CN104436056A - 一种治疗肝硬化的中药配方 - Google Patents

一种治疗肝硬化的中药配方 Download PDF

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CN104436056A
CN104436056A CN201410758805.2A CN201410758805A CN104436056A CN 104436056 A CN104436056 A CN 104436056A CN 201410758805 A CN201410758805 A CN 201410758805A CN 104436056 A CN104436056 A CN 104436056A
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rhizoma
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金延春
王玉光
张华�
黄霞
王大鹏
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Affiliated Hospital of University of Qingdao
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Abstract

本发明属于中医中药技术领域，特别涉及一种治疗肝硬化的中药配方，由以下重量份数的中药原料配制而成：柴胡3-5份、蒲公英3-5份、蚤休2-4份、紫花地丁3-5份、土茯苓3-5份、野菊花3-5份、青皮5-8份、香附5-8份、佛手5-8份、玫瑰花5-8份、香橼3-5份、大蓟5-8份、郁金8-12份、莪术5-8份、三棱5-8份、黄药子5-8份、琥珀5-8份、牡蛎5-8份、鹿茸2-4份和沙苑子5-8份，本发明通过中药的调理，活血化瘀、疏肝解郁、行气导滞、软坚散结、暖肾固精、温脾开胃、运水利湿，软化肝脏，治疗肝硬化具有显著的效果。

Description

一种治疗肝硬化的中药配方
技术领域
本发明属于中医中药技术领域，特别涉及一种治疗肝硬化的中药配方。
背景技术
肝硬化是临床常见的慢性进行性肝病，由一种或多种病因长期或反复作用形成的弥漫性肝损害。在我国大多数为肝炎后肝硬化，少部分为酒精性肝硬化和血吸虫性肝硬化。病理组织学上有广泛的肝细胞坏死、残存肝细胞结节性再生、结缔组织增生与纤维隔形成，导致肝小叶结构破坏和假小叶形成，肝脏逐渐变形、变硬而发展为肝硬化。早期由于肝脏代偿功能较强可无明显症状，后期则以肝功能损害和门脉高压为主要表现，并有多系统受累，晚期常出现上消化道出血、肝性脑病、继发感染、脾功能亢进、腹水、癌变等并发症。
发明内容
本发明提供一种治疗肝硬化的中药配方，根据中医学理论，通过中药调理，活血化瘀、疏肝解郁、行气导滞、软坚散结、暖肾固精、温脾开胃、运水利湿，软化肝脏，治疗肝硬化具有显著的效果。
本发明的药物是由以下重量份数的中药为原料药制备获得的：
柴胡3-5份、蒲公英3-5份、蚤休2-4份、紫花地丁3-5份、土茯苓3-5份、野菊花3-5份、青皮5-8份、香附5-8份、佛手5-8份、玫瑰花5-8份、香橼3-5份、大蓟5-8份、郁金8-12份、莪术5-8份、三棱5-8份、黄药子5-8份、琥珀5-8份、牡蛎5-8份、鹿茸2-4份和沙苑子5-8份。
本发明的中药配方，优选为按下述重量份数制备：柴胡4份、蒲公英4份、蚤休2份、紫花地丁4份、土茯苓4份、野菊花4份、青皮6份、香附6份、佛手6份、玫瑰花8份、香橼4份、大蓟8份、郁金10份、莪术6份、三棱6份、黄药子6份、琥珀6份、牡蛎6份、鹿茸2份和沙苑子8份。
将上述各原料药制成本发明药物的具体制备方法是：
按上述重量份数取上述中药原料，香附、琥珀研末备用；将其他药材混合均匀，洗净，加水煎煮2次，每次加水量为药材重量的4～5倍，煎煮2～4h，合并煎液，并加入香附和琥珀粉末，得到本发明的治疗肝硬化的中药汤剂。
用法：成人每次服用150-200mL，每日2次，饭后2小时温服，十二天为一个疗程。
药理分析：
柴胡：苦，凉；微寒，无毒；入肝、胆经；疏肝解郁。
蒲公英：苦、甘、寒；肝、胃经；清热解毒、消肿散结。
蚤休：苦、寒；心、肝经；清热解毒，平喘止咳，熄风定惊；治痈肿，疔疮，瘰疬，喉痹，慢性气管炎，小儿惊风抽搐，蛇虫咬伤。
紫花地丁：苦、辛、寒；心、肝经；清热解毒、凉血消肿，用于痈肿疮毒、乳痈肠痈。
土茯苓：甘、淡、平；肝、胃经；解毒、除湿、通利关节；用于杨梅毒疮、肢体拘挛、痈肿疮毒。
野菊花：苦、辛，微寒；心、肝经；清热解毒；疏风平肝。
青皮：苦、辛、寒；归肝、胆、胃经；有疏肝破气，消积化滞的功效。
香附：味甘，微寒，无毒。入肺、肝、脾、胃四经。理气解郁；调经止痛；安胎。主胁肋胀痛；乳房胀育；疝气疼痛；月经不调；脘腹痞满疼痛；嗳气吞酸，呕恶；经行腹痛；崩漏带下；胎动不安。用于肝郁气滞，胸、胁、脘腹胀痛，消化不良，胸脘痞闷，寒疝腹痛，乳房胀痛，月经不调，经闭痛经。
佛手：味辛、微苦，性温。肝、脾、胃、肺经。能舒肝解郁，理气和中，化痰。
玫瑰花：味甘微苦、性微温，归肝、脾、胃经。疏肝解郁、活血止痛。
香橼：辛、苦、酸、温；入肝、脾、胃经；具有疏肝理气，宽胸化痰，除湿和中；主治胸胁胀痛，咳嗽痰多，脘腹痞痛，食滞呕逆。
大蓟：甘、苦、寒；心、肝、胃经；活血止血、散瘀解毒、消痈。
郁金：辛、苦、寒；入心、肺、肝经；行气解郁，凉血破瘀。治胸腹胁肋诸痛，失心癫狂，热病神昏，吐血，衄血，尿血，血淋，妇女倒经，黄疸。
莪术：辛、苦，温。归肝、脾经；破血行气，消积止痛。用于血瘀腹痛、肝脾肿大、心腹胀痛，积聚，妇女血瘀经闭，跌打损伤作痛饮食积滞。
三棱：辛、苦，平。归肝、脾经。破血行气，消积止痛。用于症瘕痞块，瘀血经闭，食积胀痛。
黄药子：苦，辛，咸，性凉，有小毒。化痰散结，凉血止血。
琥珀：甘、平；入心、肝、膀胱经；镇静安神、活血散瘀、利尿通淋。
牡蛎：味咸；性微寒。重镇安神，潜阳补阴，软坚散结，收敛固涩。用于惊悸失眠，眩晕耳鸣，瘰疬痰核，徵瘕痞块，自汗盗汗，遗精崩带，胃痛泛酸。煅牡蛎收敛固涩。用于自汗盗汗，遗精崩带，胃痛吞酸。
鹿茸：甘、咸、温；如肾、肝经；壮肾阳、益肾精、强筋骨；主治肾虚、头晕、耳聋、目暗、阳痿、滑精、宫冷不孕、羸瘦、神疲、畏寒、腰脊冷痛、筋骨痿软、崩漏带下、阴疽不敛及久病虚损等症。
沙苑子：甘、温；入肾、脾经；暖肾固精、缩尿、温脾开胃摄唾，用于下元虚寒、遗精遗尿、脾胃虚寒。
肝硬化中医古称“水鼓”，中医理论认为，肝硬化多由长期大量过饮酒、过食辛、辣或蛊毒(吸血虫病)、大怒，这些原因都能损伤肝、脾，兹生湿热、导致肝脾两伤、日久致疏泄功能失常，致气血淤滞，血瘀肝脏，而成癥结；日久还可造成肝、脾、肾三脏受损，脾肾阳虚，水液运行输布不利，则鼓胀、症见有饮食减少、不消化、食后腹胀、恶心、精神疲倦、消瘦、耳鸣、腰痛、小便频数、心神不安、失眠、两肋胀痛、肝手掌、黄疸、小便黄、鼓胀。化验肝功不正常，B超肝、脾肿大，有的有丙、乙肝病毒。
本发明的中药配方中，琥珀活血化瘀，利尿通淋；莪术、三棱、黄药子破血行气、消积止痛；辅以青皮、香附、佛手、玫瑰花、郁金、柴胡疏肝解郁、消积止痛、活血、凉血、止血；活肝中之血瘀，行气散瘀，气血顺畅则肝脏软化；配伍野菊花、紫花地丁入肝经，清热解毒，凉血消肿，镇静安神；牡蛎潜阳补阴，软坚散结，收敛固涩；鹿茸、沙苑子壮肾阳、益肾精；肾水足则心神安定，疏泄功能正常，脾强胃健，脾脏运水化湿功能恢复，辅以土茯苓解毒除湿，除肝、脾脏中湿气，软化肝脏；诸药合成，相得益彰，具有活血化瘀、行气导滞、软坚散结、暖肾固精、温脾开胃，运水利湿之功效，治疗肝硬化具有显著的效果。
疗效判断：
肝硬化的主要临床症状有：肝细胞坏死、残存肝细胞结节性再生、结缔组织增生与纤维隔形成，导致肝小叶结构破坏和假小叶形成。1.代偿期：轻度乏力、腹胀、肝脾轻度肿大、轻度黄疸，肝掌、蜘蛛痣。2.失代偿期：乏力、消瘦、面色晦暗，尿少、下肢水肿；食欲减退、腹胀、胃肠功能紊乱甚至吸收不良综合征，肝源性糖尿病，可出现多尿、多食等症状；齿龈出血、鼻衄、紫癜、贫血；蜘蛛痣、肝掌、皮肤色素沉着、女性月经失调、男性乳房发育、腮腺肿大；双下肢水肿、尿少、腹腔积液、肝源性胸腔积液；腹腔积液、胸腔积液、脾大、脾功能亢进、门脉侧支循环建立、食管-胃底静脉曲张，腹壁静脉曲张。
痊愈：上述症状、体征痊愈，饮食及身体机能正常。
好转：上述症状、体征改善，饮食及身体机能改善。
无效：上述症状未改善。
治疗结果：肝硬化患者124例，其中代偿期患者93例，失代偿期患者31例，痊愈107例，占86％，好转11例，占9％，有效率为95％。
附几例病例作进一步说明：
病例1：梁某某，男性，50岁，2014年3月前来就诊，有“乙型病毒性肝炎”病史10年；否认长期饮酒史，否认有疫水疫区接触史；2年前患者无诱因出现乏力、食欲减退，当时无腹痛、腹胀、腹泻，无呕血、黑便、黄疸不适，未引起注意，自觉上述症状逐渐加重，3月前患者自觉腹胀，四肢浮肿，曾到当地中医诊所就诊，近3天自觉上述症状加重，发病以来，胃纳差，小便少许减少，日均600～700ml，大便一天两次，量约200g，色黄，质软，非陶土样，夜间睡眠差，体重近期少许增加。查体：T36.5℃、P100次/分、R20次/分、BP140/90mmHg，无扑翼样震颤，肝病面容，四肢见色素沉着，前胸面颈部见数枚蜘蛛痣，双手见肝掌，全身皮肤黏膜巩膜黄染，患者直立时下腹部饱满，仰卧时腹部两侧膨隆呈蛙腹状，见脐疝，无腹型及胃肠蠕动波，见腹壁静脉曲张，脐以上腹壁静脉血流方向向上，脐以下腹壁静脉血流方向向下，脐周静脉呈海蛇头样，脐周静脉可闻及静脉连续性蠢蠢声，剑突下轻压痛，无反跳痛，肝肋下3cm可触及，质硬，表面欠光滑，脾脏轻度肿大，莫菲氏征阴性，液波震颤阳性，移动性浊音阳性，肝上界位于右侧锁骨中线第五肋间，肝区轻叩痛，双肾区无叩痛，肠鸣音3次/分，诊断为肝硬化。
服用本发明的药物，两个疗程后，全身乏力、食欲减退改善、小便黄症状缓解；四个疗程后，食欲变好、小便不黄，继续服用两个疗程后，肝腹水消除、肝硬化逆转，肝功能逐步恢复，患者抵抗力增强，痊愈，继续服用一个疗程巩固疗效，随访六个月，康复正常。
病例2：刘XX，男性，48岁，慢乙肝病史20年，肝硬化5年，长期间歇服护肝和中药调理治疗，检查乙肝小三阳，HBVDNA103-105coples/ml间，肝功能反复异常，因腹胀，下肢浮肿2月，2013年11月来我院就诊，诊断乙肝肝硬化失代偿期，检查肝功能明显异常，白、球蛋白倒置，低蛋白血症，B超显示高度腹水，HBVDNA9.32×104coples/ml，入院给予护肝、利尿、补充蛋白及拉米夫定抗病毒等综合治疗2周，肝硬化、纤维化改善，但药效减退；给予本发明的中药配方制得的汤剂，两个疗程后，肝硬化、纤维化逆转，低蛋白血症纠正，腹水消失，给予出院，继续服用本发明的中药配方制得的汤剂，每天一次、饭后温服，服用半月停药七天，半年来病情稳定，肝功能正常，HBVDNA＜103coples/ml，生活、工作恢复正常。
具体实施方式
实施例1：
本实施例的治疗肝硬化的中药配方，由以下重量份数的中药原料配制而成：柴胡4份、蒲公英4份、蚤休2份、紫花地丁4份、土茯苓4份、野菊花4份、青皮6份、香附6份、佛手6份、玫瑰花8份、香橼4份、大蓟8份、郁金10份、莪术6份、三棱6份、黄药子6份、琥珀6份、牡蛎6份、鹿茸2份和沙苑子8份。
本发明的中药配方，按下述方法制备：
按上述重量份数取上述中药原料，香附、琥珀研末备用；将其他药材混合均匀，洗净，加水煎煮2次，每次加水量为药材重量的4～5倍，煎煮2～4h，合并煎液，并加入香附和琥珀粉末，得到本发明的治疗肝硬化的中药汤剂。
用法：成人每次服用150-200mL，每日2次，饭后2小时温服，十二天为一个疗程。

Claims (2)

1.一种治疗肝硬化的中药配方，其特征在于由以下重量份数的中药配比而成：柴胡3-5份、蒲公英3-5份、蚤休2-4份、紫花地丁3-5份、土茯苓3-5份、野菊花3-5份、青皮5-8份、香附5-8份、佛手5-8份、玫瑰花5-8份、香橼3-5份、大蓟5-8份、郁金8-12份、莪术5-8份、三棱5-8份、黄药子5-8份、琥珀5-8份、牡蛎5-8份、鹿茸2-4份和沙苑子5-8份。
2.根据权利要求1所述的治疗肝硬化的中药配方，其特征在于由以下重量份数的中药配比而成：柴胡4份、蒲公英4份、蚤休2份、紫花地丁4份、土茯苓4份、野菊花4份、青皮6份、香附6份、佛手6份、玫瑰花8份、香橼4份、大蓟8份、郁金10份、莪术6份、三棱6份、黄药子6份、琥珀6份、牡蛎6份、鹿茸2份和沙苑子8份。
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