CN104383440A - 一种内服治疗抑郁的药物制剂 - Google Patents

一种内服治疗抑郁的药物制剂 Download PDF

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CN104383440A
CN104383440A CN201410628764.5A CN201410628764A CN104383440A CN 104383440 A CN104383440 A CN 104383440A CN 201410628764 A CN201410628764 A CN 201410628764A CN 104383440 A CN104383440 A CN 104383440A
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rhizoma
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李桂亮
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Zhang Jialing
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Abstract

本发明涉及一种内服治疗抑郁的药物制剂,其由下述原料制备而得,白术、海松子、当归、山药、旋复花根、钩藤、香附、回心草、黄花菜、神曲、玉竹、黄芩、连翘、厚朴、积雪草、栀子、酸枣仁、刺五加、红景天、蒲公英、柴胡、川芎、决明子、淫羊藿、枳实、桑椹子、郁金;依照常规的制药方法制成胶囊、片剂、颗粒等剂型。本发明的药物制剂对抑郁标本兼治、无副作用、价格低廉,制作简便,应用前景广阔。

Description

一种内服治疗抑郁的药物制剂
 
技术领域
本发明属于中药制剂技术领域,具体的,涉及一种内服治疗抑郁的药物制剂及其制备方法。
背景技术
抑郁症或抑郁障碍是全球性主要精神卫生问题,其病因很复杂,至今尚未完全阐明,随着现代社会竟争日趋加剧,人们的心理压力不断增加,情志性疾病成为当代的主要疾病,世界卫生组织指出二十一世纪人们面临的最大疾病是精神疾病。WHO估计,全球患抑郁性疾病者有1.2亿到2亿人。1996年,WHO公布的一项关于“疾病负担”的调查表明:以因病造成伤残(功能缺损)统计,抑郁症占第二位,占全部疾病总负担的6.2%。这类病人情绪低落,联想缓慢,言语动作减少,内心体验十分痛苦,常有轻生念头和自杀行为,据报导国外仅抑郁症自杀死亡率就高达15%。抑郁症终生患病率为6.1-9.5%,约13-20%的人一生曾有过一次或一次以上抑郁体验。随着社会的发展、生活节奏加快,抑郁症呈逐年增长,估计在25年后,将占疾病总负担10%左右。
目前,世界上治疗抑郁症的化学药物主要有,三环抗抑郁症药(TCAS),如去甲替林和去甲丙咪嗪等,单胺氧化酶抑制剂(MAOLS),如苯乙肼,反苯环丙胺和异唑肼等,选择性5-HT再摄取抑制剂(SSRLS),如氟西汀、氟伏草胺、舍曲林等,另一种是锂制剂,锂用来治疗狂躁抑郁症,以及某些经常复发的大抑郁症。这些化学药物常引起许多不良反应,如镇静、失眠、体位性低血压、尿潴留、恶心、呕吐及与食物相互作用。
祖国医学认为郁证是由于情志不舒,气机郁滞所引起的一类病证。主要表现为心情抑郁,情绪不宁,胁肋胀痛,或易怒善哭,以及咽中如有异物梗阻,失眠等各种复杂症状。情志波动失其常度,则气机郁滞,气郁日久不愈,由气及血,变生多端,可以引起多种症状,故有“六郁”之说。即气郁、血郁、痰郁、湿郁、热郁、 食郁等六种,其中以气郁为先,而后湿、痰、热、血、食等诸郁才能形成。 
郁证的发生,是由于情志所伤,肝气郁结,逐渐引起五脏气机不和所致。但主要是肝、脾、心三脏受累以及气血失调而成: 
 (1)郁怒不畅,使肝失条达,气失疏泄,而致肝气郁结。气郁日久可以化火,气滞又可导致血瘀不行。若肝郁及脾,或思虑不解,劳倦伤脾,均能使脾失健运,蕴湿生痰,导致气滞痰郁。若湿浊停留,或食滞不消,或痰湿化热,则可发展为湿郁、食郁、热郁等证。 
 (2)情志不遂,肝郁抑脾,耗伤心气,营血渐耗,心失所养,神失所藏,即所谓忧郁伤神,可以导致心神不安。若久郁伤脾,饮食减少,生化乏源,则气血不足,心脾两虚,郁久化火易伤阴血,累及于肾,阴虚火旺,由此发展可成种种虚损之候。 
郁证因郁怒、思虑、悲哀、忧愁七情之所伤,导致肝失疏泄,脾失运化,心神失常,脏腑阴阳气血失调而成。初病因气滞而挟湿痰、食积、热郁者,则多属实证;久病由气及血,由实转虚,如久郁伤神,心脾俱亏,阴虚火旺等均属虚证。
本发明的目的是提供一种标本兼治、副作用小、安全方便、价格低廉的中药组合物。其目的是为了解决治疗抑郁,克服西药毒副作用大,停药易反复,治疗效果不显著的问题,达到标本兼治的目的。
发明内容
本申请发明人基于现有的治疗抑郁症的药物存在的缺陷,通过对传统中药的研究,并结合辩证论证,多方收集众家之长,寻求最佳治疗方案,从祖国医学宝库中,筛选出安神定志、补虚扶正的天然中药,按中医理论组方,提取精华,使其发挥清心处烦、养阴生津、安神养心之功效,采用纯天然中药原料,经系统研究、科学配伍,结合传统中医技术精心配制成本发明的用于抑郁的中药组合物,对抑郁症有快速治愈的功效。 
为实现上述目的,本发明采用的技术方案如下:
一种内服治疗抑郁的药物制剂,其特征在于其由下述原料制备而得:
白术30-40份、海松子30-40份、当归30-40份、山药30-40份、
旋复花根28-30份、钩藤28-30份、香附28-30份、回心草25-30份、
黄花菜25-30份、神曲25-30份、玉竹20-25份、黄芩20-25份、
连翘20-25份、厚朴18-20份、积雪草18-20份、栀子18-20份、
酸枣仁15-20份、刺五加15-20份、红景天15-20份、蒲公英15-20份、
柴胡10-15份、川芎10-15份、决明子10-15份、淫羊藿10-15份、
枳实8-10份、桑椹子7-9份、郁金5-8份。
优选地:一种用治疗抑郁的中成药,其特征在于其由下述重量配比原料制备而得,
白术40份、海松子40份、当归40份、山药40份、
旋复花根30份、钩藤30份、香附30份、回心草30份、
黄花菜30份、神曲30份、玉竹25份、黄芩25份、
连翘25份、厚朴20份、积雪草20份、栀子20份、
酸枣仁20份、刺五加20份、红景天20份、蒲公英20份、
柴胡15份、川芎15份、决明子15份、淫羊藿15份、
枳实10份、桑椹子9份、郁金8份。
本发明药物可以加一种或多种药学上可接受的载体混合制成任何一种临床上或药学上可接受的剂型,优选口服制剂。以口服给药的方式施用于需要这种治疗的患者时,可将其制成常规的固体制剂,如片剂、胶囊、软胶囊等。
优选地,其制备方法为:
(1) 取白术、海松子、当归、山药、旋复花根、钩藤、积雪草、栀子、酸枣仁、刺五加、红景天、蒲公英、柴胡、川芎按所述比例混合,加相对于混合物8倍量95%的乙醇,回流提取3次,每次2小时,提取液合并,浓缩至密度为1.25g/ml的清膏,80℃烘干,粉碎成粉末,即为复合物A;
(2)取剩余原料药即香附、回心草、黄花菜、神曲、玉竹、黄芩、连翘、厚朴、决明子、淫羊藿、枳实、桑椹子、郁金加5倍水煎煮两次,第一次2小时,第二次1小时,合并两次煎煮液,减压干燥获得密度为1.25g/ml的浸膏,80℃烘干后,粉碎成粉末,即为复合物B;
(3)将复合物A和复合物B混合搅拌均匀,灭菌消毒制得胶囊剂产品。
本发明中药宁心安神,养血补心、安神定志、涤痰开窍滋补肝肾,对抑郁症有确切疗效,副作用小。补气血,养心肾。
用法用量:口服,一次0.5g,一日三次。
注意:高血压患者忌服,温开水送服。服药期间忌食辛辣及寒凉食物,避免情志刺激,生活要有规律。
本发明用于抑郁的中成药优良效果在于: 
1.本发明用于抑郁的中药制剂配伍符合中药“君臣佐使”原则,由纯中药制成,各组分符合药政法规定,利用各味中药的综合作用,不含化工成分,不含激素,无毒副作用,表里兼治,达到更好的滋阴补肾、养心安神作用;
2.该药剂疗程短,总有效率高,愈后不易复发。
3.本发明的工艺简单,降低了生产成本,减轻了患者的经济负担。
 
具体实施方式
实施例1
一种用于治疗抑郁的中成药,其由下述重量配比原料制备而得,
白术30份、海松子30份、当归30份、山药30份、
旋复花根28份、钩藤28份、香附28份、回心草25份、
黄花菜25份、神曲25份、玉竹20份、黄芩20份、
连翘20份、厚朴18份、积雪草18份、栀子18份、
酸枣仁15份、刺五加15份、红景天15份、蒲公英15份、
柴胡10份、川芎10份、决明子10份、淫羊藿10份、
枳实8份、桑椹子7份、郁金5份。
其制备方法为:
(1) 取白术、海松子、当归、山药、旋复花根、钩藤、积雪草、栀子、酸枣仁、刺五加、红景天、蒲公英、柴胡、川芎按所述比例混合,加相对于混合物8倍量95%的乙醇,回流提取3次,每次2小时,提取液合并,浓缩至密度为1.25g/ml的清膏,80℃烘干,粉碎成粉末,即为复合物A;
(2)取剩余原料药即香附、回心草、黄花菜、神曲、玉竹、黄芩、连翘、厚朴、决明子、淫羊藿、枳实、桑椹子、郁金加5倍水煎煮两次,第一次2小时,第二次1小时,合并两次煎煮液,减压干燥获得密度为1.25g/ml的浸膏,80℃烘干后,粉碎成粉末,即为复合物B;
(3)将复合物A和复合物B混合搅拌均匀,灭菌消毒制得胶囊剂产品。
本发明中药宁心安神,养血补心、安神定志、涤痰开窍滋补肝肾,对抑郁症有确切疗效,副作用小。补气血,养心肾。
用法用量:口服,一次0.5g,一日三次。
 
实施例2
一种内服治疗抑郁的药物制剂,其特征在于其由下述原料制备而得:
白术40份、海松子40份、当归40份、山药40份、
旋复花根30份、钩藤30份、香附30份、回心草30份、
黄花菜30份、神曲30份、玉竹25份、黄芩25份、
连翘25份、厚朴20份、积雪草20份、栀子20份、
酸枣仁20份、刺五加20份、红景天20份、蒲公英20份、
柴胡15份、川芎15份、决明子15份、淫羊藿15份、
枳实10份、桑椹子9份、郁金8份。
其制备方法为:
(1) 取白术、海松子、当归、山药、旋复花根、钩藤、积雪草、栀子、酸枣仁、刺五加、红景天、蒲公英、柴胡、川芎按所述比例混合,加相对于混合物8倍量95%的乙醇,回流提取3次,每次2小时,提取液合并,浓缩至密度为1.25g/ml的清膏,80℃烘干,粉碎成粉末,即为复合物A;
(2)取剩余原料药即香附、回心草、黄花菜、神曲、玉竹、黄芩、连翘、厚朴、决明子、淫羊藿、枳实、桑椹子、郁金加5倍水煎煮两次,第一次2小时,第二次1小时,合并两次煎煮液,减压干燥获得密度为1.25g/ml的浸膏,80℃烘干后,粉碎成粉末,即为复合物B;
(3)将复合物A和复合物B混合搅拌均匀,灭菌消毒制得胶囊剂产品。
本发明中药宁心安神,养血补心、安神定志、涤痰开窍滋补肝肾,对抑郁症有确切疗效,副作用小。补气血,养心肾。
用法用量:口服,一次0.5g,一日三次,30天为一个疗程。
 
实施例3
急性毒性实验:应用小鼠60只,雌雄各半,体重30~40g,进行急性毒性试验。小鼠随机分为三组,即对照组和给药组一组,给药二组,每组20只,实验前禁食12小时,给药1组给予本发明的实施例1制备的中成药溶解在水中灌胃给药(灌胃单次给药剂量为50g生药/kg),给药2组给予本发明实施例2制备的中成药,对照组给予等量生理盐水,一天给药2次,给药间隔时间6小时,给药后连续观察14天,并记录小鼠的的毒性反应及死亡数。实验结果表明:与对照组比较,给药后小鼠未见明显差异,实验连续观察14天,小鼠全身状况、饮食、饮水、体重增长均正常。因此本发明的中成药急性毒性极低,临床用药安全。 
长期毒性实验:分别将本发明中药实施例1、实施例2胶囊对小鼠连续用药15周及停药3周后,结果表明:本发明中药对小鼠的毛发、行为、大小便、体重、脏器重量、血象、肝肾功能、血糖、血脂等指标均无明显影响,脏器肉眼没有发现异样变化和组织学检查结果表明,用药15周及停药3周后,小鼠各脏器均无明显改变。说明本发明中药对小鼠长期用药后毒性小,停药后也没有异样反应,应用安全。
 
实施例4
1、临床资料
临床资料选取96例临床患者,随机分为两组:治疗组48例,其中男26例,女22例,年龄17~70岁,病程1年~3年,汉密尔顿抑郁量表评分:24.1±2.2分;对照组48例,其中男25例,女23例,年龄18-69岁,病程1年~3年,汉密尔顿抑郁量表评分:23.9±2.3分;两组患者性别、年龄、病程、汉密尔顿抑郁量表评分资料,经统计学处理,无显著差异(P>0.05),具有可比性。 
病例入选条件(1)根据《中国精神疾病分类与诊断标准》第3版(CCMD-3)的诊断标准[2]确诊为抑郁症的患者;(2)生命体征平稳,神志清楚,能理解抑郁量表内容,具有一定表达能力,能配合治疗者;(3)2周内未服用抗抑郁药物者;(4)中医辩证属于肝肾阴虚者。(症见:情绪抑郁和/或兴趣丧失,失眠多梦,腰膝酸软,五心烦热,头晕耳鸣,舌红苔薄,脉细等)。 
治疗方法 
治疗组给予本发明实施例2制备的药物制剂,对照组以氟西汀(美国礼来制药有限公司生产,商品名称为百忧解,每粒20mg)起始量20mg/d。疗程6周。两组患者就诊时都进行了心理疏导和必要的人文关怀,停用其他辅助用药。 
疗效的评定 
疗效标准于治疗前及治疗1、2、4、6周,采用汉密尔顿抑郁量表、临床疗效总评量表(CGI)评定疗效。于治疗1、2、4、6周用副反应量表(TESS)评定不良反应。 
实验室检查:于治疗前及第6周时进行血、尿常规、心电图、肝、肾功能等检查,于治疗前及治疗结束时测量体质量。Kappa值为0.75-0.88,HAMD减分率≥75%为痊愈,50-74%为显著进步,25-49%为进步,<25%为无效。 
两组治疗前后抑郁量表评分比较,见表1:
                        表1
组别 例次 痊愈 显效 有效 无效 总有效率(%)
治疗组 48 20 12 12 4 91.6
对照组 48 10 19 7 12 75
由上表可见:治疗组的痊愈率和总有效率均明显优于对照组,有显著性差异。
 
实施例5
典型实施例
谢某,男,18岁,学生。由于高考复读压力过大,双眉紧锁,频频叹息,躁动不安,自卑多疑,患者被某地区级医院住院治疗15天,被确诊为癔病。神情忧郁、沉默寡言、失眠、心烦、心悸、舌质红、脉弦数。给予实施例2制备的药物组合物,配合心理疏导,人文关怀,服药3个疗程后,患者的病已痊愈,现在的身体除消化功能不太健全外,其它情况都很正常。
本发明采用的上述各中药组分互作配伍,能发挥其协同治病作用,所用中药原料各成分之间具有药效相互交织相互促进和协调效能,经临床验证,对抑郁有很好的治疗效果,本申请人多年的医疗实践中,治愈的病例数目众多,均取得良好的效果,而且成本低廉,减轻患者的负担,具有广阔的应用前景。

Claims (4)

1.一种内服治疗抑郁的药物制剂,其特征在于,所述药物制剂由下述原料制备而得:
白术、海松子、当归、山药、旋复花根、钩藤、香附、回心草、黄花菜、神曲、玉竹、黄芩、连翘、厚朴、积雪草、栀子、酸枣仁、刺五加、红景天、蒲公英、柴胡、川芎、决明子、淫羊藿、枳实、桑椹子、郁金。
2.根据权利要求1所述的药物制剂,其特征在于,所述药物制剂由如下重量份的原料制备而得:
白术40份、海松子40份、当归40份、山药40份、
旋复花根30份、钩藤30份、香附30份、回心草30份、
黄花菜30份、神曲30份、玉竹25份、黄芩25份、
连翘25份、厚朴20份、积雪草20份、栀子20份、
酸枣仁20份、刺五加20份、红景天20份、蒲公英20份、
柴胡15份、川芎15份、决明子15份、淫羊藿15份、
枳实10份、桑椹子9份、郁金8份。
3.根据权利要求1或2所述的药物制剂,其特征在于,所述药物制剂的制备方法为:
1) 按照重量份取白术、海松子、当归、山药、旋复花根、钩藤、积雪草、栀子、酸枣仁、刺五加、红景天、蒲公英、柴胡、川芎,混合,加相对于混合物8倍量95%的乙醇,回流提取3次,每次2小时,合并提取液,浓缩至密度为1.25g/ml的清膏,80℃烘干,粉碎成粉末,即为复合物A;
2)取剩余原料加5倍水煎煮两次,第一次2小时,第二次1小时,合并两次煎煮液,将煎煮液减压干燥获得密度为1.25g/ml的浸膏,80℃烘干后,粉碎成粉末,即为复合物B;
3)将复合物A和复合物B混合搅拌均匀,灭菌消毒即得。
4.权利要求1-3所述制剂的应用。
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