CN104367955A - 一种治疗顽痹的中药组合物 - Google Patents
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Abstract
本发明公开了一种治疗顽痹的中药组合物,属于中成药领域。其配方药物按重量份的组成为:黄芪25-35份,姜黄8-12份,乌头3-6份、附片8-12份,制川乌4-8份,麻黄3-8份,白芍8-12份,马钱子8-12份,西洋参8-12份,安痛藤8-12份,炙甘草8-12份,鳖甲8-12份,全蝎3-8份,地鳖虫8-12份。本发明以乌头汤合附子汤温经散寒,助阳除湿之功倍增,再以补脾实卫,益气固表之玉屏风汤含于其内,更加祛湿搜风通络的虫药入方,全方刚柔并济,温散宣通;达邪外出,且不伤正。
Description
技术领域
本发明属于一种中成药,具体地说,尤其涉及一种治疗顽痹的中药组合物。
背景技术
“顽痹”类似于现代医学的类风湿性关节炎。以其病情顽固,久治难愈,决非一般祛风燥湿、散寒、通络之品所能奏效。早期治疗得当,病情易于控制,如失治、误治,病情恶化,将留下终身残疾,严重影响患者身心健康和生活质量。顽痹常反复发作。清·陈念祖指出:“深究起源,自当以寒与湿为主。盖风为阳邪,寒与湿为阴邪,阴主闭,闭则郁滞而为痛。是痹不外寒与湿,而寒与湿亦必假风以为帅,寒曰风寒,湿曰风湿,此三气杂合之谈也。”故其发病常因感受风寒湿邪,困郁肌表,阳气被郁,痹而不通,可出现关节疼痛,伴恶寒发热、无汗或汗出不畅。此时只有通过开腠发汗,宣散肌表之风寒湿邪,使阳郁得通,气血畅行,痹痛方止。旷惠桃提出治疗此期当以温阳散寒为要;而温经散寒之药。相对于中药,西药毒副作用较大,病人依从性较差;中药能够显著改善患者自觉症状,作用持久,容易被患者接受。
发明内容
本发明目的是提供一种治疗顽痹的中药组合物,本方具有刚柔并济,温散宣通,达邪外出,且不伤正的优点。
本发明是采用以下技术方案实现的:
一种治疗顽痹的中药组合物,其配方药物按重量份的组成为:黄芪25-35份,姜黄8-12份,乌头3-6份、附片8-12份,制川乌4-8份,麻黄3-8份,白芍8-12份,马钱子8-12份,西洋参8-12份,安痛藤8-12份,炙甘草8-12份,鳖甲8-12份,全蝎3-8份,地鳖虫8-12份。
其配方药物按重量份组成药物优选为:黄芪30份,姜黄10份,乌头5份、附片10份,制川乌6份,麻黄5份,白芍10份,马钱子10份,西洋参10份,安痛藤10份,炙甘草10份,鳖甲10份,全蝎5份,地鳖虫10份。
各中药的药理作用:
黄芪:甘,微温,归脾、肺经。功能主治:补气升阳,益卫固表,利水消肿,托疮生肌,用于脾胃气虚及中气下陷诸证,用于肺气虚及表虚自汗,气虚外感诸证,用于气虚水湿失运的浮肿,小便不利,用于气血不足,疮疡内陷的脓成不溃或溃久不敛,用于气虚血亏的面色萎黄、神倦脉虚等,用于气虚不能摄血的便血、崩漏等,用于气虚血滞不行的关节痹痛、肢体麻木或半身不遂等,用于气虚津亏的消渴证。
姜黄:辛、苦,温,归肝、脾经。功能主治:破血行气,通络止痛,用于血瘀气滞诸证,用于风寒湿痹。
乌头:辛、苦,热,有大毒。归心、肝、肾、脾经。功能主治:祛风除湿,温经止痛。用于风寒湿痹,关节疼痛,心腹冷痛,寒疝作痛,麻醉止痛。生品内服宜慎。不宜与贝母类、半夏、白及、白蔹、天花粉、瓜蒌类同用。
附片:辛、甘,大热;有毒。归心、肾、脾经。功能主治:回阳救逆,补火助阳,散寒止痛。“为回阳救逆第一品药”。主治:用于阴盛克阳,大汗亡阳,吐泻厥逆,肢冷脉微,心腹冷痛,冷痢,脚气水肿,风寒湿痹,宫冷,虚寒吐泻,阴寒水肿,阳虚外感,阴疽疮疡以及一切沉寒痼冷之疾。
制川乌:辛、苦,热;有毒。归心、肝、肾、脾经。同川乌。功能主治:祛风除湿,温经止痛。用于风寒湿痹,乳房疼痛,胸部胀痛,关节疼痛,心腹冷痛,寒疝作痛,麻醉止痛。
麻黄:甘,平,归肺经,功能主治:用于自汗,盗汗。
白芍:苦、酸、甘,微寒,归肝、脾经。功能主治:养血调经,平肝止痛,敛阴止汗,用于血虚或阴虚有热的月经不调,崩漏等证,用于肝阴不足,肝气不舒或肝阳偏亢的头痛、眩晕、胁肋疼痛、脘腹四肢拘挛作痛等证,用于阴虚盗汗,及营卫不和的表虚自汗证。
马钱子:苦、温;有大毒,归肝、脾经。功能主治:通络止痛,散结消肿,用于风湿痹痛,跌打肿腿,用于痈疽肿痛。
西洋参:苦、微甘,寒,归心、肺、胃经。功能主治:补气养阴,清火生津,用于阴虚火旺、肺失清肃的喘咳痰血证,用于热病气阴两伤之烦倦,口渴。
安痛藤:淡、微涩,平。归肺、胃经。功能主治:祛风止痛,舒筋活络,拔脓消肿。用于跌打损伤,扭伤,风湿关节疼痛,骨折,痈疮肿毒。
炙甘草:甘,平,归心、肺、脾、胃经。功能主治:益气补中,清热解毒,祛痰止咳,缓急止痛,调和药性,用于心气不足的心动悸,脉结代,与脾气虚弱的倦怠乏力,食少便溏等,用于痰多咳嗽,用于脘腹及四肢挛急作痛,用于药性峻猛的方剂中,用于热毒疮疡,咽喉肿痛及药物、食物中毒等。
鳖甲:咸,寒,归肝、肾经,功能主治:滋阴潜阳,软坚散结,用于阴虚发热,阴虚阳亢,阴虚风动等证,用于癥瘕积聚,疟母等。
全蝎:辛,平;有毒,归肝经。功能主治:息风止痉,攻毒散结,通络止痛,用于痉挛抽搐,用于疮疡肿毒,瘰疬结核,用于风湿顽痹、顽固性偏正头痛。
地鳖虫:咸,寒;有小毒。归肝经。功能主治:破瘀血,续筋骨。用于筋骨折伤,瘀血经闭,症瘕痞块。
顽痹发生,常与风寒湿邪郁阻经络关节,气血不行,经络不畅有关,故用药以温通宣散为要。附子、乌头为辛温散寒之良药,所用之乌头汤合三附子汤温经散寒,助阳除湿之功倍增;再以补脾实卫,益气固表之玉屏风汤含于其内,更加祛湿搜风通络的虫药入方,则全方刚柔并济,温散宣通;达邪外出,且不伤正。
以下结合临床试验及典型病例对本发明进一步说明。
一、临床试验:
1、临床资料:选取患有风湿病专科门诊病例200例,其中男92例,女113例,年龄最小19岁,最大64岁,平均48.68岁。病程最长15年,最短3个月,平均病程7.12年。全部病人随机分为治疗组100例,对照组100例。两组年龄病程均无差异,具有可比性。
2、诊断标准:
参照卫生部药政局颁布的《中药新药治疗痹病临床研究指导原则》制定,(1)临床治愈:症状全部消失,功能活动恢复正常,主要理化检查指标正常;(2)显效:全部症状消除或主要症状消除,关节功能基本恢复,能参加正常工作或劳动,理化检查指标基本正常;(3)有效:主要症状基本消除,主要关节功能基本恢复或有明显进步,生活不能自理转为能够自理,或者失去工作劳动能力转为劳动工作能力基本恢复,主要理化检查指标有所改善;(4)无效:和治疗前相比较,各方面均无改善。
3、治疗方法:治疗组服用本发明,每日一剂,两周为一疗程;对照组口服甲氨喋呤7.5mg,每周1次,双氯芬酸钠缓释片0.1g,每日3次。
治疗结果:治疗组愈显率、有效率分别为35%、96%,对照组分别为18%、73%,两组比较均有显著性差异,如表所示,本发明疗效明显优于对照组的疗效。
组别 | 临床治愈 | 显效 | 有效 | 无效 | 总有效率 |
治疗组 | 14 | 21 | 61 | 4 | 96% |
对照组 | 8 | 10 | 55 | 27 | 73% |
二、病例:
赵某,男,60岁,2012年10月31日就诊。主诉:周身关节肌肉疼痛、畏寒,反复30余年。就诊时全身肌肉关节酸痛,畏寒,胸闷,稍感气促,神疲困倦,多梦,头昏沉,纳可,夜尿频多,5~6次,大便可;舌淡,苔薄白,脉细弦。诊断:顽痹,肝肾亏虚,脾阳不振。治拟补肝肾,温脾阳,施以独活寄生汤加味。服用本方14剂。
复诊:服药后胸闷气促、头昏沉等症消失,周身疼痛较前减轻,但仍畏寒,夜尿1~2次;舌淡苔薄白,脉细涩。上方去附片、白芍、麻黄,加重安痛藤至30克,加重黄芪至30克;再14剂后已无明显畏寒感,周身疼痛明显缓解,继续自服后方。
邹某,女,57岁,2013年3月7日就诊。主诉:双上肢关节肿痛6年,右手指关节变形1年,加重1周。就诊时双上肢关节僵硬疼痛,屈伸不利,麻木,双手晨僵,夜间及受凉后明显,右手中指关节呈梭形肿胀,周身酸胀,胁肋不适,伴乏力腿软,尿频,色淡黄,大便2天1次;舌淡苔白稍腻,脉细涩。检查:类风湿因子:82.7IU/mL,C反应蛋白:22.0mg/L,抗“O”:487IU/mL,血沉:89mm/h;双手X片提示“类风湿性关节炎改变”。
复诊:肩手疼痛、双手晨僵、胁肋不适、乏力腿软、尿频及苔腻等症状明显好转。但觉双膝、双足跟疼痛,不肿,行走胀痛,双下肢酸软无力,双肩稍痛,手麻,偶有潮热汗出,喜冷饮,纳可,寐欠安,二便调,舌红苔白,脉细弦。检查:类风湿因子:47.4IU/mL,C反应蛋白:12.0mg/L,抗“O”:364U/mL,血沉:51mm/h。以上方去麻黄、姜黄、制川乌,加骨碎补15克、天麻10克、青蒿10克、海风藤20克、僵蚕10克。14剂后诉周身关节已无明显疼痛,活动自如,仅遇天凉稍感晨僵,未见明显潮热盗汗。
具体实施方式
下面结合实施例对本发明作进一步说明。
实施例1:
黄芪25份,姜黄8份,乌头3份、附片8份,制川乌4份,麻黄3份,白芍8份,马钱子8份,西洋参8份,安痛藤8份,炙甘草8份,鳖甲8份,全蝎3份,地鳖虫8份。
实施例2:
黄芪30份,姜黄10份,乌头5份、附片10份,制川乌6份,麻黄5份,白芍10份,马钱子10份,西洋参10份,安痛藤10份,炙甘草10份,鳖甲10份,全蝎5份,地鳖虫10份。
实施例3
黄芪35份,姜黄12份,乌头6份、附片12份,制川乌8份,麻黄8份,白芍12份,马钱子12份,西洋参12份,安痛藤12份,炙甘草12份,鳖甲12份,全蝎8份,地鳖虫12份。
Claims (2)
1.一种治疗顽痹的中药组合物,其特征在于,其配方药物按重量份的组成为:黄芪25-35份,姜黄8-12份,乌头3-6份、附片8-12份,制川乌4-8份,麻黄3-8份,白芍8-12份,马钱子8-12份,西洋参8-12份,安痛藤8-12份,炙甘草8-12份,鳖甲8-12份,全蝎3-8份,地鳖虫8-12份。
2.根据权利要求1所述的治疗顽痹的中药组合物,其特征在于:其配方药物按重量份组成药物为:黄芪30份,姜黄10份,乌头5份、附片10份,制川乌6份,麻黄5份,白芍10份,马钱子10份,西洋参10份,安痛藤10份,炙甘草10份,鳖甲10份,全蝎5份,地鳖虫10份。
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