CN103874499B9 - 用于治疗多种起因的外周溃疡的组合物 - Google Patents

用于治疗多种起因的外周溃疡的组合物 Download PDF

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CN103874499B9
CN103874499B9 CN201280044588.XA CN201280044588A CN103874499B9 CN 103874499 B9 CN103874499 B9 CN 103874499B9 CN 201280044588 A CN201280044588 A CN 201280044588A CN 103874499 B9 CN103874499 B9 CN 103874499B9
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E·邦巴尔代利
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Abstract

本发明涉及刺激细胞增殖的活性剂与抗炎剂/镇痛剂的组合，其可用于治疗多种起因的外周溃疡，例如放射皮炎、糖尿病性溃疡、因肢体静脉淤滞导致的溃疡、褥疮、和相关皮肤感染、直肠炎、外阴阴道炎和具有血管损害的痔。这些组合可以作为用于局部应用的制剂存在。

Description

用于治疗多种起因的外周溃疡的组合物
本发明涉及纯花色素苷(anthocyanosides)的亚硫酸氢盐加合物或包含 它们的提取物，其作为局部药物用于治疗溃疡和创伤。
本发明还涉及包含所述亚硫酸氢盐加合物作为细胞增殖刺激剂与抗炎 剂/镇痛剂的组合物。本发明的组合物可用于治疗放射皮炎、烧伤、多种起 因的外周溃疡，例如糖尿病性溃疡、因肢体静脉淤滞导致的溃疡、褥疮和 相关皮肤感染。
更特别地，本发明涉及包含纯花色素苷的亚硫酸氢盐加合物或包含它 们的提取物和紫锥花属物种(Echinacea sp)提取物的组合物。该组合物还可 以任选包含其它活性成分，例如天然或合成的血管动力剂(vasokinetics)。
技术背景
外周溃疡，无论它们是具有创伤性起因还是具有代谢性起因，例如糖 尿病性溃疡或那些因肢体静脉淤滞导致的溃疡、褥疮和相关皮肤感染，都 具有不同的病因，但是，它们通常具有相同的症状。某些涉及外周微循环 和循环并且主要与动脉硬化相关，其导致中小动脉闭合，随后导致水肿， 因偶发原因或瘙痒导致的搔抓可以产生损害，其因随后的细菌和/或真菌感 染而愈合缓慢。其它溃疡例如那些因放射或热或机械性损伤导致的溃疡和 褥疮具有确定的起因。
与慢性静脉机能不全相关的溃疡需要长期使用具有不同协同作用的物 质的组合治疗。糖尿病性溃疡具有与前者相似的起因并且伴随周围疼痛和 紫癜。创伤起因的溃疡具有强烈抗痛组分(antalgic component)。
通常，血管动力剂和血管保护剂(vasoprotectors)改善创伤愈合，尤其 是在褥疮的情况中，但是，它们单独不能使创伤愈合。因此，感觉需要组 合创伤愈合和血管动力作用与镇痛和杀菌/抗菌作用的药理学治疗。
保持动脉微循环活动并且通过淋巴转归从溃疡的区域除去蛋白质渗出 进一步加速了组织的表皮细胞再生。
发明描述
已经发现纯形式的花色素苷的亚硫酸氢盐加合物或包含它们的提取物 具有优于最初的花色素苷的生物活性。
还已经发现所述花色素苷的亚硫酸氢盐加合物与紫锥花属物种的亲脂 提取物的组合令人惊讶地诱导快速的创伤愈合，其中周围水肿减轻并且表 皮细胞再生，这归因于纤维蛋白产生和蛋白质渗出即刻减少，使得溃疡得 到清洁并且肉芽组织快速增殖。
因此，本发明涉及组合物，其包含如下成分作为活性成分：
a)纯形式的花色素苷的亚硫酸氢盐加合物或包含它们的提取物；
b)紫锥花属物种的亲脂提取物；
和任选的
c)具有血管动力作用的物质。
本发明的组合物可用于治疗多种起因的外周溃疡，例如放射皮炎、烧 伤、痔、淤滞或糖尿病性溃疡、褥疮和相关皮肤感染。
众所周知，具有花色素苷(anthocyanin)骨架的物质在体外对成纤维细 胞增殖具有活性，对结缔组织基质具有抗蛋白酶活性，并且在静脉和淋巴 水平上具有血管动力活性。然而，这些化合物不适合于局部施用，因为它 们导致不期望的、不可接受的溃疡和邻近组织染色。已知二氧化硫和亚硫 酸氢盐与氧基质发生相互作用，得到无色化合物，其生成如下加合物：
其中R是氢或甲基。
所述加合物在药物制剂中的应用解释了它们的显著的抗细菌和抗真菌 活性，从而能够消除抗微生物稳定剂。亚硫酸氢盐加合物与花色素苷 (anthocyanins)化合物保持平衡，但不染色它们所接触的组织。
根据本发明，所述加合物可以在制剂中通过混合花色素苷 (anthocyanins)/花色素苷(anthocyanosides)与亚硫酸盐例如焦亚硫酸钠直 接形成。该加合物可以以分离形式或包含它们的提取物形式存在。当以提 取物形式存在时，优选使用如下提取物：杜鹃花科(Ericaceae)提取物，优 选越桔属物种(Vaccinium sp)，例如欧洲越桔(Vaccinium myrtillus)、 Vaccinium erythrocarpon、大果越桔(Vaccinium macrocarpon)、小果红莓苔 子(Vaccinium microcarpum)和红莓苔子(Vaccinium oxycoccos)；虎耳草科 (Saxifragaceae)提取物，优选黑茶藨子(Ribes nigrum)；葡萄科(Vitaceae)提 取物，优选葡萄(Vitis vinifera)；忍冬科(Caprifoliaceae)提取物，优选西洋 接骨木(Sambucus nigra)；和杜英科(Elaeocarpaceae)提取物，优选马基树 (Aristotelia chilensis)。
优选欧洲越桔、葡萄、黑茶藨子或西洋接骨木的成熟果实的提取物。
术语花色素苷包含通常所谓的花色素苷及其苷元(花色素 (anthocyanidins))。
根据一个优选的方面，花色素苷优选衍生自越桔(欧洲越桔)提取物。 已知越桔提取物具有显著的创伤愈合活性，其结果是它们已经用于治疗胃 溃疡和十二指肠溃疡；且它们还具有显著的抗炎作用，尤其是在局部水平 上，这归因于其对毛细血管通透性和脆性的活性。越桔花色素苷还具有抑 菌和抗病毒作用。
已知包含花色素苷的越桔提取物的制剂。
紫锥花属的亲脂提取物发挥镇痛、抗病毒和抗炎活性，对创伤愈合产 生总体改善；它还对所有的瘙痒形式具有显著作用，即通常伴随因静脉淤 滞导致的溃疡形成的病症，并且可用于愈合和上述所有溃疡的预防。因异 丁基酰胺组分导致的镇痛作用与其和大麻素受体CB1和CB2的相互作用 和辣椒素活化相关。
根据本发明的一个优选的方面，紫锥花属物种的亲脂提取物是狭叶紫 锥菊(Echinacea angustifolia)或紫松果菊(Echinacea purpurea)的亲脂提取 物。
活性成分的百分比范围可以为0.05至2％的儿茶素多酚或花色素苷或 包含它们的提取物和0.01至1％的紫锥花属物种的亲脂提取物。
优选加入选自维司那定或七叶苷糖(esculoside)的血管动力剂用于治疗 褥疮。
本发明的组合物优选包含如下百分比范围的活性组分：
a)花色素苷的亚硫酸氢盐加合物或包含它们的提取物：0.05至2％， 优选0.5至1％；
b)紫锥花属物种的亲脂提取物：0.01至1％，优选0.05至0.3％；
和任选的
c)0.2至1％的维司那定或七叶苷糖，优选0.5％百分比的维司那定。
通过将亚硫酸氢盐添加到花色素苷(anthocyanins)或包含它们的提取 物中形成亚硫酸氢盐加合物，所添加的亚硫酸氢盐的量约为花色素苷或具 有36±5％花色素苷含量的花色素苷(anthocyanin)提取物重量的一半。
可以将本发明的组合物例如作为水/油乳剂、无菌扑粉或封闭制剂局部 施用。根据一个优选的方面，封闭制剂可以是设计为在施用时水化并且包 含海藻酸作为胶凝多糖的固体形式。
用于制剂的优选的赋形剂是多糖，例如透明质酸、硫酸软骨素或海藻 酸，它们有助于形成刺激创伤愈合的保护膜。
将制剂应用于创伤，并且使该制剂保留以便吸收。特别的感染的创伤 应当用胶布覆盖。每天重复该治疗1至3次，小心保护创伤或溃疡以免受 到机械性创伤。
根据众所周知的常规方法与适合的赋形剂制备本发明的组合物，所述 的方法例如描述在“Remington’s Pharmaceutical Handbook”,Mack Publishing Co.,N.Y.,USA中的那些方法。
下列实施例详细地说明本发明。
实施例1-水凝胶
欧洲越桔(36％花色素苷) 0.50g
狭叶紫锥菊(根提取物) 0.25g
聚乙二醇400 5.00g
甘油 5.00g
卡波姆 1.00g
10％氢氧化钠溶液 2.00g
亚硫酸氢钠 0.20g
对羟基苯甲酸丙酯 0.05g
山梨酸钾 0.15g
适量纯水至 100g
实施例2-乳膏剂(O/W乳剂)
欧洲越桔干燥提取物 1.00g
狭叶紫锥菊(根提取物) 0.25g
液体石蜡 8.000g
硬脂酸 10.000g
亚硫酸钠 0.5g
聚山梨酯80 2.000g
甘油 12.000g
适量纯水至 100.000g
实施例3-对因下肢静脉淤滞导致的溃疡的作用
在本研究中包括患有因静脉淤滞导致的下肢溃疡、但未并发其它血管 障碍的50位患者(每组10位)。
使用如实施例1中所述的制剂治疗这些患者，以2cm(相当于1g)的 量，每日2次应用于损伤上。然后用绷带覆盖所治疗的损伤以确保凝胶不 被除去，并且保护它们以免外部物质/或机械性创伤。监测损伤21天，并 且通过测定两次直径评价表皮细胞再生。
将结果表示为所测定的两次直径的平均值。
结果如下表中所示。
在放射皮炎治疗中，评价因放射导致的损伤的原位修复时间：最常见 类型的放射皮炎是发生在头、颈、乳房、子宫和前列腺肿瘤中的那些。在 这些最近的病例中，放射治疗在很大面积上导致溃疡，并且如果快速表皮 细胞再生不可能，则治疗周期必须终止。
例如，在唾液腺肿瘤的情况中，体外颈颜面区域中的原发性损伤完全 缓解在48小时内出现，这可以与在正常的肿瘤学实践中至少1周相竞争。
另外，令人意外地发现，与未治疗的对照组和接受常规治疗的患者相 比，本发明的制剂将放疗诱导的直肠炎的消退时间减少了500％。

Claims (6)

1.组合物，其包含：
a)0.05至2％的包含在欧洲越桔提取物中的花色素苷的亚硫酸氢盐加 合物；
b)0.01至1％的狭叶紫锥菊或紫松果菊的亲脂提取物；
和任选的
c)0.1至1％的维司那定和/或七叶苷糖；
其用于治疗外周淤滞性溃疡。
2.权利要求1的组合物，其适合于局部施用。
3.权利要求2的组合物，其中溃疡是因静脉淤滞导致的肢体溃疡。
4.权利要求1的组合物在制备用于治疗外周淤滞性溃疡的药物中的用 途。
5.权利要求4的用途，其中组合物适合于局部施用。
6.权利要求5的用途，其中溃疡是因静脉淤滞导致的肢体溃疡。
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