CN104189242A - 一种治疗慢性肺源性心脏病的中药 - Google Patents
一种治疗慢性肺源性心脏病的中药 Download PDFInfo
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Abstract
本发明涉及一种治疗慢性肺源性心脏病的中药，包括以下组分的原料药：黄芪20-30份、党参20-30份、丹参20-30份、熟地黄10-15份、当归10-20份、五味子10-15份、桑白皮10-15份、紫菀10-15份、丝瓜络10-15份、赤芍5-10份、杏仁10-15份、白术5-10份、红花10-15份、甘草10-15份。每日1剂，早、晚服用。本发明治疗慢性肺源性心脏病的中药对该病具有非常显著的疗效，结合常规西药治疗，有效率可以达到93.9％。
Description
技术领域
本发明涉及一种治疗慢性肺源性心脏病的中药，属于中医中药领域。
背景技术
慢性肺源性心脏病(chronic cor pulmonale)是由肺组织、肺动脉血管或胸廓的慢性病变引起肺组织结构和功能异常，产生肺血管阻力增加，肺动脉压力增高，使右心扩张、肥大，伴或不伴右心衰竭的心脏病。它可以发生于老年人，但多数是从中年迁延发展而来。老年肺心病大多是从慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)发展而来。它的发病率很高，尤其在吸烟人群中，且呈逐年增高的趋势。
慢性肺源性心脏病有急性加重期和缓解期，急性期多由上呼吸道感染诱发，患者短期内咳嗽、咯痰、气短和(或)喘息加重，痰景增多，呈脓性或粘脓性，可伴发热等炎症明显加重的表现，导致心功能下降出现心衰加重。急性期主要是抗感染、抗呼吸衰竭及抗心衰治疗。肺心病患者在急性发作期过后，临床症状虽有所缓解，但其肺功能仍在继续恶化，并且由于自身防御和免疫功能的降低以及外界各种有害因素的影响，经常反复发作。呈现急性加重期与缓解期交替出现。
目前，治疗肺心病没有特效药，多数以消炎、止咳、平喘或用治疗心脏病的药物进行治疗，但是效果很不理想，极易复发且死亡率高。
发明内容
本发明针对现有对慢性肺源性心脏病在治疗中存在的不足，提供一种治疗慢性肺源性心脏病的中药。
本发明技术方案为，一种治疗慢性肺源性心脏病的中药，以重量份计，包括以下组分的原料药：黄芪20-30份、党参20-30份、丹参20-30份、熟地黄10-15份、当归10-20份、五味子10-15份、桑白皮10-15份、紫菀10-15份、丝瓜络10-15份、赤芍5-10份、杏仁10-15份、白术5-10份、红花10-15份、甘草10-15份。
每日1剂，早、晚服用。
本发明方中以黄芪，丹参、当归、熟地黄为君药，黄芪重用以补益元气、益卫固表，丹参活血通络，祛胸中之瘀血；当归补血活血；熟地黄滋阴补血、益精填髓。党参补脾益肺，增强黄芪补肺气之功；赤芍助丹参加强活血祛瘀；紫菀润肺下气，消痰止咳；桑白皮泻肺平喘，兼可利水以通调水道；白术健脾益气；杏仁祛痰止咳、平喘；上六味共为臣药。五味子收敛肺气，以防肺气耗散，丝瓜络化痰清热，与桑白皮一宣一降，可调理肺之宣发肃降，且能理气调中；红花活血通经，散瘀止痛；与补益之药相配以防滋腻太过，使补而不滞，共为佐药；甘草调和诸药为使药。上诸药共奏补肺益气活血祛瘀之功效。
黄芪:甘，温。归肺、脾经。补气固表，利尿托毒，排脓，敛疮生肌。用于气虚乏力，食少便溏，中气下陷，久泻脱肛，便血崩漏，表虚自汗，气虚水肿，痈疽难溃，久溃不敛，血虚痿黄，内热消渴；慢性肾炎蛋白尿，糖尿病。黄芪乃补气之圣药，其主要药理成分为甙类、多糖、氨基酸及微量元素等，具有增强机体免疫功能、抗衰老、抗病毒等作用。还能抑制血小板聚集，降低血粘度；松弛平滑肌，扩张肺血管，降低血管阻力，改善血循环，尤其是微循环，从而改善心肺功能，促进肺换气，组织换气，改善缺氧。黄芪能增强非特异性免疫功能，显著增加血液中的白细胞总数，促进中性粒细胞及巨噬细胞的吞噬功能和杀菌能力。黄芪中主要是黄芪皂甙，具有强心作用，其作用机理为药物作用于NA-K-ATP酶，从而改善心肌收缩力，且黄芪具有稳定缺血心肌细胞膜、保护线粒体及溶酶体作用，从而保护心肌细胞，减轻心肌细胞损伤程度。黄芪还具有利尿，提高血清蛋自，减少尿蛋白，降低血压，提高免疫功能作用；己有研究显示黄芪治疗慢性肺原性心脏病可降低血粘度，降低血小板聚集，增加细胞变形能力。
党参：味甘；性平；归脾；肺经；健脾补肺、益气生津。主脾胃虚弱、食少便溏、四肢乏力、肺虚喘咳、气短自汗、气微两亏诸证。
丹参：苦，微寒。入心、肝经。功效活血调经，祛瘀止痛，凉血消痈，清心除烦，养血安神。现代药理研究对丹参对心血管系统具有：强心、扩张冠脉、增加心肌血流量、抗血栓形成、改善微循环等作用；对微循环障碍具有改善作用；还可促进组织的修复与再生。
当归：甘、辛，温。归肝、心、脾经。补血活血，调经止痛，润肠通便。用于血虚萎黄，眩晕心悸，月经不调，经闭痛经，虚寒腹痛，肠燥便秘，风湿痹痛，跌扑损伤，痈疽疮疡。酒当归活血通经。用于经闭痛经，风湿痹痛，跌扑损伤。
熟地黄：甘，微温。归肝、肾经。滋阴补血，益精填髓。用于肝肾阴虚，腰膝酸软，骨蒸潮热，盗汗遗精，内热消渴，血虚萎黄，心悸怔忡，月经不调，崩漏下血，眩晕，耳鸣，须发早白。
五味子：酸、甘，温。归肺，心、肾经。收敛固涩，益气生津，补肾宁心。用于久嗽虚喘，梦遗滑精，遗尿尿频，久泻不止，自汗，盗汗，津伤口渴，短气脉虚，内热消渴，心悸失眠。
桑白皮：甘，寒。归肺经。泻肺平喘，利水消肿。用于肺热喘咳，水肿胀满尿少，面目肌肤浮肿。
紫菀：味苦；辛；性温；归肺经；润肺下气；化痰止咳。主咳嗽；肺虚劳嗽；肺痿肺痈；咳吐脓血；小便不利。
丝瓜络：甘，平。归肺、胃、肝经。通经活络，清热化痰。治胸胁疼痛，腹痛，腰痛，睾丸肿痛，肺热痰咳，妇女经闭，乳汁不通，痈肿，痔漏。炭：能止血。治便血、血崩。
白术：苦、甘，温。归脾、胃经。健脾益气，燥湿利水，止汗，安胎。用于脾虚食少，腹胀泄泻，痰饮眩悸，水肿，自汗，胎动不安。
赤芍：苦，微寒。归肝经。清热凉血，散瘀止痛。用于温毒发斑，吐血衄血，目赤肿痛，肝郁胁痛，经闭痛经，症瘕腹痛，跌扑损伤，痈肿疮疡。
杏仁：苦；温；有毒；肺；脾；大肠经；祛痰止咳；平喘；润肠；下气开痹。主外感咳嗽；喘满；伤燥咳嗽；寒气奔豚；惊痫；胸痹；食滞脘痛；血崩；耳聋；疳肿胀；湿热淋证；疥疮；喉痹；肠燥便秘。
红花：辛，温。归心、肝经。活血通经，散瘀止痛。用于经闭，痛经，恶露不行，症瘕痞块，跌扑损伤，疮疡肿痛。
甘草：甘，平。归心、肺、脾、胃经。补脾益气，清热解毒，祛痰止咳，缓急止痛，调和诸药。用于脾胃虚弱，倦怠乏力，心悸气短，咳嗽痰多，脘腹、四肢挛急疼痛，痈肿疮毒，缓解药物毒性、烈性。
下面结合临床治疗情况，进一步说明本发明治疗慢性肺源性心脏病的中药的疗效。
一、资料与方法
1、病例来源：收集自2011年4月一2012年12月期间在省立医院呼吸科住院治疗的慢性肺源性心脏病急性加重期患者108例，其中对照组54例。试验组54例，两组之间的性别、年龄、病情、病程等临床特征无显著差异性。
2、方法：对照组及试验组患者均给予卧床休息、低流量吸氧、抗感染、强心利尿、扩血管、祛痰平喘、维持电解质平衡等常规治疗，试验组在常规治疗基础上加用本发明中药，一天一剂。两组疗程均为28天。治疗期间密切观察并记录两组患者的临床症状、体征，心功能变化，治疗前后的血气分析指标及不良反应。
3、观察指标
①临床疗效：分为显效、有效及无效，显效和有效计入总有效率；
②血气分析指标：主要对比治疗前后Pa02、PaCO2和PH变化；
③并发症及死亡率：观察两个治疗组的并发症及计算死亡率，比较有无差别；
④不良反应：密切观察并记录可能出现的不良反应。
4、统计学方法
所有资料用SPSS 16.0统计软件进行分析，计量资料采用组间t验，计数资料以率来表示，检验采用了x2检验和方差分析。所有的假设检验均采用双侧P检验，P<0.05差异有统计学意义。
二、结果
1.临床疗效：试验组显效占40.3％，有效占53.6％，总有效率为93.9％；对照组显效占30.5％，有效占44.7％,总有效率为75.2％；两组总有效率比较P<0.05，差异有统计学意义。
2.血气分析指标：结果见表1
表1 血气分析指标
3、并发症及死亡率：治疗后两组并发症比较，电解质紊乱无明显差异(P>0.05〕，但心律失常有显著差别(P<O.05),差异有统计学意义。两个观察组中均有1例死亡病例。
4、不良反应：应用本发明中药的试验组未出现不良反应。
由以上临床治疗结果可知，本发明治疗慢性肺源性心脏病的中药对该病具有非常显著的疗效，结合常规西药治疗，有效率可以达到93.9％。
病例1：赵某，男，58岁，2011年6月开始出现心悸、气短、胸闷、咳嗽多痰等症，未及时采取治疗措施，1周后症状加剧，出现气促憋闷，咳嗽不断，胸闷加重。经诊断为慢性肺源性心脏病，使用本发明的中药制剂进行治疗，3周后症状稳定并好转，继续用药2周，症状消失，无复发。
病例2：吴某，男，55岁，就诊时证见咳喘气急，痰白而稀，胸部胀闷，咳喘时加重。经诊断为慢性肺源性心脏病，常规西药治疗2周无效，后服用本发明的中药制剂1周，症状好转，咳喘气急症状缓解，胸部胀闷减轻，继续服药2周，症状完全消失，至今半年无复发。
病例3：刘某，女，45岁，工作劳累后出现气喘急，咳嗽，气紧，痰多且痰黄而稠，舌红、苔黄。伴有胸闷，心悸症状。两周后症状加剧，服用本发明的中药组合物4周，上述症状全部消失，至今半年未见发作。
具体实施方式
实施例1.一种治疗慢性肺源性心脏病的中药，包括以下组分的原料药：黄芪20克、党参20克、丹参20克、熟地黄10克、当归10克、五味子10克、桑白皮10克、紫菀10克、丝瓜络10克、赤芍5克、杏仁10克、白术5克、红花10克、甘草10克。
每日1剂，早、晚服用。
实施例2.一种治疗慢性肺源性心脏病的中药，包括以下组分的原料药：黄芪30克、党参30克、丹参30克、熟地黄15克、当归20克、五味子15克、桑白皮15克、紫菀15克、丝瓜络15克、赤芍10克、杏仁15克、白术10克、红花15克、甘草15克。
每日1剂，早、晚服用。
实施例3.一种治疗慢性肺源性心脏病的中药，包括以下组分的原料药：黄芪25克、党参25克、丹参25克、熟地黄12克、当归15克、五味子12克、桑白皮12克、紫菀12克、丝瓜络12克、赤芍8克、杏仁12克、白术8克、红花12克、甘草12克。
每日1剂，早、晚服用。
实施例4.一种治疗慢性肺源性心脏病的中药，包括以下组分的原料药：黄芪30克、党参25克、丹参26克、熟地黄14克、当归18克、五味子11克、桑白皮14克、紫菀13克、丝瓜络11克、赤芍6克、杏仁14克、白术9克、红花11克、甘草15克。
每日1剂，早、晚服用。
Claims (2)
1.一种治疗慢性肺源性心脏病的中药，其特征是，以重量份计，包括以下组分的原料药：黄芪20-30份、党参20-30份、丹参20-30份、熟地黄10-15份、当归10-20份、五味子10-15份、桑白皮10-15份、紫菀10-15份、丝瓜络10-15份、赤芍5-10份、杏仁10-15份、白术5-10份、红花10-15份、甘草10-15份。
2.如权利要求1所述的一种治疗慢性肺源性心脏病的中药，其特征是，以重量份计，包括以下组分的原料药：黄芪25份、党参25份、丹参25份、熟地黄12份、当归15份、五味子12份、桑白皮12份、紫菀12份、丝瓜络12份、赤芍8份、杏仁12份、白术8份、红花12份、甘草12份。
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