CN103816262B - The medicine for the treatment of Neonatal gastrointestinal dysfunction - Google Patents
The medicine for the treatment of Neonatal gastrointestinal dysfunction Download PDFInfo
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- CN103816262B CN103816262B CN201410114425.5A CN201410114425A CN103816262B CN 103816262 B CN103816262 B CN 103816262B CN 201410114425 A CN201410114425 A CN 201410114425A CN 103816262 B CN103816262 B CN 103816262B
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Abstract
The present invention is the medicine for the treatment of Neonatal gastrointestinal dysfunction, and belong to the field of Chinese medicines, feature makes effective ingredient according to a certain weight ratio by Radix Et Rhizoma Rhei, the Radix Astragali, Rhizoma Atractylodis Macrocephalae (parched), Poria, Fructus Aurantii Immaturus, Radix Paeoniae Rubra and Herba Artemisiae Scopariae.Obviously can improve gastrointestinal dysfunction infant clinical symptoms, effectively improve gastrointestinal function, also can excite infant self immune system IgA, IgG, IgM secrete increase simultaneously, thus improve children patient humoral immune function.And this Chinese medicine preparation, have no side effect, in medication process, have no any untoward reaction, can coloclysis also can be oral, be easy to accept.
Description
Technical field
The invention belongs to the field of Chinese medicines, particularly a kind of Chinese medicine preparation for the treatment of Neonatal gastrointestinal dysfunction.
Background technology
Gastrointestinal dysfunction is the commitment of gastrointestinal functional failure, neonate due to gastrointestinal growth immature, more easily occur gastrointestinal dysfunction, and the state of an illness is dangerous, treatment difficulty.The pathogenesis of current Neonatal gastrointestinal dysfunction is not set forth clear completely, lacks unified perfect diagnosis and treatment standard, clinically mainly adopts Comprehensive Treatment, Cure the Primary Disease also without specific treatment method, but case fatality rate is still very high.Doctor trained in Western medicine is being treated in primary disease without specific therapy, the digestive tract power such as acid inhibitor and the motilium medicines such as main employing cimetidine, as neonate takes Medilac-Vita medicine, but curative effect is not given prominence to, because microbial ecological agent is not enough in neonate application experience, also can cause infection, larger to neonate toxic and side effects.The Chinese patent medicine of Chinese traditional treatment primary disease mainly contains YUNNAN BAIYAO, XUEBIJING etc., and YUNNAN BAIYAO main component is Radix Notoginseng (its effective ingredient is triterpenoid saponin, flavonoid glycoside, alkaloid), has blood circulation promoting and blood stasis dispelling, hemostasis, anti-inflammation detumescence, toxin expelling effect.XUEBIJING has the effect of potent anti-endotoxin, the effect of the runaway release of endogenous inflammatory medium also having potent anti-endotoxin induced monocyte/macrophage to produce, but cure rate, effective percentage are lower.
Summary of the invention
The object of the present invention is to provide a kind of medicine for the treatment of Neonatal gastrointestinal dysfunction, pure Chinese medicinal preparation, has no side effect, and cure rate is high.
The present invention is except possessing blood circulation promoting and blood stasis dispelling, hemostasis, anti-inflammation detumescence, toxin expelling effect, also emphasize " The spleen and stomach provide the material basis of the acquired ", by improving digestive tract environment, promote congenital and adaptive immunity, curative effect more comprehensively, deficiency and excess is taken into account, and embodies " organic conception " and " determination for the treatment of based on pathogenesis obtained through differentiation of symptoms and signs " application in clinical better.
The present invention is achieved in that
The medicine for the treatment of Neonatal gastrointestinal dysfunction, is characterized in that the raw material composition making effective ingredient is by weight ratio: Radix Et Rhizoma Rhei 2-3, Radix Astragali 3-6, Rhizoma Atractylodis Macrocephalae (parched) 3-6, Poria 3-6, Fructus Aurantii Immaturus 3-6, Radix Paeoniae Rubra 3-6 and Herba Artemisiae Scopariae 3-6.
Medicine of the present invention obviously can improve gastrointestinal dysfunction infant clinical symptoms, effectively improves gastrointestinal function, and also can excite infant self immune system IgA, IgG, IgM secrete increase simultaneously, thus improves children patient humoral immune function.And this Chinese medicine preparation, have no side effect, in medication process, have no any untoward reaction, can coloclysis also can be oral, be easy to accept.
The present invention has following clinical effectiveness:
One, prescription medical material high quality materials, meet and according to Chinese Pharmacopoeia and pharmacology compatibility, concoct, compatibility is proper, coordinate scientific and reasonable;
Two, pure Chinese medicinal preparation, has no side effect, taking convenience, and price is economical;
Three, cure rate is high.Empirical tests, total effective rate 90% of the present invention.
Modern medicine thinks neonate gastrointestinal function developmental immaturity, especially premature infant, gastric mucosa rich blood vessel, but goblet cell and body of gland are all less than adult, hydrochloric acid and the various enzyme of secretion are all less than adult, gastric acidity is low, be unfavorable for killing pathogen, when anoxia-induced apoptosis and infection, a large amount of reactive oxygen free radical is produced during gastrointestinal mucosa Reperfu-sion, infringement mucosa cells causes mucosa to come off necrosis, there is toxical paralytic ileus, enterokinesia is slowed down, antibacterial and endotoxin directly or indirectly cause intestinal mucosal lesion simultaneously, Mucosa Barrier destroys, permeability increases, increase the weight of gastrointestinal function damage further, cause abdominal distention, vomiting or the symptom such as hemorrhage occur.Middle severe hypoxia suffocates, severe infections, premature infant and Low body weight, septicemia, necrotizing enterocolitis, intracranial hemorrhage, severe are firmly swollen to cause the cause of disease of Neonatal gastrointestinal dysfunction to mainly contain, and wherein causes gastrointestinal dysfunction the most common with newborn with heavy asphyxia Hypoxia and ischemia.Chinese medicine is thought, neonate natural endowment is not enough, " immature yin and yang ", easily occurs that improper feeding damaging the stomach, exopathogen are violated in stomach, retardance burnt, disturbance mechanism of qi, the performances such as stagnation of QI causing retention of food.Many genus " deficiency in origin and excess in superficiality ".Therefore the treatment of Neonatal gastrointestinal dysfunction is mainly intended to QI and blood regulating, invigorating spleen and reinforcing stomach, Tongli purge heat, it is remaining evil to remove.
The present invention with reference to motherland medical science to the Neonatal gastrointestinal dysfunction cause of disease and the understanding of pathogenesis and the invaluable experience for the treatment of, consult existing reasonable formula, determination for the treatment of based on pathogenesis obtained through differentiation of symptoms and signs, according to motherland's pharmacopeia and pharmacology compatibility, weed out the old and bring forth the new, be the successful medication for traditional medicine treatment Neonatal gastrointestinal dysfunction, effectively can treat Neonatal gastrointestinal dysfunction.
Modern pharmacological research proves:
1, Radix Et Rhizoma Rhei
Property bitter, cold, have heat and toxic materials clearing away, clearing away heat-fire, removing toxic substances, blood circulation promoting and blood stasis dispelling, effect of hemostasis, can be used for treatment tire just discharges delay, and tire is just discharged not smooth.The main component in Radix Et Rhizoma Rhei with catharsis effect is anthraquinone glycoside and dianthracene ketone glycoside, and again containing rheotannic acid (Rheum tannic acids) and related substances thereof, as gallic acid, cachou extract, tetrarin, this type of material has anti-diarrhea effect.In addition, Radix Et Rhizoma Rhei is still containing fatty acid, calcium oxalate, glucose, fruit sugar and starch.
2, Fructus Aurantii Immaturus
Nature and flavor bitter, acrid, cold, have and regulate the flow of vital energy except painful abdominal mass, effect of circulation of qi promoting intestinal stasis relieving, can be used for controlling feeling of fullness, lead stagnant.Modern pharmacology finds that this Chinese medicine can excited gastrointestinal, makes it shrink the rhythm and pace of moving things strong, and its extract has obvious antagonism to intestinal contraction caused by acetylcholine and histamine.
3, Radix Paeoniae Rubra
Property acid, bitter, cool, purify the blood a point excess-heat, the effect that dissipating blood stasis blood is detained.Containing paeoniflorin, oxypaeoniflorin, benzoylpaeoniflorin, albiflorin, paeoniflorin without ketone, Galla Turcica (Galla Helepensis) acyl paeoniflorin, again containing dextrorotation cachou extract and volatilization wet goods, there is the modern pharmacology effect of antithrombus formation, antiplatelet aggregation.
4, Poria
Sweet in the mouth, light flat.There is effect of promoting diuresis to eliminate damp pathogen, spleen invigorating.Containing β-pachyman, multiple tetracyclic triterpenoid, ergosterol, choline, adenine etc.There are immunity moderation, strengthening the spleen and stomach, anti-infective effect, clinical in the strong treatment waiting card of insufficiency of the spleen transporting mistake.
5, the Rhizoma Atractylodis Macrocephalae
Property bitter, sweet, temperature.There is the function such as air making-up and spleen enlivening, dampness diuretic.Main chemical compositions is volatile oil, lactone compound and polysaccharide.Can strengthen small intestinal Spontaneous Contraction movable, and Rhizoma Atractylodis Macrocephalae oil can suppress the autonomic movement of intestinal tube, suppress stress ulcer to occur.
6, the Radix Astragali
Nature and flavor, sweet, tepor, effect is gentle, and main pharmacological is the feature of benefiting QI for strengthening the superficies.The Radix Astragali contains the Multiple components such as polysaccharide, glycoside, flavone and trace element, has remarkable effect, all have wide influence to immune system, hormonal system etc. to cellular metabolism, nucleic acid metabolism, antibacterial and viral infection etc.
7, Herba Artemisiae Scopariae
Bitter in the mouth, has the effect of clearing away heat-damp and promoting diuresis, jaundice eliminating, containing volatile oil, capillarisin, 6,7-dimethoxy coumarin, arcapillin A, B etc., has antipyretic, anti-inflammation, excited intestinal smooth, and immunity-regulating.
Theory of Chinese medical science is thought, Neonatal Congenital reports QI-insufficiency, easily occurs in improper feeding damaging the stomach, retardance burnt, and exopathogen criminal stomach, enteral have bacterium, disturbance mechanism of qi, the performances such as stagnation of QI causing retention of food.Belong to " deficiency in origin and excess in superficiality ".Therefore the treatment of Neonatal gastrointestinal dysfunction is mainly intended to regulate QI and blood, clearing heat and expelling damp, Tongli purge heat, invigorating spleen and reinforcing stomach, the remaining heresy of removing.Study discovery by experiment, we, by antiinflammatory, antipathogen, can stimulate the suppression causing macrophage phagocytic and sterilizing function by effective preventing common cold, and prevention suppress lymphocytic immunologic function, has good immunoregulation effect.In addition, theory of Chinese medical science is emphasized " The spleen and stomach provide the material basis of the acquired ", and we, by improving gastrointestinal function, improve digestive tract internal environment, resist the transplanting of other bacterial strain, regulates mucomembranous immune system, regulates respiratory mucosa, promotes innate immunity and adaptive immunity.Said preparation is made up of Radix Et Rhizoma Rhei, Fructus Aurantii Immaturus, Radix Paeoniae Rubra, the Radix Astragali, the Rhizoma Atractylodis Macrocephalae, Poria, Herba Artemisiae Scopariae seven flavor medicine.Radix Et Rhizoma Rhei heat and toxic materials clearing away, clearing away heat-fire, removing toxic substances, blood circulation promoting and blood stasis dispelling, hemostasis; Poria promoting diuresis to eliminate damp pathogen, spleen invigorating; Fructus Aurantii Immaturus, dispelling the stagnated QI removes painful abdominal mass, removing food stagnancy; The Rhizoma Atractylodis Macrocephalae, air making-up and spleen enlivening, dampness diuretic; The Radix Astragali, tonifying Qi and lifting yang, benefit defends consolidating superficial resistance, inducing diuresis to remove edema; Herba Artemisiae Scopariae, eliminating damp-heat, promoting the function of the gallbladder to alleviate jaundice; Radix Paeoniae Rubra, clearing away heat and cooling blood, eliminating stasis to stop pain.We are principal agent with Radix Et Rhizoma Rhei, and it rushes down exerts oneself strong, helps with Poria spleen invigorating, and the two one falls He, in case under rushing down too, and firm middle gas; Fructus Aurantii Immaturus, Radix Paeoniae Rubra are ministerial drug, are intended to enhancing and disappear stagnant blood stasis dispelling effect; Neonate because of its internal organs tender and lovely, shape gas does not fill, dysfunction of the spleen, and experiencing damp and hot heresy can not defeatedization, pent-up in inner, functional activity of QI being not smooth, hot and suffocating liver and gall, so that bile leaks, and overflows in skin appearance, yellowing of the skin, this side adds with Herba Artemisiae Scopariae, is intended to eliminating damp-heat, promoting the function of the gallbladder to alleviate jaundice; Neonatal immune system developmental immaturity, has a low resistance, and this side gets the Radix Astragali, Rhizoma Atractylodis Macrocephalae replenishing QI to invigorate the spleen, and the effect of tonifying Qi and lifting yang, is intended to righting.Full side is eliminating evil is main, and righting is auxiliary, and one dispels one holds up, and complement each other, righting is in order to eliminating evil, by strengthening the method for healthy energy, getting rid of evils and going out, i.e. so-called " just containing evil in dispelling ".Eliminating evil is in order to righting, eliminates the infringement of paathogenic factor and reaches protection healthy energy, restorative object, namely so-called: " heresy is gone just from peace ".
Detailed description of the invention
Below in conjunction with embodiment, the present invention is elaborated.
Embodiment 1
1, the side's of getting Chinese medicine Radix Et Rhizoma Rhei 2g, Radix Astragali 3g, Rhizoma Atractylodis Macrocephalae (parched) 3g, Poria 3g, Fructus Aurantii Immaturus 3g, Radix Paeoniae Rubra 3g and Herba Artemisiae Scopariae 3g.Soak half an hour, hot digestion 1.5 hours, gets filtrate stand-by.
2, after steaming and decocting, residue adds water steaming and decocting 1 hour again, obtains filtrate.
3, merge 2 times to obtain filtrate, obtain medicine of the present invention.Oral: every day 3 times, every day 2-10ml.
Using method: the present invention can be prepared into oral liquid formulation, can also be prepared into powder, pill, electuary, capsule and unguentum according to a conventional method, also can get above-mentioned raw materials medicine and make important decoct by proportioning and take.
Embodiment 2
Divide and get Radix Et Rhizoma Rhei 3g, Radix Astragali 4g, Rhizoma Atractylodis Macrocephalae (parched) 4g, Poria 4g, Fructus Aurantii Immaturus 4g, Radix Paeoniae Rubra 4g and Herba Artemisiae Scopariae 4g.Manufacture method and instructions of taking, with embodiment 1, effectively can treat soft stools, complete Gu not change person.
Embodiment 3
Divide and get Radix Et Rhizoma Rhei 2g, Radix Astragali 6g, Rhizoma Atractylodis Macrocephalae (parched) 6g, Poria 6g, Fructus Aurantii Immaturus 6g, Radix Paeoniae Rubra 6g and Herba Artemisiae Scopariae 6g.Manufacture method and instructions of taking, with embodiment 1, effectively can treat intestinal bleeding, and hold concurrently stool alteration of form person.
Clinical trial
For verifying the curative effect of medicine of the present invention, applicant carries out following clinical trial in 2010-2013 in Liaocheng of Shandong Province the People's Hospital department of pediatrics:
One, clinical data
1, neonatal patient 230 example of birth less than 28 days of gastrointestinal dysfunction is tested altogether, wherein female 93 example, man 137 example.
2, above-mentioned patient is divided into two groups at random:
First group is treatment group, totally 117 examples, wherein female 55 example, man 62 example;
Second group is matched group, totally 113 examples, wherein female 38 example, man 75 example.
Two, diagnostic criteria
In conjunction with the Neonatal gastrointestinal dysfunction guide of AAP's proposition in 2003, formulate Neonatal gastrointestinal dysfunction standard:
Slight performance: the 25%-50% of Wei Zhu Liu≤feeding volume, occurs 2,3 times; Gastroesophageal reflux or vomiting, or slight hematemesis; Light moderate abdominal distention or hypoactive bowel sounds; Defecation postpones or tire is just discharged not smooth; Laxativeness or have blood in stool.
Severe shows: serious abdominal distention or skin of abdomen variable color, or borborygmus disappears; Intestinal obstruction or intestinal perforation sign; Severe diarrhea or obvious courageous and upright feces; Serious asphyxia or bradycardia; The serious heart, pulmonary insufficiency; Gastrointestinal tract congenital malformation, intestinal obstruction etc. all.
In above-mentioned treatment group, patients with mild 57 example, severe patient 60 example; Matched group mild or moderate patient 55 example, severe patient 58 example.
Three, Therapeutic Method
Treatment group: oral medicine water decoction of the present invention, every day potion, 1ml/Kg, 2 times/day.
Matched group: oral 0.5/ time of Medilac-Vita, 3 times/day.
Four, the standard of curative effect evaluation
Neonatal gastrointestinal dysfunction recovery from illness and the diagnostic criteria taken a turn for the better:
(1) infant is fed rear without vomiting abdominal distention;
(2) the residual milk amount <2mL/kg of each stomach of infant of stomach feeding tube nursing;
(3) infant is without having blood in stool or the occult blood positive;
(4) have a medical check-up abdominal part without obvious visible peristalsis visible intestinal peristalsis, borborygmus is normal;
(5) abdominal part founds position plain film without dilatation of intestine or pneumatosis etc.
Haemostatic effect criterion:
After medication 24 hours Occult blood of gastric fluids continue strong positive or+it is invalid number not become; By ++++to ++ or by +++ to+for stopping blooding effectively.
Borborygmus recovers criterion:
After medication, absent bowel sounds recovery in 24 ~ 48 hours or < 3 beats/min are invalid; If it is effective that borborygmus returns to >3 beat/min.
Five, curative effect
Statistical method: use SPSS17.0 statistical software statistical data, to the statistics of continuous data, represent with mean, standard deviation, add if desired and represent with median or percentile, minima, maximum, Normal distribution test is carried out to variable distribution, during Normal Distribution, checks with t, heterogeneity of variance person, checks with t '; Nonnormal distribution, with rank test etc.; To enumeration data, adopt fisher precise probabilistic method or X
2inspection; Level data self before and after compare and use Wilcoxon signed rank sum test; The comparison Ridit of two groups of level data analyzes, or corresponding rank test.All statistical computations are all carried out with statistical software, using P≤0.5 as there being significance statistical significance, using P≤0.01 as there being very significant statistical significance.
Efficacy result sees the following form:
| Group | Effectively (example) | Invalid (example) | Effective percentage |
| Treatment group (117 example) | 96 | 21 | 82% |
| Matched group (113 example) | 74 | 39 | 65% |
Two groups of total effective rates compare, P < 0.05, significant difference.
Six, conclusion
Treatment group effective percentage 82%, matched group effective percentage 65%.Treatment level effective percentage is apparently higher than matched group.
Seven, concrete case
Case 1, man, 3 days.
Because of few being admitted to hospital for 3 days of taking food.Infant anoxia after birth history, alleviates after namely giving clearing pneogaster, chafe and oxygen uptake after raw, and feed is few, vomiting, and the green stool of row, urine volume is few, and psychoreaction is poor, drowsiness.Have a medical check-up: psychoreaction is poor, breathe steadily, the visible xanthochromia of skin, poor flexibility, cardiopulmonary are without exception, and abdominal part is distension slightly, and borborygmus is weak, and Primitive reflex is weak.Plain abdominal radiograph shows intestinal tympanites.Be diagnosed as hypoxic ischemic encephalopathy of newborn, Neonatal gastrointestinal dysfunction.Except treatment protopathy, give medicine of the present invention, be decocted in water for oral dose use, and after taking medicine 3 days, just, feed increases row's yellow, and vomiting disappears, and psychoreaction is clearly better, and intestinal tympanites disappears, and abdominal part is soft, and borborygmus is normal.Treat to cure for 2 weeks and leave hospital.
Case 2, man, 8 days
Because of vomiting, companion's abdominal distention is admitted to hospital for 5 days.The premature labor in 34 weeks of infant system gestational age, tire premature rupture of fetal membrane history, birth weight 2400g, namely live local hospital department of pediatrics after life to give warming, fluid infusion, infection control etc. and to suit the medicine to the illness Supporting Therapy, within 4-6 hour, opens milk after raw, because breast milk is not enough, feeding formula breast, feed is few, the green stool of row, within raw latter 3 days, occur vomiting, vomitus is containing coffee-like thing, and day vomits 2-3 time, engender abdominal distention, stool and hypourocrinia, psychoreaction is poor, heating, body temperature is the highest 37.9 DEG C, transfers my institute.Have a medical check-up: psychoreaction is poor, rapid breathing, the visible xanthochromia of skin, poor flexibility, two pulmonary respiration sound is coarse, abdominal part distension, stomach wall edema, and borborygmus is weak, and Primitive reflex is weak.Visible occult blood of defecating is positive, and plain abdominal radiograph shows intestinal tympanites, intestinal wall thickens.Be diagnosed as pneumonia of newborn, neonatal necrotizing enterocolitis, Neonatal Sepsis.Except treatment protopathy, give medicine of the present invention, be decocted in water for oral dose use, and after taking medicine 5 days, just, feed increases row's yellow, and vomiting disappears, and psychoreaction is clearly better, and intestinal tympanites disappears, and abdominal part is soft, and borborygmus is normal.Check fecal occult blood disappears.Treat to cure for 3 weeks and leave hospital.
Claims (2)
1. treat the medicine of Neonatal gastrointestinal dysfunction, it is characterized in that the raw material composition making effective ingredient is by weight ratio: Radix Et Rhizoma Rhei 2-3, Radix Astragali 3-6, Rhizoma Atractylodis Macrocephalae (parched) 3-6, Poria 3-6, Fructus Aurantii Immaturus 3-6, Radix Paeoniae Rubra 3-6 and Herba Artemisiae Scopariae 3-6.
2. the medicine for the treatment of Neonatal gastrointestinal dysfunction according to claim 1, the raw material composition and the weight proportion that it is characterized in that wherein making effective ingredient are: Radix Et Rhizoma Rhei 2, the Radix Astragali 3, Rhizoma Atractylodis Macrocephalae (parched) 3, Poria 3, Fructus Aurantii Immaturus 3, Radix Paeoniae Rubra 3 and Herba Artemisiae Scopariae 3.
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| CN1602915A (en) * | 2004-07-28 | 2005-04-06 | 昆明市中医医院 | Stomach motility promoting medicine for treating stomach and intestine function failure and its preparation |
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| CN1602915A (en) * | 2004-07-28 | 2005-04-06 | 昆明市中医医院 | Stomach motility promoting medicine for treating stomach and intestine function failure and its preparation |
Non-Patent Citations (2)
| Title |
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| 新生儿胃肠功能障碍48例临床分析;徐学芹、张丽丽;《社区医学杂志》;20051231;第3卷(第8期);73-74 * |
| 新生儿胃肠功能障碍的研究进展;杨彤、王琳琳;《医学综述》;20061130;第12卷(第21期);1314-1316 * |
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