CN103800800B - 一种用于急性呼吸窘迫综合征护理的药物及制备方法 - Google Patents
一种用于急性呼吸窘迫综合征护理的药物及制备方法 Download PDFInfo
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Abstract
本发明公开了一种用于急性呼吸窘迫综合征护理的药物及制备方法，属中药领域；本发明药物有效成分的原料组成为：黄槿、白豆蔻、草石蚕、柴胡、朝天罐、刺参、浮萍、广藿香、桑椹、豆蔻、青竹标、甘蔗、天文草、昙花、文旦皮和沙七；本发明药物选用优质中药材科学配伍，具有补血滋阴、生津润燥、解毒利湿、止咳定喘之功效，对急性呼吸窘迫综合征引起的肺损伤具有明显的保护作用，且疗程短、见效快，无任何毒副作用，安全可靠，成本低廉，对急性呼吸窘迫综合征的治疗能够到达标本兼治的目的，值得临床广泛推广应用。
Description
所属技术领域
本发明涉及中药领域，尤其涉及一种用于急性呼吸窘迫综合征护理的药物及制备方法。
背景技术
急性呼吸窘迫综合征是指肺内、外严重疾病导致以肺毛细血管弥漫性损伤、通透性增强为基础，以肺水肿、透明膜形成和肺不张为主要病理变化，以进行性呼吸窘迫和难治性低氧血症为临床特征的急性呼吸衰竭综合征。ARDS是急性肺损伤发展到后期的典型表现，该病起病急骤，发展迅猛，预后极差，死亡率高达50％以上；ARDS曾有许多名称，如休克肺、弥漫性肺泡损伤、创伤性湿肺、成人呼吸窘迫综合征；其临床特征为呼吸频速和窘迫，进行性低氧血症，X线呈现弥漫性肺泡浸润。在许多情况下，创伤者可发生呼吸损害，多发性肋骨骨折、肺挫伤、肺破裂、血胸和气胸等造成胸廓及胸腔内的直接损伤是常见的原因。头部创伤后意识昏迷者，由于血液和胃内容物的误吸或神经源性反射性肺水肿，引起呼吸损害也不少见。
除与有关相应的的发病征象外，当肺刚受损的数小时内，患者可无呼吸系统症状；随后呼吸频率加快，气促逐渐加重，肺部体征无异常发现，或可听到吸气时细小湿啰音；X线胸片显示清晰肺野，或仅有肺纹理增多模糊，提示血管周围液体聚集；动脉血气分析示PaO2和PaCO2偏低。随着病情进展，患者呼吸窘迫，感胸部紧束，吸气费力、发绀，常伴有烦躁、焦虑不安，两肺广泛间质浸润，可伴奇静脉扩张，胸膜反应或有少量积液。由于明显低氧血症引起过度通气，PaCO2降低，出现呼吸性碱中毒；呼吸窘迫不能用通常的氧疗使之改善；如上述病情继续恶化，呼吸窘迫和发绀继续加重，胸片示肺部浸润，阴曩大片融合，乃至发展成“白肺”。呼吸肌疲劳导致通气不足，二氧化碳潴留，产生混和性酸中毒。心脏停搏。部分患者出现多器官衰竭。
近年来，对非胸廓的创伤者发生的急性呼吸衰竭，越来越被注意，如大量输血及输液过多，骨折后的脂肪栓塞，以及创伤后感染，都是造成呼吸窘迫综合征的熟知原因。
目前，对该种疾病临床上主要采用脱水以减轻肺水，常用西药固尔苏缓解症状，依情况使用肾上腺皮质激素，缓解某些致病因素对肺的损伤。西药的作用都是暂时性的缓解，对于基本病情没有得到根本性的解决，且价格昂贵，高额的费用对患者造成了沉重的经济负担。因此，无论是从治疗效果、经济性、用药方便程度方面来说，都迫切需要一种疗程短、见效快，价钱低，用药方便的治疗呼吸窘迫综合症的药物。
发明内容
本发明提供了一种用于急性呼吸窘迫综合症护理的药物及制备方法；本发明药物选用优质中药材科学配伍，具有补血滋阴、生津润燥、解毒利湿、止咳定喘之功效，对急性呼吸窘迫综合征引起的肺损伤具有明显的保护作用，且疗程短、见效快，无任何毒副作用，安全可靠，成本低廉，对急性呼吸窘迫综合征的治疗能够到达标本兼治的目的，值得临床广泛推广应用。
为实现上述目的，本发明的技术方案实施如下：
一种用于急性呼吸窘迫综合征护理的药物，制成所述药物有效成分的原料组成及重量份数为：
黄槿57～83份白豆蔻54～80份草石蚕46～72份柴胡41～68份
朝天罐41～67份刺参37～66份浮萍37～66份广藿香33～60份
桑椹32～59份草豆蔻27～56份青竹标25～55份甘蔗21～49份
天文草20～46份昙花17～43份文旦皮14～35份沙七12～31份。
制成所述药物有效成分的原料组成及重量份数为：
黄槿61～79份白豆蔻58～76份草石蚕50～68份柴胡46～64份
朝天罐45～63份刺参43～61份浮萍41～61份广藿香40～55份
桑椹36～55份草豆蔻31～51份青竹标30～50份甘蔗26～44份
天文草24～42份昙花21～39份文旦皮18～31份沙七16～28份。
制成所述药物有效成分的原料组成及重量份数为：
黄槿66～74份白豆蔻63～71份草石蚕55～63份柴胡51～59份
朝天罐50～58份刺参48～56份浮萍46～54份广藿香42～50份
桑椹41～49份草豆蔻36～46份青竹标35～45份甘蔗31～39份
天文草29～37份昙花26～34份文旦皮22～26份沙七20～24份。
制成所述药物有效成分的原料组成及重量份数为：
黄槿70份白豆蔻67份草石蚕59份柴胡55份
朝天罐54份刺参52份浮萍50份广藿香46份
桑椹45份草豆蔻41份青竹标40份甘蔗35份
天文草33份昙花30份文旦皮24份沙七22份。
一种用于急性呼吸窘迫综合征护理的药物的制备方法，包括以下工艺步骤：
(1)将黄槿、浮萍和甘蔗洗净，切碎，放入容器内，绞汁，滤杂质，留汁液备用；
(2)将白豆蔻、草石蚕、朝天罐、刺参、广藿香、草豆蔻、青竹标、昙花、文旦皮和沙七洗净，放入容器内，加入8～10倍量的蒸馏水，浸泡5～6小时后，煮沸3～4小时，提取；再次加入6～8倍量蒸馏水，煮沸2～3小时，提取；最后，加入4～6倍量蒸馏水，加热煮沸1～2小时，提取；合并三次提取液，过滤，得滤液，浓缩为60℃下相对密度为1.13～1.17的稠膏，备用；
(3)将柴胡去杂质，洗净，切片，晒干，置于容器内，用醋拌匀，置锅内用文火炒至醋吸尽并微干，取出，晒干，置于研钵内，研末，过180目细粉备用；
(4)将桑椹洗净，浸入6倍量的70％的乙醇溶液浸泡3～4小时，加热回流提取2～3小时，回收乙醇，滤过，将滤液浓缩为65℃环境下相对密度1.11～1.13的稠膏，备用；
(5)将天文草放入容器内，进行粉碎处理，研末，过200目细粉，备用；
(6)将上述步骤(1)～(5)所制得的汁液、稠膏以及细粉混合，制成片剂，即得本发明所述的用于急性呼吸窘迫综合征护理的药物。
本发明所用中药的药性如下：
黄槿：味甘、淡，性微寒；归肺经。清肺止咳，解毒消肿。主治肺热咳嗽，疮疖肿痛，木薯中毒。《新华本草纲要》载：“功效有退热、止吐、止咳功能。用于发烧咳嗽支气管炎；外敷肿毒。”
白豆蔻：味辛、性温；归肺、脾、胃经。化湿行气，温中止呕，暖胃消食。主治气滞，食滞，胸闷，腹胀，噫气，噎膈，吐逆，反胃，疟疾。《医学启源》载：“《主治秘要》云，肺金本药，散胸中滞气，感寒腹痛，温暖脾胃，赤眼暴发，白睛红者。”
草石蚕：味甘，性平；归肺、肝、脾经。解表清肺，利湿解毒，补虚健脾。主治风热感冒，虚劳咳嗽，黄疸，淋症，疮毒肿痛，毒蛇咬伤。广州空军《常用中草药手册》载：“全草：祛风散湿，凉血利尿。治破伤风，风湿性关节炎，慢性腰腿痛，腰肌劳损，血尿。”
柴胡：味苦、辛，性微寒；归肝、胆经。疏肝利胆，疏气解郁，散火，透表泄热，疏肝解郁，升举阳气。主治感冒发热，寒热虚劳发热，小儿痘疹余热，面黄肌瘦腹部膨大，疟疾，肝郁气滞，胸肋胀痛，脱肛，子宫脱落，月经不调。现代医学研究证实，柴胡煎剂发热有明显的解热作用，对多种致炎剂所致的炎症均有抑制作用，并能促进免疫功能。
朝天罐：味甘、涩，性平。清热利湿，止咳调经。用于急性胃肠炎，细菌性痢疾，消化不良，慢性支气管炎，吐血，月经不调，补虚益肾，收敛止血。治痨伤咳嗽吐血，下肢酸软，筋骨拘挛，小便失禁，白浊白带。
刺参：味甘、微苦，性温。补气血，接筋骨。用于神经功能症，贫血，肺虚咳嗽，消化不良，白带过多，子宫脱垂；外用治跌打损伤。《云南中草药选》载：“益胃，镇静，补肾，壮阳。治神经衰弱，消化不良，子宫脱垂，白带过多，阳痿。”
浮萍：味辛，性寒；归肺、膀胱经。发汗解表，透疹止痒，利水消肿，清热解毒。主治风热表症，麻疹不透，隐疹瘙痒，水肿，癃闭，疮癣，丹毒，烫伤。《纲目》载：“主风湿麻痹，脚气，打扑损伤，目赤翳膜，口舌生疮，吐血，衄血，瘫风，丹毒。”
广藿香：味辛，微温；归脾、胃、肺经。芳香化浊，开胃止呕，发表解暑。用于湿浊中阻，脘痞呕吐，暑湿倦怠，胸闷不舒，寒湿闭暑，腹痛吐泻，鼻渊头痛。研究证实，广藿香酮体对白色含珠菌、新型隐球菌、黑根霉等真菌有明显的抑制作用，对甲型溶血性链球菌等细菌也有一定的抑制作用。
桑椹：味甘、酸，性寒；归心、肝、肾经。补血滋阴，生津润燥。用于眩晕耳鸣，心悸失眠，须发早白，津伤口渴，内热消渴，血虚便秘。《随息居饮食谱》载：“滋肝肾，充血液，祛风湿，健步履，息虚风，清虚火。”
草豆蔻：味辛，性热；归肺、脾、胃经。散寒燥湿，解酒毒，化湿消痞，行气温中，开胃消食。用于湿浊中阻，不思饮食，湿温初起，胸闷不饥，寒湿呕逆，胸腹胀痛，食积不消。《本草原始》载：“补脾胃，磨积滞，调散冷气甚速，虚弱不能饮食者最宜，兼解酒毒。”
青竹标：味苦，性寒。清肺止咳，续筋接骨。用于上呼吸道感染，支气管炎，百日咳，心绞痛，跌打损伤，骨折，筋骨疼痛。《云南中草药选》载：“续筋接骨，活血，润肺止咳。治骨折，跌打损伤，风湿麻木，支气管炎，百日咳。”
甘蔗：味甘、涩、性平，无毒。治下气和中，助脾气，利大肠，消痰止渴，除心胸烦热，解酒毒；还可治呕吐反胃，宽胸膈。现代医学研究表明，甘蔗中含有丰富的糖分、水分，此外，还含有对人体新陈代谢非常有益的各种维生素、脂肪、蛋白质、有机酸、钙、铁等物质。
天文草：味辛，性温。解毒利湿，止咳定喘，消肿止痛。用于疟疾，牙痛，肠炎，痢疾，咳嗽，哮喘，百日咳，肺结核。外用治毒蛇咬伤，狗咬伤，痈疖肿毒。广州部队《常用中草药手册》载：“止咳定喘，消肿止痛。治感冒咳嗽，慢性支气管炎，哮喘，百日咳，肺结核，蛇咬伤，疮疡肿毒，牙痛。”
昙花：味甘，性平；归肺、心经。清肺止咳，凉血止血，养心安神。主治肺热，咳嗽，肺痨，咯血，崩漏，心悸，失眠。《陆川本草》载：“清肺，止咳，化痰。治心胃气痛，吐血，最适于肺结核。”
文旦皮：味辛、苦、甘，性温，无毒；入脾、肾、膀胱三经。化痰消食，下气快膈。治气郁胸闷，脘腹冷痛，食滞，咳喘，疝气。《四川中药志》载，“解酒毒，治肾脏水肿，宿食停滞，湿痰咳逆及疝气。”
沙七：味苦，性凉。清热消炎，止血生肌。主治肺热咳嗽，咽喉疼痛，大便下血，外伤出血，骨折，跌打扭伤，风湿痹痛等。
本发明与现有技术相比，具有以下有益效果：
1、本发明药物选用优质中药材科学配伍制成，具有补血滋阴、生津润燥、解毒利湿、止咳定喘之功效，对急性呼吸窘迫综合征引起的肺损伤具有明显的保护作用。
2、本发明药物疗程短、见效快，无任何毒副作用，安全可靠，成本低廉，对急性呼吸窘迫综合征的治疗能够到达标本兼治的目的，值得临床广泛推广应用。
具体实施方式
下面结合具体实施例对本发明做进一步阐述。
实施例1
本发明药物有效成分的原料组成及重量为：
黄槿79g白豆蔻76g草石蚕68g柴胡64g
朝天罐63g刺参61g浮萍61g广藿香55g
桑椹55g草豆蔻51g青竹标50g甘蔗44g
天文草42g昙花39g文旦皮31g沙七28g。
一种用于急性呼吸窘迫综合征护理的药物的制备方法，包括以下工艺步骤：
(1)将黄槿、浮萍和甘蔗洗净，切碎，放入容器内，绞汁，滤杂质，留汁液备用；
(2)将白豆蔻、草石蚕、朝天罐、刺参、广藿香、草豆蔻、青竹标、昙花、文旦皮和沙七洗净，放入容器内，加入8～10倍量的蒸馏水，浸泡5～6小时后，煮沸3～4小时，提取；再次加入6～8倍量蒸馏水，煮沸2～3小时，提取；最后，加入4～6倍量蒸馏水，加热煮沸1～2小时，提取；合并三次提取液，过滤，得滤液，浓缩为60℃下相对密度为1.13～1.17的稠膏，备用；
(3)将柴胡去杂质，洗净，切片，晒干，置于容器内，用醋拌匀，置锅内用文火炒至醋吸尽并微干，取出，晒干，置于研钵内，研末，过180目细粉备用；
(4)将桑椹洗净，浸入6倍量的70％的乙醇溶液浸泡3～4小时，加热回流提取2～3小时，回收乙醇，滤过，将滤液浓缩为65℃环境下相对密度1.11～1.13的稠膏，备用；
(5)将天文草放入容器内，进行粉碎处理，研末，过200目细粉，备用；
(6)将上述步骤(1)～(5)所制得的汁液、稠膏以及细粉混合，制成片剂，即得本发明所述的用于急性呼吸窘迫综合征护理的药物。
用法用量：口服即可，每日2次，早晚各1次，每次2片(每片0.5g)，饭后温开水送服；12天为1个疗程，3～4个疗程即可痊愈，病情严重者遵医嘱酌增用量。
实施例2
本发明药物有效成分的原料组成及重量为：
黄槿74g白豆蔻71g草石蚕63g柴胡59g
朝天罐58g刺参56g浮萍54g广藿香50g
桑椹49g草豆蔻46g青竹标45g甘蔗39g
天文草37g昙花34g文旦皮26g沙七24g。
本实施例的药物制备方法工艺步骤及用法用量与实施例1相同。
实施例3
本发明药物有效成分的原料组成及重量为：
黄槿70g白豆蔻67g草石蚕59g柴胡55g
朝天罐54g刺参52g浮萍50g广藿香46g
桑椹45g草豆蔻41g青竹标40g甘蔗35g
天文草33g昙花30g文旦皮24g沙七22g。
本实施例的药物制备方法工艺步骤及用法用量与实施例1相同。
实施例4
本发明药物有效成分的原料组成及重量为：
黄槿66g白豆蔻63g草石蚕55g柴胡51g
朝天罐50g刺参48g浮萍46g广藿香42g
桑椹41g草豆蔻36g青竹标35g甘蔗31g
天文草29g昙花26g文旦皮22g沙七20g。
本实施例的药物制备方法工艺步骤及用法用量与实施例1相同。
实施例5
本发明药物有效成分的原料组成及重量为：
黄槿61g白豆蔻58g草石蚕50g柴胡46g
朝天罐45g刺参43g浮萍41g广藿香40g
桑椹36g草豆蔻31g青竹标30g甘蔗26g
天文草24g昙花21g文旦皮18g沙七16g。
本实施例的药物制备方法工艺步骤及用法用量与实施例1相同。
临床资料：
1、病例选择：
作为一种用于急性呼吸窘迫综合征护理的药物，选择确诊的急性呼吸窘迫综合征患者120例临床观察，病人随机分成治疗组和对照组两组，治疗组60例，其中男性30例，女性30例，年龄1～75岁，平均年龄38岁，病程1～30年；对照组60例，其中男性31例，女性28例，年龄1～74岁，平均年龄37.5岁，病程1～29年；
治疗组和对照组两组病例的病程、症状轻重程度基本一致，无显著差异，具有可比性。
2、药物选择：
治疗组服用本发明药物，口服，每日2次，早晚各1次，每次2片(每片0.5g)，饭后温开水送服；12天为1个疗程，连续服用3～4个疗程，病情严重者遵医嘱酌增用量。
对照组使用尼可刹米注射液，皮下注射、肌内注射、静脉注射成人常用量1次，必要时1～1.25g；小儿常用量6个月以下一次75mg，1岁一次0.125g，4～7岁一次0.175g。
3、疗效判定：
(1)治愈：经临床治疗症状全部消失，呼吸功能恢复正常。
(2)显效：经临床治疗症状明显减轻，呼吸功能明显好转。
(3)有效：经临床治疗症状有所减轻，呼吸功能有所好转。
(4)无效：通过治疗后临床症状无减轻或加重。
4、结果：
以上结果显示，治疗组的治愈率和总有效率明显高于对照组。
典型病例举例：
1、范某，女，3岁，河北石家庄人。患者喘气急促，张口抬肩，呼多吸少，神疲气短，并伴有汗出肢冷，面青唇紫，舌质淡，脉沉细无力，入院诊断为成人呼吸窘迫综合症。服药本发明药物1个疗程后，患者自觉呼吸顺畅，继续服用3个疗程后，症状消失，呼吸恢复如初，至今未复发。
2、谭某，男，23岁，山西阳泉人。患者呼吸短浅难续，甚则张口抬肩，不能平卧，胸满气短，心悸，咳嗽，痰白如沫，咯吐不利，形寒汗出，舌淡或黯紫，苔白润，脉沉细无力或结代。后转化为急性呼吸窘迫综合征。患者多年来一直运用西医西药，输液，打针，但其中的效果不大，后来我医院治疗，服用本发明药物2个疗程后，以上症状有所减轻，随后再服用1个疗程的制剂，症状基本消失，行动自如，至今尚未复发。
3、廖某，男，32岁，辽宁大连人。患者由于休克创伤大量失血造成低血容量，致心输出量降低，同时也造成了肺血流量减少，并引起肺间质充血、水肿，使呼吸阻力加大，持久性休克的基础上，导致了呼吸窘迫综合征。患者病情十分危急，医生急忙对其使用本发明中药制剂，服药后，患者休克症状缓解，继续服药3个疗程后，病情痊愈。
4、雷某，女，48岁，吉林白城人。患者在一次出车过程中发生严重车祸，造成多发性肋骨骨折，从而导致肺部挫伤，引起呼吸损害，出现急性呼吸窘迫综合征。患者生命垂危。医生对患者给予本发明药物治疗，服药后，患者呼吸系统逐渐恢复正常，继续服药2个疗程，患者肺部损伤得到修复，停药后，症状无复发。
5、熊某，男，55岁，江苏扬州人。患者喘足气涌，咳嗽痰多，黏稠色黄，或痰中带血，并伴有胸中烦热，咽干口渴，尿赤便秘，舌红，苔黄腻，脉滑数，入院诊断为呼吸窘迫综合症。一直采用西医输液、打针治疗，但是都是暂时性的得到缓解，后来我院使用本发明药物1疗程后，上述症状明显减轻，并且感觉神清气爽、呼吸顺畅，继续服用2个疗程，病情痊愈。
6、龚某，女，69岁，安徽合肥人。患者喘气急，张口抬肩，不能平卧，高热烦渴，面唇发绀，舌质绛，苔薄白或薄黄，脉洪数。入院诊断为呼吸衰竭并窘迫综合征。服药多种中西药物及使用其他治疗方法治疗，均无明显效果，生命垂危。后医院给予其本发明药物进行治疗，服用本发明药物2疗程后，上述症状明显减轻，继续服用1疗程，症状消失。
Claims (5)
1.一种用于急性呼吸窘迫综合征护理的药物，其特征在于：制成所述药物有效成分的原料组成及重量份数为：
黄槿57～83份白豆蔻54～80份草石蚕46～72份柴胡41～68份
朝天罐41～67份刺参37～66份浮萍37～66份广藿香33～60份
桑椹32～59份草豆蔻27～56份青竹标25～55份甘蔗21～49份
天文草20～46份昙花17～43份文旦皮14～35份沙七12～31份。
2.根据权利要求1所述的一种用于急性呼吸窘迫综合征护理的药物，其特征在于：制成所述药物有效成分的原料组成及重量份数为：
黄槿61～79份白豆蔻58～76份草石蚕50～68份柴胡46～64份
朝天罐45～63份刺参43～61份浮萍41～61份广藿香40～55份
桑椹36～55份草豆蔻31～51份青竹标30～50份甘蔗26～44份
天文草24～42份昙花21～39份文旦皮18～31份沙七16～28份。
3.根据权利要求1所述的一种用于急性呼吸窘迫综合征护理的药物，其特征在于：制成所述药物有效成分的原料组成及重量份数为：
黄槿66～74份白豆蔻63～71份草石蚕55～63份柴胡51～59份
朝天罐50～58份刺参48～56份浮萍46～54份广藿香42～50份
桑椹41～49份草豆蔻36～46份青竹标35～45份甘蔗31～39份
天文草29～37份昙花26～34份文旦皮22～26份沙七20～24份。
4.根据权利要求1所述的一种用于急性呼吸窘迫综合征护理的药物，其特征在于：制成所述药物有效成分的原料组成及重量份数为：
黄槿70份白豆蔻67份草石蚕59份柴胡55份
朝天罐54份刺参52份浮萍50份广藿香46份
桑椹45份草豆蔻41份青竹标40份甘蔗35份
天文草33份昙花30份文旦皮24份沙七22份。
5.一种如权利要求1～4任一项所述用于急性呼吸窘迫综合征护理的药物的制备方法，其特征在于：包括以下工艺步骤：
（1）将黄槿、浮萍和甘蔗洗净，切碎，放入容器内，绞汁，滤杂质，留汁液备用；
（2）将白豆蔻、草石蚕、朝天罐、刺参、广藿香、草豆蔻、青竹标、昙花、文旦皮和沙七洗净，放入容器内，加入8～10倍量的蒸馏水，浸泡5～6小时后，煮沸3～4小时，提取；再次加入6～8倍量蒸馏水，煮沸2～3小时，提取；最后，加入4～6倍量蒸馏水，加热煮沸1～2小时，提取；合并三次提取液，过滤，得滤液，浓缩为60℃下相对密度为1.13～1.17的稠膏，备用；
（3）将柴胡去杂质，洗净，切片，晒干，置于容器内，用醋拌匀，置锅内用文火炒至醋吸尽并微干，取出，晒干，置于研钵内，研末，过180目细粉备用；
（4）将桑椹洗净，浸入6倍量的70%的乙醇溶液浸泡3～4小时，加热回流提取2～3小时，回收乙醇，滤过，将滤液浓缩为65℃环境下相对密度1.11～1.13的稠膏，备用；
（5）将天文草放入容器内，进行粉碎处理，研末，过200目细粉，备用；
（6）将上述步骤（1）～（5）所制得的汁液、稠膏以及细粉混合，制成片剂，即得所述的用于急性呼吸窘迫综合征护理的药物。
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