CN103948827A - Medicinal composition for aerosol inhalation in preoperative period - Google Patents
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Abstract
The invention discloses a medicinal composition for aerosol inhalation in a preoperative period to achieve the prevention effect of reducing operative lung-related complications. The medicinal composition is characterized by being prepared from the following active pharmaceutical ingredients in parts by weight: piny flower, prinos-like salacia root, jasminum grandiflorum, Entada phaseoloides, sunflower flower, wolfberry fruit, tabasheer, Tetrapanax papyriferum, erythrina bark, common eulaliopsis juvenile rhizome, cassiabarktree fruit and Japanese sweetflag. Clinical experiment proves that the medicinal composition has the characteristics of favorable curative effect and high safety for lung protection during the preoperative period, and deserves clinical application and popularization.
Description
Technical field
The present invention relates to the field of Chinese medicines, be specifically related to a kind of peri-operation period atomization inhaled medication compositions.
Background technology
Lungs are whole kinemic organs of unique acceptance in body, be also systemic vein blood must through huge filter; Lungs are also open organs simultaneously, and alveolar communicates with the external world through bronchus at different levels, trachea.Therefore, lungs are easy to be subject to the effect of endogenous and exogenous harmful factor and sustain damage.Preoperative risk factors, operation, anesthesia, blood transfusion, extracorporeal circulation and other medical measures etc. all can cause certain damage to lungs at peri-operation period, the various pulmonarys of peri-operation period complication occurs, and severe patient generation respiratory insufficiency, threatens patient's life security.Therefore, peri-operation period Lung protection, prevention and treatment peri-operation period pulmonary complication are extremely important, are the strong guarantees of surgery patients quick recovery.
What postoperative pulmonary complications incidence rate was the highest is nosocomial pneumonia, but infection appropriate measures have in recent years been controlled its mortality rate effectively.Bronchospasm is one of the most serious obstruction of pulmonary ventilation of peri-operation period, and incidence rate is about 0.6% ~ 0.8%.And for having chronic obstructive pulmonary disease (COPD), asthma patients with history, the incidence rate increase of peri-operation period bronchospasm reaches 10%, especially thoracic operation is up to 39.5%.Once serious bronchospasm occurs patient, especially, in stage of surgery, as processed not in time, can cause severe depletion of oxygen and carbon dioxide accumulation, even threat to life.In operation process, the operations such as anesthesia medication and tracheal intubation all can be brought out the generation of bronchospasm, and its mortality rate is up to 70%.
But bronchospasm is not isolated disease; air flue has pathophysiological change before this; in order to describe this pathological process, the common recognition > > of < < thoracic surgery peri-operation period lung protection in 2009 has proposed " a reactive high high-impedance state " concept.A reactive high high-impedance state refers to: have the high risk factor patient of (together), vagal tone increases, Airway inflammatory response causes airway hyperreactivity, airway constriction and airway resistance are increased, and causes a series of peri-operation period pulmonary complications.A reactive high high-impedance state is a progressively quantitative change process for evolution, in any one stage of this process, all can under risk factor effect, cause bronchospasm.Even if do not bring out bronchospasm, also can cause flow limitation, sputum inadequate drainage, cause the even peri-operation period pulmonary complication such as adult respiratory distress syndrome (ARDS) of pulmonary atelectasis, pulmonary edema, pneumonia, respiratory failure.Wherein, it is the core of a reactive high high-impedance state that airway resistance is increased, and is also the one of the main reasons that causes peri-operation period pulmonary complication.
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 peri-operation period atomization inhaled medication compositions of side effect.
The technical scheme that the present invention solves its technical problem is: a kind of peri-operation period atomization inhaled medication compositions, is characterized in that being prepared from by the crude drug of following weight proportion: 10 ~ 30 parts of Flos pinis, 6 ~ 12 parts of Radix salaciae prinoidiss, 3 ~ 10 parts of Flos jasmini, 6 ~ 12 parts of Caulis Entadae, 3 ~ 10 parts of Flos Helianthis, 6 ~ 12 parts of Fructus Lycii, 6 ~ 12 parts of Concretio silicea Bambusae seu schizostachyis, go back 6 ~ 12 parts, bobbin, 6 ~ 12 parts of Cortex erythrinaes, 1 ~ 5 part of Rhizoma eulatiopsis binatae, 3 ~ 10 parts of Fructus cinnamomi immaturus, 10 ~ 25 parts of Rhizoma Acori Graminei.
Chinese medicine of the present invention is that the raw material by following optimum weight part proportioning is prepared from: 20 parts of Flos pinis, 10 parts of Radix salaciae prinoidiss, 6 parts of Flos jasmini, 10 parts of Caulis Entadae, 6 parts of Flos Helianthis, 10 parts of Fructus Lycii, 10 parts of Concretio silicea Bambusae seu schizostachyis, go back 10 parts, bobbin, 10 parts of Cortex erythrinaes, 2 parts of Rhizoma eulatiopsis binataes, 6 parts of Fructus cinnamomi immaturus, 20 parts of Rhizoma Acori Graminei.
Wherein said: Flos pini is the pollen of pinaceae plant Pinus massoniana Lamb Pinus massoniana Lamb., Pinus tabulaeformis tabulaeformis Carr., Pinus densiflora Pinus densiflora Sieb.et Zucc, Pollen pini thunbergii Pinus thunbergii Parl etc.Nature and flavor are sweet; Warm in nature.Return liver; Stomach warp.Merit can be dispeled the wind; QI invigorating; Removing dampness; Hemostasis.
Radix salaciae prinoidis is the root of Hippocrateaceae plant Salacia prinoides (Willd.) DC. Salacia prinoides (Willd.) DC..Nature and flavor are puckery; Temperature.Return liver; Kidney channel.Merit can dispelling wind and removing obstruction in the collateral; Restore menstrual flow and invigorate blood circulation.
Flos jasmini is Oleaceae plants Flos jasmini Jasminu, the dry flower of grandiflorum L..Property mildly bitter flavor; Property is put down.Return Liver Channel.Merit can soothing liver-QI for relieving depression, promoting the circulation of QI to relieve pain.
Caulis Entadae is stem, the leaf of moraceae plants Radix Pachyrhizi Erosi banyan Ficus tikoua Bur..Nature and flavor bitter in the mouth; Cold in nature.Merit can clearing away heat-damp and promoting diuresis; Promoting blood circulation to remove obstruction in the collateral; Removing toxic substances and promoting subsidence of swelling.
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.
Fructus Lycii, is the fruit of Solanaceae Lycium Fructus Lycii Polygonatum kingianum Coll.et Hemsl., and merit can be mended marrow, enriching yin and nourishing kidney, benefiting vital QI for tranquillizing by spermatogenesis.
Concretio silicea Bambusae seu schizostachyi, for Mycophyta Ascomycetes Rou Zuo section Concretio silicea Bambusae seu schizostachyi belongs to Fungus Zhuhuang Shiraia bambusicola Henn., is used as medicine with Stroma.Nature and flavor are light, flat.Merit can expelling wind and removing dampness, the easypro warp of invigorating blood circulation, cough-relieving.
Also bobbin, is the fruit of orchid Rhizoma Gastrodiae Gastrodia elata Bl..Sweet in the mouth; Cold in nature.Merit can tonify deficiency subduing the wind syndrome.
Cortex erythrinae is bark or the root bark of pulse family Erythrinae Arborescentis Erythrina indica Lam..Nature and flavor are bitter, flat.Return liver, kidney channel.Merit can wind-damp dispelling, channels sootheing and network vessel quickening.Wind-damp dispelling, the meridian dredging, parasite killing.
Rhizoma eulatiopsis binatae is the tender rhizome of grass plan Jin Mao.Merit can circulation of qi promoting removing blood stasis.
Fructus cinnamomi immaturus is the tender fruit of children of 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.
Rhizoma Acori Graminei, is the dry rhizome of Rhizoma Acori Graminei Citrus reticulata Blanco, and merit can be whetted the appetite in removing dampness, the eliminating phlegm of having one's ideas straightened out, refreshment Fructus Alpiniae Oxyphyllae.
Composition principle: the pathologic basis of bronchospasm is " a reactive high high-impedance state ", also there is the high risk factor patient of (together), vagal tone increases, Airway inflammatory response causes airway hyperreactivity, airway constriction and airway resistance are increased, and causes a series of peri-operation period pulmonary complications.Wherein, it is the core of a reactive high high-impedance state that airway resistance is increased, and is also the one of the main reasons that causes peri-operation period pulmonary complication.In traditional medicine, do not have " airway resistance is increased " this concept, inventor's clinical experience gained, think " airway resistance is increased " its be that pathogen is detained in a kind of performance of lung network.But, this " airway resistance is increased " is only the sign that symptom occurs, factor not starts, it brings out basis for " high risk factor " the lower a kind of high reactive state producing, and common people stress not can cause the result of generation " airway resistance is increased ", but there is patient's network QI-insufficiency of chronic obstructive pulmonary disease and asthma medical history, stress play in network QI and blood not all right, then body fluid stays to gather and falls apart, and then becomes bronchospasm.Therefore its treatment, answers QI invigorating, dredging collateral to go forward side by side.
Compared with prior art, the present invention has following characteristics:
1, prescription is unique: in side, get Flos pini, Radix salaciae prinoidis is monarch, described Flos pini is real defends gas, Radix salaciae prinoidis walks nutrient blood, and the two coordinates, and jointly reaches the effect of activating qi and collateral.Select the reason of the QI invigorating medicine of Flos pini rather than ginseng stilbene and so on to be: Flos pini invigorating middle warmer is walked, and the merit that has row to defend minute, contribute to gain, disperse the network gas that lung is defended; For chronic obstructive pulmonary disease rat open chest surgery model, Flos pini: the mixing water decocting liquid under Radix salaciae prinoidis=2:1 ratio and the comparison of blank group, airway resistance obviously reduces, minute ventilation volume increases;
2, in side, getting Flos jasmini, Caulis Entadae, Fructus Lycii, Concretio silicea Bambusae seu schizostachyi is minister, Caulis Entadae, Concretio silicea Bambusae seu schizostachyi dampness removing promoting blood circulation to remove obstruction in the collateral, the minimizing of secretions in favourable Rhizoma Atractylodis Macrocephalae; Fructus Lycii is assisted Flos pini enriching yin boost qi.And the spasm that Flos jasmini can antagonism acetylcholine causes has bronchus relexation;
3, Flos Helianthi expelling wind and removing dampness; Bobbin tonify deficiency also; Cortex erythrinae dredging collateral is to alleviate pleura symptom; Rhizoma eulatiopsis binatae circulation of qi promoting removing blood stasis; The raw yang-energy in the heart of Fructus cinnamomi immaturusization;
4, using corrigent: go back the merit that bobbin also has using corrigent, prevent postoperative blood deficiency and circulation of qi promoting too, absurd raw endogenous wind;
5, the refreshment of Rhizoma Acori Graminei eliminating phlegm, is applicable to post-operative recovery;
6, medicine material consumption of the present invention is groped in a large number to sum up through inventor and is drawn, each raw material consumption is for all to have good curative effect in following weight parts scope.
The specific embodiment
Below in conjunction with practical situation, the specific embodiment of the present invention is elaborated.
Embodiment 1, crude drug weight proportion: 20 parts of Flos pinis, 10 parts of Radix salaciae prinoidiss, 6 parts of Flos jasmini, 10 parts of Caulis Entadae, 6 parts of Flos Helianthis, 10 parts of Fructus Lycii, 10 parts of Concretio silicea Bambusae seu schizostachyis, go back 10 parts, bobbin, 10 parts of Cortex erythrinaes, 2 parts of Rhizoma eulatiopsis binataes, 6 parts of Fructus cinnamomi immaturus, 20 parts of Rhizoma Acori Graminei.
The preparation method of embodiment 1 is: by Flos pini (decocting a drug wrapped), Radix salaciae prinoidis, Flos jasmini, Caulis Entadae, Flos Helianthi, Fructus Lycii, Concretio silicea Bambusae seu schizostachyi, go back bobbin, Cortex erythrinae, Rhizoma eulatiopsis binatae, Fructus cinnamomi immaturus, Rhizoma Acori Graminei mixing and water adding and decoct, after 30 minutes, get filtrate, medicinal residues add water continuation decoction and get filtrate after 20 minutes, twice filtrate merges, and is divided into two parts of morning and evenings to take.
Embodiment 2, crude drug weight proportion: 10 parts of Flos pinis, 6 parts of Radix salaciae prinoidiss, 3 parts of Flos jasmini, 6 parts of Caulis Entadae, 3 parts of Flos Helianthis, 6 parts of Fructus Lycii, 6 parts of Concretio silicea Bambusae seu schizostachyis, go back 6 parts, bobbin, 6 parts of Cortex erythrinaes, 1 part of Rhizoma eulatiopsis binatae, 3 parts of Fructus cinnamomi immaturus, 10 parts of Rhizoma Acori Graminei.
Embodiment 3, crude drug weight proportion: 20 parts of Flos pinis, 10 parts of Radix salaciae prinoidiss, 6 parts of Flos jasmini, 10 parts of Caulis Entadae, 6 parts of Flos Helianthis, 10 parts of Fructus Lycii, 10 parts of Concretio silicea Bambusae seu schizostachyis, go back 10 parts, bobbin, 10 parts of Cortex erythrinaes, 2 parts of Rhizoma eulatiopsis binataes, 6 parts of Fructus cinnamomi immaturus, 20 parts of Rhizoma Acori Graminei.
Embodiment 4, crude drug weight proportion: 30 parts of Flos pinis, 12 parts of Radix salaciae prinoidiss, 10 parts of Flos jasmini, 12 parts of Caulis Entadae, 10 parts of Flos Helianthis, 12 parts of Fructus Lycii, 12 parts of Concretio silicea Bambusae seu schizostachyis, go back 12 parts, bobbin, 12 parts of Cortex erythrinaes, 5 parts of Rhizoma eulatiopsis binataes, 10 parts of Fructus cinnamomi immaturus, 25 parts of Rhizoma Acori Graminei.
The Chinese medicine of embodiment 2 ~ 4 can be prepared from by following method:
(1) by Flos pini, Flos jasmini, Concretio silicea Bambusae seu schizostachyi, Radix salaciae prinoidis, Flos Helianthi, Cortex erythrinae, go back bobbin, Rhizoma Acori Graminei, Fructus cinnamomi immaturus coarse powder and with vapor distillation, extract volatile oil respectively, and collect medicinal residues mixing for standby use;
(2) in Caulis Entadae, Fructus Lycii, Rhizoma eulatiopsis binatae and step 1, gained medicinal residues mix and add 5 times of water yields, decoct with water 2 times, and each 1 hour, collecting decoction, standing; Then toward 95% the ethanol that adds 3 ~ 4 times of medicinal liquids in decocting liquid, standing 15 minutes, then with 3000rpm/min centrifugal 20 minutes, get supernatant, spraying is dry, draws just material;
(3) gained volatile oil in step 1 is sprayed in the first material of step 2 gained, mix, pulverize, cross 100 mesh sieves, subpackage forms.
During use, get 10g atomization inhaled medication powder, add 50 ℃ of normal saline or water purification 40ml, carry out atomizing face mask suction.Every day 2 times.
Effective combination of said medicine, coordinates mutually, and activating qi and collateral effectively reach the object of peri-operation period lung protection, and side effect is less.The above results is that clinical data fully proves, interrelated data is as follows.
1 object and method.
1.1 object.
1.1.1 case selection: in June, 2012 ~ 2014 operation patients 205 examples in year January, male 127 examples wherein, female's 78 examples; Age 19 ~ 75(48.32 ± 12.71) year.The past chronic obstructive pulmonary disease medical history 48 examples, asthma medical history 37 examples.Art formula: lung perform the operation 83 examples, operation on chest wall 54 examples, esophagus perform the operation 44 examples, repair of diaphragmatic hernia 12 examples, other 12 examples.
1.1.2 grouping: patient is divided into matched group 68 examples, decoction group 67 examples and atomization group 70 examples at random.Three groups of patients compare in sex, age, art formula, chronic obstructive pulmonary disease and asthma medical history, and difference not statistically significant (P>0.05), has comparability.
1.2 method.
1.2.1 Therapeutic Method: matched group adopts conventional thoracic surgery preoperative care, comprises clean respiratory tract and expectoration.Decoction group and atomization group are respectively on the basis of matched group, and first three sky of Rhizoma Atractylodis Macrocephalae starts following intervention scheme: decoction group is with gained decoction oral in the embodiment of the present invention 1,2 times/d; Atomization group, to add with proportioning raw materials and preparation method gained atomization inhaled medication powder 10g in the embodiment of the present invention 3, adds 50 ℃ of normal saline or water purification 40ml, mixes, and carries out atomizing face mask suction.Every day 2 times.All cases are preoperative avoids taking anticholinergic agents.
1.2.2 observation index: respiratory system related complication situation; Hospital stays.
1.2.3 statistical analysis: SPSS 13.0 carries out statistical analysis.Measurement data is checked with t, enumeration data χ
2check.
2 results.
2.1 3 group calling desorption system related complication situation comparisons: see the following form,
| Group | Number of cases | Pulmonary infection | Pulmonary atelectasis | Bronchospasm | Other |
| Matched group | 68 | 16 | 6 | 12 | 2 |
| Decoction group | 67 | 13 | 1 | 4 | 2 |
| Atomization group | 70 | 14 | 1 | 3 | 1 |
Incidence of pulmonary infection, decoction group and atomization group, lower than matched group, are still distinguished not statistically significant.
Decoction group pulmonary atelectasis incidence rate, lower than matched group, is still distinguished not statistically significant; Bronchospasm incidence rate is starkly lower than matched group (χ
2=4.40, P<0.05).
Atomization group pulmonary atelectasis and bronchospasm incidence rate are all starkly lower than matched group (χ
2=3.91, P<0.05; χ
2=4.36, P<0.05).
2.2 3 groups of hospital stays comparisons: the matched group hospital stays is 19.38 ± 5.78d, decoction group is 14.29 ± 4.22d, and atomization group is 13.65 ± 6.03d, and decoction group and atomization group are significantly shorter than matched group (P<0.05).
A situation arises for 2.3 3 groups of patient's medicine related reactions: three groups all do not occur obvious medicine related reactions.
3. conclusion.
This result of study shows; use decoction group of the present invention and atomization group can effectively reduce postoperative pulmonary atelectasis and bronchospasm incidence rate; and the hospital stays is lower than matched group, illustrate the present invention aspect the protection of peri-operation period lung, have curative effect certainly, the higher advantage of safety.
Claims (2)
1. a peri-operation period atomization inhaled medication compositions, is characterized in that being prepared from by the crude drug of following weight proportion: 10 ~ 30 parts of Flos pinis, 6 ~ 12 parts of Radix salaciae prinoidiss, 3 ~ 10 parts of Flos jasmini, 6 ~ 12 parts of Caulis Entadae, 3 ~ 10 parts of Flos Helianthis, 6 ~ 12 parts of Fructus Lycii, 6 ~ 12 parts of Concretio silicea Bambusae seu schizostachyis, go back 6 ~ 12 parts, bobbin, 6 ~ 12 parts of Cortex erythrinaes, 1 ~ 5 part of Rhizoma eulatiopsis binatae, 3 ~ 10 parts of Fructus cinnamomi immaturus, 10 ~ 25 parts of Rhizoma Acori Graminei.
2. a kind of peri-operation period atomization inhaled medication compositions according to claim 1, is characterized in that being prepared from by the crude drug of following weight proportion: 20 parts of Flos pinis, 10 parts of Radix salaciae prinoidiss, 6 parts of Flos jasmini, 10 parts of Caulis Entadae, 6 parts of Flos Helianthis, 10 parts of Fructus Lycii, 10 parts of Concretio silicea Bambusae seu schizostachyis, go back 10 parts, bobbin, 10 parts of Cortex erythrinaes, 2 parts of Rhizoma eulatiopsis binataes, 6 parts of Fructus cinnamomi immaturus, 20 parts of Rhizoma Acori Graminei.
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