Herba Sarcandrae is invigorated blood circulation motionless blood, and has the strong muscle effect of dredging collateral.
5, inventor's experimentation shows: low dose of Turbo cornutus Solander can stablize intestinal mucosa effectively.
6, Flos Helianthi is using corrigent, and this medicine obviously can strengthen intestinal contraction, and lasting medicine, utilize low dose of Flos Helianthi to prevent Conyza canadensis (L.) Cronq. overaction.
7, in one row falls apart dredging collateral medicine, add low dose of Folium Salicis Babylonicae moss, play assistant and make use, reduce side effect.
8, medicine material consumption of the present invention is groped to sum up to draw through inventor in a large number, and each raw material dosage is for all to have good curative effect in following weight parts scope.
Detailed description of the invention
Below in conjunction with practical situation, the specific embodiment of the present invention is elaborated.
Embodiment 1, crude drug weight proportion: Conyza canadensis (L.) Cronq. 20 parts, Fructus cinnamomi immaturus 10 parts, Radix Ranunculi Ternati 6 parts, Caulis Trachelospermi 10 parts, Herba Sarcandrae 6 parts, Radix Adenophorae (Radix Glehniae) 10 parts, Radix Dipsaci 10 parts, Pericarpium Citri Reticulatae 10 parts, Flos Helianthi 10 parts, Turbo cornutus Solander 2 parts, Folium Salicis Babylonicae moss 6 parts, 20 parts, magnesium sulfate.
The preparation method of embodiment 1 is: Conyza canadensis (L.) Cronq., Fructus cinnamomi immaturus, Radix Ranunculi Ternati, Caulis Trachelospermi, Herba Sarcandrae, Radix Adenophorae (Radix Glehniae), Radix Dipsaci, Pericarpium Citri Reticulatae, Flos Helianthi, Turbo cornutus Solander, Folium Salicis Babylonicae moss, magnesium sulfate mixing and water adding are decocted, filtrate is got after 30 minutes, medicinal residues add water continue decoction get filtrate after 20 minutes, twice filtrate is merged into decoction.
Embodiment 2, crude drug weight proportion: Conyza canadensis (L.) Cronq. 10 parts, Fructus cinnamomi immaturus 6 parts, Radix Ranunculi Ternati 3 parts, Caulis Trachelospermi 6 parts, Herba Sarcandrae 3 parts, Radix Adenophorae (Radix Glehniae) 6 parts, Radix Dipsaci 6 parts, Pericarpium Citri Reticulatae 6 parts, Flos Helianthi 6 parts, Turbo cornutus Solander 1 part, Folium Salicis Babylonicae moss 3 parts, 10 parts, magnesium sulfate.
Embodiment 3, crude drug weight proportion: Conyza canadensis (L.) Cronq. 20 parts, Fructus cinnamomi immaturus 10 parts, Radix Ranunculi Ternati 6 parts, Caulis Trachelospermi 10 parts, Herba Sarcandrae 6 parts, Radix Adenophorae (Radix Glehniae) 10 parts, Radix Dipsaci 10 parts, Pericarpium Citri Reticulatae 10 parts, Flos Helianthi 10 parts, Turbo cornutus Solander 2 parts, Folium Salicis Babylonicae moss 6 parts, 20 parts, magnesium sulfate.
Embodiment 4, crude drug weight proportion: Conyza canadensis (L.) Cronq. 30 parts, Fructus cinnamomi immaturus 12 parts, Radix Ranunculi Ternati 10 parts, Caulis Trachelospermi 12 parts, Herba Sarcandrae 10 parts, Radix Adenophorae (Radix Glehniae) 12 parts, Radix Dipsaci 12 parts, Pericarpium Citri Reticulatae 12 parts, Flos Helianthi 12 parts, Turbo cornutus Solander 5 parts, Folium Salicis Babylonicae moss 10 parts, 25 parts, magnesium sulfate.
The Chinese medicine of embodiment 2 ~ 4 can be prepared from by following method:
(1) Radix Dipsaci, Fructus cinnamomi immaturus, Herba Sarcandrae coarse powder are extracted volatile oil with vapor distillation respectively, and mixing for standby use after collecting;
(2) Turbo cornutus Solander, Folium Salicis Babylonicae moss are pulverized 150 mesh sieves, and become fine powder for subsequent use;
(3) Conyza canadensis (L.) Cronq., Radix Ranunculi Ternati, Caulis Trachelospermi, Radix Adenophorae (Radix Glehniae), Flos Helianthi, Pericarpium Citri Reticulatae are decocted with water 2 times, filter, merging filtrate, it is 1.20(50 DEG C that filtrate is concentrated into relative density), adding ethanol makes alcohol content be 60%, leaves standstill and makes precipitation, get supernatant, reclaim ethanol and be concentrated into relative density 1.25, obtaining thick paste;
(4) volatile oil of step 1 gained, the fine powder of step 2 gained, magnesium sulfate are added the thick paste of step 3 gained, stir, make granule, dry, to obtain final product.
In prioritization scheme, described simmer down to concentrating under reduced pressure.
Described magnesium sulfate can be magnesium sulfate powder, also can be Adlerika.
The efficient combination of said medicine, coordinates mutually, effectively reaches the object of the preoperative cleaning intestinal of abdominal operation, and does not affect Sleeping, be beneficial to post-operative recovery.The above results is clinical data sufficient proof, and interrelated data is as follows.
1 object and method.
1.1 object.
1.1.1 case selection: abdominal part Patients Undergoing Elective Surgery 90 example that in March, 2012 ~ 2013 are accepted for medical treatment year March.Wherein man 52 example, female 38 example; 26 ~ 70 years old age; Gastrointestinal surgery 49 example, hepatobiliary surgery 41 example;
1.1.2 divide into groups: be divided into matched group 30 example, decoction group 30 example, groups of grains 30 example at random.Compare in age, sex, type of surgery before three groups of patient treatments, no significant difference (P>0.05), has comparability.
1.2 method.
1.2.1 administering mode: all case art proxima luce (prox. luc)s enter without slag liquid food, and matched group takes conventional method of clyster: preoperative late oral mannitol, art morning, normal saline cleansing enema was once again.Decoction group preoperative late 8 time adopt embodiment 1 gained decoction oral, art normal saline in morning cleansing enema is once.Groups of grains preoperative late 8 time adopt embodiment 3 gained particulate oral, art normal saline in morning cleansing enema is once.
1.2.2 observation index: after bowel relieving operation, observe patient's defecation frequency, intestinal tract cleaning and pneumatosis situation in record art, and micturition time, defecation time and untoward reaction after operation in patients are passed judgment on.
1.2.3 intestine cleaning effect evaluation criterion: be effectively intestinal in operation in patients and keep complete relaxed state, and visual area exposes completely; Invalidly be intestinal high level expansion in operation in patients, and visual area is capped.
2 results.
Intestinal tract cleaning situation and transfusion definition situation in 2.1 arts: the effective percentage of matched group, decoction group, groups of grains bowel relieving is 100%.
Between 2.2 3 groups of operation in patients eve, defecation, art defecation in morning situation, insomnia situation postoperative bowel situation saw the following form:
Group Number of cases Defecation at night (secondary) Art defecation in morning (secondary) Insomnia (example) Postoperative bowel (h) Postoperative defecation (h)
Matched group 30 2.51±0.63 2.62±0.13 20 34.21±10.51 47.86±9.78
Decoction group 30 0.94±0.56 5.46±0.73 9 25.22±7.73 33.56±7.76
Groups of grains 30 0.89±0.46 4.26±0.77 6 24.38±9.12 39.56±8.38
Result shows: apply decoction of the present invention or bead dosage form preoperative night orally can reduce defecation frequency at night, increases art defecation in morning, reduces the generation of having a sleepless night, reach postoperative bowel as early as possible, and compare with matched group (P<0.05).
Before 2.3 3 groups of operation in patients, bowel relieving nursing satisfaction compares: matched group patient is 90% to preoperative bowel relieving nursing satisfaction, and the satisfaction of decoction group, groups of grains bowel relieving is 100%.
3. conclusion.
This result of study shows, and the preoperative oral decoction of the present invention or granule intestine cleaning effect obviously, can effectively reduce defecation frequency at night, increase art defecation in morning, reduce the generation of insomnia, reach postoperative bowel as early as possible, increases patient to the satisfaction of nursery work.

Claims (2)

1. for a medicine for the preoperative bowel relieving of abdominal operation, it is characterized in that being prepared from by the crude drug of following weight proportion: Conyza canadensis (L.) Cronq. 10 ~ 30 parts, Fructus cinnamomi immaturus 6 ~ 12 parts, Radix Ranunculi Ternati 3 ~ 10 parts, Caulis Trachelospermi 6 ~ 12 parts, Herba Sarcandrae 3 ~ 10 parts, Radix Adenophorae 6 ~ 12 parts, Radix Dipsaci 6 ~ 12 parts, Pericarpium Citri Reticulatae 6 ~ 12 parts, Flos Helianthi 6 ~ 12 parts, Turbo cornutus Solander 1 ~ 5 part, Folium Salicis Babylonicae moss 3 ~ 10 parts, 10 ~ 25 parts, magnesium sulfate.
2. a kind of medicine for the preoperative bowel relieving of abdominal operation according to claim 1, is characterized in that being prepared from by the crude drug of following weight proportion: Conyza canadensis (L.) Cronq. 20 parts, Fructus cinnamomi immaturus 10 parts, Radix Ranunculi Ternati 6 parts, Caulis Trachelospermi 10 parts, Herba Sarcandrae 6 parts, Radix Adenophorae 10 parts, Radix Dipsaci 10 parts, Pericarpium Citri Reticulatae 10 parts, Flos Helianthi 10 parts, Turbo cornutus Solander 2 parts, Folium Salicis Babylonicae moss 6 parts, 20 parts, magnesium sulfate.
CN201310360149.6A 2013-08-19 2013-08-19 A kind of medicine for the preoperative bowel relieving of abdominal operation Expired - Fee Related CN103405554B (en)

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