CN103735974B - A kind of care drug of preventing the rear discomfort of operative incision healing - Google Patents
A kind of care drug of preventing the rear discomfort of operative incision healing Download PDFInfo
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- CN103735974B CN103735974B CN201310746233.1A CN201310746233A CN103735974B CN 103735974 B CN103735974 B CN 103735974B CN 201310746233 A CN201310746233 A CN 201310746233A CN 103735974 B CN103735974 B CN 103735974B
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Abstract
The invention discloses a kind of care drug of preventing the rear discomfort of operative incision healing, to solve the treatment problem that postoperative surgical otch does not feel like oneself.It is characterized in that being prepared from by the crude drug of following weight proportion: Radix Tylophorae arenicolae, Semen Aesculi, nine layers of wind, Flos jasmini, Semen Litchi, Flos Helianthi, Radix Platycodonis, Fructus Mori, Alpinia japonica (Thunb.) Miq., emplastra sinapis powder, Magnetitum, Radix Puerariae.Clinical trial certificate: the present invention treats postoperative surgical otch and does not feel like oneself and have good effect and the higher feature of safety, clinic application, promotes.
Description
Technical field
The present invention relates to the field of Chinese medicines, be specifically related to a kind of care drug of preventing the rear discomfort of operative incision healing.
Background technology
Post-surgical incisions state is the problem of doctors and patients' general concern, and the nursing at present for otch mainly concentrates on prevention infection, reduces pain, or even how to reduce in cicatrix reaction.But a multicenter clinical investigation shows, when primary healing, local is without red, swollen, hot, bitterly and ooze out, have when the patient of 32.63% one month after surgery and still have obvious otch sense of discomfort, showing as numbness, pain, paraesthesia and local skin to harden, within three months after surgery, be the Proportion of patients with otch sense of discomfort is still 24.67%.Its reason complexity is various, and need successively to cut in doctor's art on the one hand, cortex, connective tissue layer, muscle layer, tegumentary nerve has damage in various degree; On the other hand in local soft tissue repair process, due to patient body quality factor, cause interstitial fibers connective tissue (extracellular matrix) hyperplasia degree higher than normal parenchyma cytothesis process, due to this kind of fibrous connective tissue only remedy be local form instead of local parenchyma 26S Proteasome Structure and Function, cause local discomfort and skin hardening.
Still lack the therapeutic scheme for sense of discomfort after this kind of postoperative wound healing at present, clinician is many causes local stagnation of QI-blood to explain according to local operation, and recommend patient's external safflower oil blood circulation promoting and blood stasis dispelling, but exist, so this kind of therapeutic scheme is substantially invalid because this pathogenesis system there is no stagnation of QI-blood.
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 care drug uncomfortable after the little prevention operative incision healing of side effect.
The technical scheme that the present invention solves its technical problem is: a kind of prevent operative incision to heal after uncomfortable care drug, it is characterized in that being prepared from by the crude drug of following weight proportion: Radix Tylophorae arenicolae 10 ~ 30 parts, Semen Aesculi 6 ~ 12 parts, nine layers of wind 3 ~ 10 parts, Flos jasmini 6 ~ 12 parts, Semen Litchi 3 ~ 10 parts, Flos Helianthi 6 ~ 12 parts, Radix Platycodonis 6 ~ 12 parts, Fructus Mori 6 ~ 12 parts, Alpinia japonica (Thunb.) Miq. 6 ~ 12 parts, 1 ~ 5 part, emplastra sinapis powder, Magnetitum 3 ~ 10 parts, Radix Puerariae 10 ~ 25 parts.
Chinese medicine of the present invention is prepared from by the raw material of following optimum weight part proportioning: Radix Tylophorae arenicolae 20 parts, Semen Aesculi 10 parts, nine layers of wind 6 parts, Flos jasmini 10 parts, Semen Litchi 6 parts, Flos Helianthi 10 parts, Radix Platycodonis 10 parts, Fructus Mori 10 parts, Alpinia japonica (Thunb.) Miq. 10 parts, 2 parts, emplastra sinapis powder, Magnetitum 6 parts, Radix Puerariae 20 parts.
Wherein said: Radix Tylophorae arenicolae, for the spirit of asclepiadaceae plant bamboo disappears Cynanchuminamoenum(Maxim.) root of Loes. or aerial parts.Nature and flavor are bitter; Micro-pungent; Property is put down.Return lung meridian.Merit can the kidney invigorating, spleen invigorating, removing toxic substances.
Semen Aesculi is Hippocastanaceae plant Aesculus chinensis Bunge AesculuschinensisBge., Radix Aesculi AesculuschinensisBge.var.chekiangensis(HuetFang) dry mature seed of Fang or Aesculus AesculuswilsoniiRehd..Nature and flavor are sweet, temperature.Return liver, stomach warp.Merit can regulating the flow of QI to ease the stomach, and stomach and alleviating pain.
Nine layers of wind are the dry rattan of leguminous plant spatholobus suberectus SpatholobussuberectusDunn.Nature and flavor are bitter, sweet, temperature.Return liver, kidney channel.Merit can be enriched blood, and invigorates blood circulation, dredging collateral.
Flos jasmini is Oleaceae plants Flos jasmini Jasminu, the dry flower of grandiflorumL..Property mildly bitter flavor, property put down.Return Liver Channel.Merit can soothing liver-QI for relieving depression, promoting the circulation of QI to relieve pain.
Semen Litchi is the dry mature seed of sapindaceous plant Fructus Litchi LitchichinensisSonn..Sweet, the micro-hardship of nature and flavor, temperature.Return liver, kidney channel.Merit can promoting QI to circulate and dispersing the agglomeration of the pathogens, cold-dispelling pain-relieving.
Flos Helianthi is the flower of feverfew Helianthi HelianthusannuusL..Taste is micro-sweet; Property is put down.Merit can be dispeled the wind; Suppressing the hyperactive liver; Dampness removing.
Radix Platycodonis is the dried roots of Campanulaceae Radix Platycodonis, and merit can expelling phlegm for arresting cough, and has lung qi dispersing, evacuation of pus effect.
Fructus Mori is the dry fruit ear of moraceae plants Mulberry MorusalbaL..Nature and flavor are sweet, sour, cold.GUIXIN, liver, kidney channel.Merit can be enriched blood YIN nourishing, promotes the production of body fluid and moisturizes.
Alpinia japonica (Thunb.) Miq., is Zingiberaceae Alpinia plants Alpinia japonica (Thunb.) Miq. AlpiniajaponicaMiq., is used as medicine with root stock.Nature and flavor are pungent, warm.Return lung, spleen, Liver Channel.Merit can dispelling wind and removing obstruction in the collateral, regulating QI to relieve pain.
Emplastra sinapis powder is crucifer Caulis et Folium Sinapis albee SinapisalbaL. or mustard Brassicajuncea(L.) dry mature seed of Czern.etCoss., remove fatty oil after dry grinds and obtain.Nature and flavor are pungent, temperature.Return lung meridian.Merit can warming the lung eliminating phlegm promoting the circulation of QI, resolving mass and removing the obstruction of the collateral pain relieving.
Magnetitum is oxide-based mineral spinelle race magnetic iron ore, main containing ferroso-ferric oxide (Fe3O4).Nature and flavor are salty, cold.Return liver, the heart, kidney channel.Merit can suppressing the hyperactive liver and subsiding YANG, hearing-improing and eyesight improving, tranquillizing the mind by relieving convulsion, helping inspiration to relieve asthma.
Radix Puerariae, Radix Puerariae is the root of leguminous plant Pachyrhizua angulatus.Sweet, pungent, flat.Enter spleen, stomach warp.Merit can be induced sweat, rash, and relaxing muscles and tendons promotes the production of body fluid, antidiarrheal.
Composition principle: postoperative wound does not feel like oneself, refers to primary healing, when local without red, swollen, hot, bitterly and when oozing out, and patient has obvious otch sense of discomfort, shows as numbness, pain, paraesthesia and local skin and hardens.This kind of its reason complexity of sense of discomfort is various, and need successively to cut in doctor's art on the one hand, cortex, connective tissue layer, muscle layer, tegumentary nerve has damage in various degree; On the other hand in local soft tissue repair process, due to patient body quality factor, cause interstitial fibers connective tissue (extracellular matrix) hyperplasia degree higher than normal parenchyma cytothesis process, due to this kind of fibrous connective tissue only remedy be local form instead of local parenchyma 26S Proteasome Structure and Function, cause local discomfort and skin hardening.Still lack the therapeutic scheme for sense of discomfort after this kind of postoperative wound healing at present, clinician is many causes local stagnation of QI-blood to explain according to local operation, and recommend patient's external safflower oil blood circulation promoting and blood stasis dispelling, but exist, so this kind of therapeutic scheme is substantially invalid because this pathogenesis system there is no stagnation of QI-blood.
Compared with prior art, the present invention has following characteristics:
1, we adopt Radix Tylophorae arenicolae and Semen Aesculi to coordinate for monarch drug: lung and skin phase the exterior and the interior, described Radix Tylophorae arenicolae enters lung meridian, can by adjusting being entangled with of lung network skin, Radix Tylophorae arenicolae decocting liquid can improve the albumen caused by inflammation cyst caused anti-mouse carboxymethyl cellulose and ooze out and leukocyte migration, promotes parenchyma hypertrophy; And Semen Aesculi Total saponin 5mg/kg is applied topically to, in rat Ovum Gallus domesticus album connective tissue stimulation model, can suppress fibrous connective tissue hypertrophy;
2, inventor's clinical empirical summary draws, postoperative surgical otch does not feel like oneself relevant with local channels apoplexy cold-damp after wound, so we adopt Flos Helianthi, Alpinia japonica (Thunb.) Miq., Flos jasmini, Semen Litchi wind-damp dispelling, and the meridian dredging; The reason choosing this three herbal medicine in numerous related drugs is, these three kinds of Drugs are gentle, and non-dispelling the damp pathogen with drugs of bitter in taste and cold in nature, does not have the anxiety of impairment of YIN.Add Radix Platycodonis, have priming to enter to defend the effect of table channels, contribute to passages through which vital energy circulates unobstructed;
3, postoperative surgical otch discomfort is also relevant with the dry impairment of YIN of local blood, and stirring of wind due to deficiency of YIN and numbness, fiber crops are itched, so we adopt Fructus Mori to enrich blood YIN nourishing, promotes the production of body fluid and moisturizes, and nine layers of wind are enriched blood promoting blood circulation to remove obstruction in the collateral, and the two coordinates reinforcement and elimination in combination.Nine layers of wind total saponins are used for mouse skin cell culture experiments, have the effect suppressing fibrous connective tissue hypertrophy;
4, Semen Sinapis eliminating phlegm eliminating stagnation, postoperative surgical otch discomfort belongs to the operative incision of primary healing, this kind of operative incision acute stage mistake, cold-phlegm residual in meridians is all more obstinate, coordinates Semen Litchi to help tonneau so add Semen Sinapis.Semen Sinapis is containing potassium myronate, potassium myronate meets the effect generation volatile oil of water through myrosase, and main component is allyl isosulfocyanate, has stimulation, be applied to skin, there is warm sensation and make it rubescent, even causing blister, pustule, so adopt emplastra sinapis powder in prescription of the present invention, i.e. gained after mustard flour removing fatty oil, this kind of de-fatty oil method is conventional in the industry, and emplastra sinapis powder can directly be buied from market, sufficient raw.But because the present invention needs in local action more than 3 hours, so coordinate Radix Puerariae, Radix Puerariae contains much starch, can alleviate the skin irritation of Semen Sinapis;
5, Magnetitum is originally the product in important city, but rat local topical, local neutrophil phagocytosis reaction can be made to increase.
6, avoid use to take offence promoting the circulation of blood medicine, reducing local fiber hypertrophy initiating stimulates.
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: Radix Tylophorae arenicolae 20 parts, Semen Aesculi 10 parts, nine layers of wind 6 parts, Flos jasmini 10 parts, Semen Litchi 6 parts, Flos Helianthi 10 parts, Radix Platycodonis 10 parts, Fructus Mori 10 parts, Alpinia japonica (Thunb.) Miq. 10 parts, 2 parts, emplastra sinapis powder, Magnetitum 6 parts, Radix Puerariae 20 parts.
The preparation method of embodiment 1 is: Radix Tylophorae arenicolae, Semen Aesculi, nine layers of wind, Flos jasmini, Semen Litchi, Flos Helianthi, Radix Platycodonis, Fructus Mori, Alpinia japonica (Thunb.) Miq., emplastra sinapis powder (decocting a drug wrapped), Magnetitum, Radix Puerariae 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 merges, be condensed into thick paste, appropriate soak is in healing on operative incision.
Embodiment 2, crude drug weight proportion: Radix Tylophorae arenicolae 10 parts, Semen Aesculi 6 parts, nine layers of wind 3 parts, Flos jasmini 6 parts, Semen Litchi 3 parts, Flos Helianthi 6 parts, Radix Platycodonis 6 parts, Fructus Mori 6 parts, Alpinia japonica (Thunb.) Miq. 6 parts, 1 part, emplastra sinapis powder, Magnetitum 3 parts, Radix Puerariae 10 parts.
Embodiment 3, crude drug weight proportion: Radix Tylophorae arenicolae 20 parts, Semen Aesculi 10 parts, nine layers of wind 6 parts, Flos jasmini 10 parts, Semen Litchi 6 parts, Flos Helianthi 10 parts, Radix Platycodonis 10 parts, Fructus Mori 10 parts, Alpinia japonica (Thunb.) Miq. 10 parts, 2 parts, emplastra sinapis powder, Magnetitum 6 parts, Radix Puerariae 20 parts.
Embodiment 4, crude drug weight proportion: Radix Tylophorae arenicolae 30 parts, Semen Aesculi 12 parts, nine layers of wind 10 parts, Flos jasmini 12 parts, Semen Litchi 10 parts, Flos Helianthi 12 parts, Radix Platycodonis 12 parts, Fructus Mori 12 parts, Alpinia japonica (Thunb.) Miq. 12 parts, 5 parts, emplastra sinapis powder, Magnetitum 10 parts, Radix Puerariae 25 parts.
The Chinese medicine of embodiment 2 ~ 4 can be prepared from by following method:
(1) Semen Aesculi, Semen Litchi coarse powder are extracted volatile oil with vapor distillation respectively, and mixing for standby use after collecting;
(2) emplastra sinapis powder, Magnetitum, Radix Puerariae are pulverized 150 mesh sieves respectively, and become fine powder for subsequent use;
(3) Radix Tylophorae arenicolae, Radix Platycodonis, Alpinia japonica (Thunb.) Miq., Fructus Mori, Flos Helianthi, Flos jasmini, nine layers of wind mixing add 10 times of water yields, decoct with water 2 times, each 1 hour, collecting decoction, leave standstill; Then in decocting liquid, add the ethanol of 95% of 3 ~ 4 times of medicinal liquids, leave standstill 15 minutes, then with 3000rpm/min centrifugal 20 minutes, get precipitation, spraying dry, draw just material;
(4) sprayed into by gained volatile oil in step 1 during step 3 gained just expects, add gained fine powder mixing in step 2, cross 60 mesh sieves, sterilizing, subpackage form.
During use, dress the operative incision place after healing with warm water.
The efficient combination of said medicine, coordinates mutually, effectively reach the object that treatment postoperative wound does not feel like oneself, and side effect is less.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: one-level otch patient 110 example of choosing date for operation in May, 2011 ~ in May, 2013.Wherein incision of abdominal wall 43 example, lower back otch 19 example, extremity otch 38 example.Be divided into matched group 37 example, thick paste group 37 example and dress group 36 example.Compare in sex, age, operative incision distribution before three groups of patient treatments, no significant difference (P>0.05), has comparability.
1.1.2 inclusive criteria is: one-level of 1. choosing date for operation otch, the primary healing of postoperative surgical otch; 2. after surgery without other post-operative complication; 3. non-diabetic and mental sickness medical history.
1.2 method.
1.2.1 Therapeutic Method: matched group takes conventional postoperative wound nursing care mode.Thick paste group and dress group on the nursing basis of matched group, the day of certainly taking out stitches, thick paste group with the appropriate soak in gained thick paste local in the embodiment of the present invention 1 in healing on operative incision, 2 times/d.Dressing group dresses in healing on operative incision with the appropriate warm water in gained medicated powder local in the embodiment of the present invention 2,2 times/d, and these two groups was all 1 course for the treatment of with 14 days.During three groups of patients 1 month all after surgery, 3 months, follow up a case by regular visits to patient main suit, sign.
1.2.2 postoperative wound does not feel like oneself criterion: 1. the otch of main suit does not feel like oneself, and comprises local pain, fiber crops, itches, referred pain, formication, paraesthesia; 2. sign: companion or do not accompany otch surrounding skin and subcutaneously to harden; 3. without deep seated infections or liquefaction of fat performance.
1.2.3 postoperative wound does not feel like oneself degree ranking criterion: without any discomfort, be 0 point; Slight discomfort, non-continuous exists, and is 1 point; Slight discomfort, sustainable existence is 2 points; Uncomfortable impact life, paroxysm is 3 points; Uncomfortable impact life, sustainable existence is 4 points.
1.2.4 statistical analysis: SPSS13.0 carries out statistical analysis.Measurement data t checks, enumeration data χ
2inspection.
2 results.
Occur during 2.1 3 groups of month after operations that the situation that postoperative wound does not feel like oneself compares: matched group 35.14%(13/37); Thick paste group 13.51%(5/37); Dress group 13.89%(5/36).Can find out, incidence rate and the bibliographical information of blank group are basically identical, and thick paste group is starkly lower than matched group (thick paste group χ with the incidence rate dressing group
2=4.70, P<0.05; Dress group χ
2=4.43, P<0.05).
Occur during 2.1 3 groups of 3 months after operations that the situation that postoperative wound does not feel like oneself compares: matched group 21.62%(8/37); Thick paste group 5.41%(2/37); Dress group 5.41%(2/37).Can find out, incidence rate and the bibliographical information of blank group are basically identical, and thick paste group is starkly lower than matched group (thick paste group χ with the incidence rate dressing group
2=4.16, P<0.05; Dress group χ
2=3.98, P<0.05).
During 2.3 month after operation, three groups exist patient's postoperative wound that postoperative wound does not feel like oneself degree integration situation that does not feel like oneself and compare: matched group 13 example, and integration mean is 2.82 ± 0.34, and in thick paste group 5 example, 3 examples are 1 point, and 2 examples are 2 points; Dressing 3 examples in group is 1 point, and 1 example is 2 points, and 1 example is 3 points.Due to positive sample very little, so cannot statistical analysis be done, but can find out that matched group integration mean is higher than thick paste group and dress group.
2.4 adverse reaction rates: thick paste group and dress group and all do not occur obvious adverse reaction.
3. conclusion.
This result of study shows, use thick paste group of the present invention and dress the group postoperative wound situation about occurring that does not feel like oneself and be starkly lower than blank group, illustrates the present invention prevention of postoperative healed operative incision do not feel like oneself in have untoward reaction comparatively gently, the higher advantage of safety.
Claims (2)
1. a care drug uncomfortable after preventing operative incision to heal, is characterized in that being prepared from by the crude drug of following weight proportion: Radix Tylophorae arenicolae 10 ~ 30 parts, Semen Aesculi 6 ~ 12 parts, nine layers of wind 3 ~ 10 parts, Flos jasmini 6 ~ 12 parts, Semen Litchi 3 ~ 10 parts, Flos Helianthi 6 ~ 12 parts, Radix Platycodonis 6 ~ 12 parts, Fructus Mori 6 ~ 12 parts, Alpinia japonica (Thunb.) Miq. 6 ~ 12 parts, 1 ~ 5 part, emplastra sinapis powder, Magnetitum 3 ~ 10 parts, Radix Puerariae 10 ~ 25 parts.
2. according to claim 1 a kind of prevent operative incision to heal after uncomfortable care drug, it is characterized in that being prepared from by the crude drug of following weight proportion: Radix Tylophorae arenicolae 20 parts, Semen Aesculi 10 parts, nine layers of wind 6 parts, Flos jasmini 10 parts, Semen Litchi 6 parts, Flos Helianthi 10 parts, Radix Platycodonis 10 parts, Fructus Mori 10 parts, Alpinia japonica (Thunb.) Miq. 10 parts, 2 parts, emplastra sinapis powder, Magnetitum 6 parts, Radix Puerariae 20 parts.
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