CN104001131A - 一种防治应激性溃疡的内服中药 - Google Patents
一种防治应激性溃疡的内服中药 Download PDFInfo
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- CN104001131A CN104001131A CN201410222545.7A CN201410222545A CN104001131A CN 104001131 A CN104001131 A CN 104001131A CN 201410222545 A CN201410222545 A CN 201410222545A CN 104001131 A CN104001131 A CN 104001131A
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- KWGRBVOPPLSCSI-WPRPVWTQSA-N Ephedrine Chemical compound 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Abstract
本发明公开了一种防治应激性溃疡的内服中药。该膏药主要由党参、黄芪、白术、茯苓、山药、薏苡仁、当归、白芍、元胡、郁金、枳实、陈皮、乌贼骨、煅瓦楞、浙贝、白芨、仙鹤草、五倍子、紫珠、三七粉、大黄、生姜、炙甘草等按一定重量配比制备而成。本发明药物能够大幅度降低应激性溃疡大出血的发生机率；对普通溃疡病症也有良好的治疗效果。
Description
一种防治应激性溃疡的内服中药
技术领域
[0001] 本发明涉及一种防治应激性溃疡的内服中药，属于中药生产领域。
背景技术
[0002] 应激性溃疡泛指休克、创伤、手术后和严重全身性感染时发生的急性胃炎，多伴有出血症状，是一种急性胃黏膜病变。应激性溃疡的发病率近年来有增高的趋势，主要原因是由于重症监护的加强，生命器官的有效支持，以及抗感染药物的更新，增加了发生应激性溃疡的机会。严重创伤及重症病人术后合并应激性溃疡临床上较常见，对于应激性溃疡发生大出血时，由于病者全身情况差，不能耐受手术，加以术后再出血发生率高，所以一般先用内科治疗，无效时才考虑外科治疗。预防应激性溃疡大出血的发生，在临床上具有重要意义。 发明内容
[0003] 本发明人经反复研究，并通临床试验的反复验证，终于找到了有更好预防效果的防治应激性溃疡的内服中药。
[0004] 本发明的技术任务是提供一种防治应激性溃疡的内服中药，对严重创伤及重症病人术后合并应激性溃疡有良好的预防效果。
[0005] 应激性溃疡患者常表现为气虚不能摄血，本发明选党参、黄芪、茯苓、白术、山药、薏苡仁补气健脾，扶助正气，共为君；当归、白芍养血活血，元胡、郁金行气活血止痛，枳实、陈皮行气降气，共为臣；乌贼骨、煅瓦楞、浙贝、白芨收敛制酸，仙鹤草、五倍子、紫珠收敛止血，三七粉、大黄活血止血，大黄配枳实理气通便，共为佐药；生姜、甘草和胃止呕，调和诸药，为使药。本方标本兼治，取得较好临床疗效。
[0006] 具体来说，本发明选用上述药物是因为它们具有以下功用主治:
党参:甘，平。归脾、肺经。益气，生津，养血。补气兼能养血，治脾胃虚弱，中气不足，气血两亏，体倦无力，食少，口渴，久泻，脱肛。
[0007] 黄芪:甘，微温。归脾、肺经。黄芪具有补气升阳，益卫固表、托疮生肌、利水消肿之功效。
[0008] 白术:苦、甘，温。归脾、胃经。补气健脾，燥湿利水，止汗。
[0009] 茯苓:甘、淡，平。归心、脾、肾经。利水渗湿，健脾安神。用于脾虚诸证。
[0010] 山药:甘，平。归脾、肺、肾。益气养阴，补脾肺肾，固精止带。
[0011] 薏苡仁:甘、淡，微寒。归脾、胃、肺经。利水渗湿，健脾，除痹，清热排脓。本品力缓，用量宜大，可作粥食用，为食疗佳品。
[0012] 当归:甘、辛，温。归肝、心、脾经。补血，活血，调经，止痛，润肠。当归既能活血消肿止痛又能补血生肌。
[0013] 白芍:苦、酸、甘，微寒，归肝、脾经。养血调经，平肝止痛，敛阴止汗。
[0014] 元胡:辛、苦，温。归肝、脾、心经。活血，行气，止痛。[0015] 郁金:辛、苦，寒。归肝、胆、心经。活血行气止痛，解郁清心，利胆退黄，凉血。
[0016] 枳实:苦、辛，微寒。归脾、胃、大肠经。破气除痞，化痰消积。
[0017] 陈皮:辛、苦，温。归脾、肺经。理气健脾，燥湿化痰。用于脾胃气滞证。
[0018] 乌贼骨:又名海螵蛸，咸、涩，微温。归肝、肾经。固精止带，收敛止血，制酸止痛，收湿敛疮。用于崩漏下血，吐血，便血，外伤出血，胃痛吐酸。本品主要含碳酸钙，故有良好制酸止痛作用。
[0019] 煅瓦楞:咸，平。归肺、胃、肝经。消痰软坚，化瘀散结。煅用抑酸止痛，用于肝胃不和，胃痛吐酸者。
[0020] 浙贝:苦、寒。归肺，心经。清热化痰，开郁散结。
[0021] 白芨:苦、甘、潘，寒。归肺、胃、肝经。收敛止血，消肿生肌。用于内外诸出血证。
[0022] 仙鹤草:苦、涩，平。归肺、肝、脾经。收敛止血，补虚，消积，止痢，杀虫。
[0023] 五倍子:酸、涩，寒。归肺、大肠、肾经。敛肺降火，涩肠止泻，固精止遗，敛汗止血。还有解毒、消肿、收湿、敛疮、止血等功效。
[0024] 紫珠:苦涩，凉。归肝、肺、胃经。收敛止血，清热解毒。主治各种内外出血、烧烫伤、热毒疮瘍。
[0025] 三七粉:甘、微苦，温。归肝、胃经。化瘀止血，活血定痛。
[0026] 大黄:苦，寒。归脾、胃、大肠、肝、心经。泻下攻积，清热泻火，止血，解毒，活血化瘀。
[0027] 生姜:辛，温。归肺、脾、胃经。发汗解表，温中止呕，温肺止咳。
[0028] 炙甘草:甘，平。归心、肺、脾、胃经。益气补中，清热解毒，祛痰止咳，缓急止痛，调和药性。
[0029] 本发明药物组分的用量也是经过发明人进行大量摸索总结得出的，各原料用量为在下述重量份范围都具有较好的疗效:
党参12~18份黄芪20~40份 白术12~18份
茯苓20~40份山药12~18份 薏苡仁20~40份
当归10~15份白芍12~18份 元胡10~15份
郁金10~15份枳实10~15份 陈皮10~15份
乌贼骨20~40份煅瓦楞20~40份 浙贝12~18份
白芨10-15份仙鹤草12~18份五倍子10-15份 紫珠12~18份三七粉I飞份 大黄3飞份
生姜9~12份 炙甘草6~12份。
[0030] 各原料药的最佳重量配比为:
党参15份黄芪30份白术15份 茯苓30份山药15份薏苡 仁30份 当归12份白芍15份元胡12份 郁金12份枳实12份陈皮12份 乌贼骨30份煅瓦楞30份浙贝15份 白芨12份仙鹤草15份五倍子12份 紫珠15份三七粉3份大黄6份生姜12份炙甘草9份。
[0031 ] 本发明的内服药物可以采用中药制剂的常规方法制备成任何常规内服制剂。例如可以将这些原料药一起水煎，然后浓缩水煎液；研成粉末混合均匀制成散剂冲服。或者水提或醇提得有效成份后，有效成分与崩解剂、润滑剂、粘合剂等辅料以常规的中成药制剂方法制备成任何一种常用口服剂型，如丸剂、片剂、胶囊剂等。但是这些不能用于限制本发明的保护范围。
[0032] 与现有技术相比，本发明的内服中药对应激性溃疡具有良好的防治效果。临床实验证实，该药物能够大幅度降低应激性溃疡大出血的发生机率；对普通消化道病症也有良好的治疗效果，有效率高达89%。
具体实施方式
[0033] 以下通过实施例来进一步阐述本发明药物的制备方法。
[0034] 实施例一(水煎剂):
原料配方:
党参15g 黄芪30g 白术15g 茯苓30g 山药15g 薏苡仁30g 当归12 g 白芍15g 元胡12g 郁金12 g 枳实12g 陈皮12g 乌贼骨30g 煅瓦榜30g 浙贝15g 白芨12g 仙鹤草15g 五倍子12g 紫珠15g 三七粉3g 大黄6g 生姜12g 炙甘草9g。
[0035] 制备步骤:
(1)根据各原料配比筛选出各原料药，除杂后备用；
(2)1500ml的水中放入配方量的原料药，慢煎20分钟，倒出煎液(煎液a，约500ml)，再加入500ml的水，慢煎15分钟，再倒出煎液(煎液b，约500ml)，再加入500ml的水，继续慢煎20分钟，将煎液倒出，与前两次倒出的煎液(煎液a、b)混合搅匀即可，分三次服用(6-8小时一次)，宜热服。
[0036] 实施例二 (颗粒剂):
原料配方:
党参18g 黄芪33g 白术15g 茯苓33g 山药12g 薏苡仁21g 当归15 g 白苟18g 元胡IOg 郁金12 g 枳实15g 陈皮12g 乌贼骨21g 煅瓦榜33g 浙贝15g 白芨15g 仙鹤草18g 五倍子15g 紫珠12g 三七粉3g 大黄3g 生姜9g 炙甘草12g。
[0037] 制备步骤:(1)根据各原料配比筛选出各原料药，除杂后备用；
(2)将各原料混合后，加水煎煮三次(第一次I小时，第二次、三次0.5小时)，混合煎液，减压浓缩得浓缩膏；
(3)浓缩膏干燥后，研成细粉，加入黏合剂、填充剂等，以常规方法压制成颗粒剂。
[0038] 实施例三(片剂):
原料配方:
党参12g 黄芪27g 白术12g 茯苓27g 山药18g 薏苡仁33g 当归12 g 白芍12g 元胡15g 郁金15 g 积实15g 陈皮15g 乌贼骨36g 煅瓦榜27g 浙贝12g 白芨15g 仙鹤草12g 五倍子15g 紫珠18g 三七粉3g 大黄6g 生姜12g 炎甘草6g。
[0039] 制备步骤:
(1)根据各原料配比筛选出各原料药，除杂后备用；
(2)将各原料混合后，加水煎煮三次(第一次I小时，第二次、三次0.5小时)，混合煎液，减压浓缩得浓缩膏；
(3)浓缩膏干燥后，研成粉末，加入辅料，以常规方法压制成片。
[0040] 以下通过临床疗效观察举例来进一步阐述本发明所述药物的有益效果。
[0041] 以实施例一所得水煎剂进行临床实验。
[0042]【预防效果观察】
选取严重创伤或重症病人100例，患者有呕血、胃液常规潜血阳性；黑便，大便潜血阳性；血红蛋白不明原因下降20g/l ;出现上述之一者。
[0043] 随机分为A、B两组(各50人)。A组为对照组，仅采用原有治疗措施；B组为实验组，采取原有治疗措施的同时服用实施例一所述方法制得的水煎剂。
[0044] 观察结果如上表所示，服用本发明药物后，患者出现应激性溃疡的机率降低了24%。
[0045]【治疗效果观察】通过对150例溃疡患者用药后的临床观察及后期随访得出，对于溃疡患者，单独使用本发明药物可以有效地改善患者症状，总有效率达89%。
[0046] 实验人群:
病房或门诊患者，150例，患者有上腹疼痛，呈节律性、周期性疼痛，烧心、反胃、嗳酸、恶心、呕吐等表现。上消化道钡餐透视示:胃或十二指肠溃疡。
[0047] 服用方法:实施例一水煎剂，只要患者启动胃肠功能，能进水即可口服或鼻饲，一周为一疗程。
[0048] 典型病例:1.患者鲁某，女，80岁，2013年10月患脑梗塞住院治疗，期间出现上消化道出血，考虑为应激性溃疡导致，给予常规西药治疗好转后出院，仍需卧床，12月份患者又出现呕吐咖啡色胃内容物，腹泻，质稀，大便褐色，因消化道出血入住我科，患者昏迷，阵发肢体抽搐，鼻饲流质饮食，长期卧床，肢体活动功能受限，住院禁食5天后予本方药鼻饲，一周后大便潜血、胃液潜血均阴性。以后随访未再发生消化道出血。
[0049] 2.患者王某，离休保健干部，90岁，因“心肺复苏术后、呼吸衰竭、肺炎、感染性休克”由保健科于2013年11月转入我科，给予抗感染、纠正休克、床旁血滤等治疗，患者血小板迅速下降，胃管、气管插管内吸出大量鲜血，血红蛋白下降，间断输注血制品，开启胃肠功能的同时给予该方药鼻饲，2周后患者生命体征平稳，2月后患者死亡，本方药的应用延长了患者生命。
[0050] 3.患者李某，男，40岁，慢性胃炎病史，上腹疼痛，呈节律性、周期性疼痛，季节交替时易发作，烧心、反胃、嗳酸，乏力、纳差。上消化道钡餐透视示:胃、十二指肠溃疡。服用上方7剂，症状减轻，14剂后未再发作。 [0051] 4.患者王某，男，45岁，既往胃溃疡、胃出血病史，10天前大便潜血阳性，因劳累、过量饮酒后出现吐血，柏油样便，舌淡无苔脉沉细。服上方3剂后，呕血止，大便颜色变浅，再服7剂后，大便潜血阴性，嘱其饮食调理，禁食酸甜辣刺激之品。
Claims (2)
1.一种防治应激性溃疡的内服中药，其特征在于，由下列重量份的原料药制成该内服药物的有效部分: 党参12~18份 黄芪20~40份 白术12~18份 茯苓20~40份 山药12~18份 薏苡仁20~40份 当归10~15份 白芍12~18份 元胡10~15份 郁金10~15份 枳实10~15份 陈皮10~15份 乌贼骨20~40份 煅瓦楞20~40份 浙贝12~18份 白芨10-15份 仙鹤草12~18份 五倍子10-15份 紫珠12~18份 三七粉I飞份 大黄3飞份 生姜9~12份 炙甘草6~12份。
2.根据权利要求1所述内服中药，其特征在于:各原料药的用量为: 党参15份 黄芪30份 白术15份 茯苓30份 山药15份 薏苡仁30份 当归12份 白芍15份 元胡12份 郁金12份 枳实12份 陈皮12份 乌贼骨30份 煅瓦楞30份 浙贝15份 白芨12份 仙鹤草15份 五倍子12份 紫珠15份 三七粉3份 大黄6份 生姜12份 炎甘草9份。
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| CN104435950A (zh) * | 2014-11-06 | 2015-03-25 | 赵霞 | 一种治疗上消化道出血症的中药止血散及其制备方法 |
| CN104840694A (zh) * | 2015-05-04 | 2015-08-19 | 马清华 | 一种预防和治疗脑血管病应激性溃疡的中药组合物 |
| CN107693751A (zh) * | 2017-11-13 | 2018-02-16 | 郭辉栋 | 一种预防和治疗脑血管病应激性溃疡的中药组合物 |
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| CN104435950A (zh) * | 2014-11-06 | 2015-03-25 | 赵霞 | 一种治疗上消化道出血症的中药止血散及其制备方法 |
| CN104840694A (zh) * | 2015-05-04 | 2015-08-19 | 马清华 | 一种预防和治疗脑血管病应激性溃疡的中药组合物 |
| CN107693751A (zh) * | 2017-11-13 | 2018-02-16 | 郭辉栋 | 一种预防和治疗脑血管病应激性溃疡的中药组合物 |
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