CN104826016B - A kind of pharmaceutical composition and its preparation method and application for treating the proliferation of mammary gland - Google Patents

A kind of pharmaceutical composition and its preparation method and application for treating the proliferation of mammary gland Download PDF

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CN104826016B
CN104826016B CN201510245798.0A CN201510245798A CN104826016B CN 104826016 B CN104826016 B CN 104826016B CN 201510245798 A CN201510245798 A CN 201510245798A CN 104826016 B CN104826016 B CN 104826016B
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parts
preparation
radix
mammary gland
pharmaceutical composition
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CN104826016A (en
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夏隆江
何宇新
刘蓓
李昌龙
张翠媚
蔡玉贵
吴彬
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CHENGDU COMFAITH PHARMACEUTICAL Co Ltd
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CHENGDU COMFAITH PHARMACEUTICAL Co Ltd
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Abstract

The invention discloses a kind of pharmaceutical compositions for treating the proliferation of mammary gland, it is the preparation that is prepared of bulk pharmaceutical chemicals for including following weight proportion: 5~15 parts of the root of Dahurain angelica, 1~11 part of radix bupleuri, 10~20 parts of rhizoma atractylodis macrocephalae, 1~11 part of Radix Angelicae Sinensis, 15~25 parts of calcined oyster shell, 3~13 parts of curcuma zedoary, 10~20 parts of Poria cocos, 1~11 part of ramulus cinnamomi, 7~17 parts of seaweed, 5~15 parts of Cortex Magnoliae Officinalis, 7~17 parts of Radix Astragali, 3~13 parts of wrinkled giant hyssop, 5~15 parts of tangerine seed, 7~17 parts of thallus laminariae, 1~9 part of radix gentianae, 1~9 part of myrrh, 1~5 part of olibanum, 3~13 parts of trigone, 1~9 part of cimicifugae foetidae, 10~20 parts of water tinctorius seed, 1~7 part of leech, 10~20 parts of luffa, 3~13 parts of peach kernel, 5~15 parts of STEVIA REBAUDIANA, 1~11 part of excrementum pteropi, Prunella vulgaris 3~ 13 parts, 10~20 parts of radix scrophulariae, 1~5 part of dragon's blood, 7~17 parts of fritillaria thunbergii.The symptom of the proliferations of mammary gland such as breast pain, lump in breast, nipple discharge, menstrual disorder, the change of feelings will can be effectively relieved in pharmaceutical composition of the present invention, it is efficient high, it can treat the I phase proliferation of mammary gland, the II phase proliferation of mammary gland and the III phase proliferation of mammary gland, provide a kind of new medicament selection for clinic.

Description

A kind of pharmaceutical composition and its preparation method and application for treating the proliferation of mammary gland
Technical field
The present invention relates to a kind of pharmaceutical compositions and its preparation method and application for treating the proliferation of mammary gland.
Background technique
The proliferation of mammary gland refers to breast epithelium and proliferation of fibrous tissue, the regression of breast tissue conduit and newborn leaflet in structure Venereal disease becomes and the growth of progressive connective tissue.The proliferation of mammary gland is a kind of disease that gynaecology is common, is apt to occur in 25-39 years old or so Middle-aged women shows as the different parts single-shot or multiple of breast because this period is women's sexual function most vigorous period Ground grows some lumps, and soft, obscure boundary is movable, is often accompanied by different degrees of pain, especially the moon is premenstrual, labor When mood swings such as tired rear or angry (Chinese medicine claim the obstruction of the circulation of vital energy), lump increases, and pain aggravates, and lump obviously contracts after menstruation Small, pain relief, pain is usually distending pain, seldom tingle.
The proliferation of mammary gland can be divided into the I phase proliferation of mammary gland, the increasing of II phase mammary gland and the III phase proliferation of mammary gland according to light and heavy degree.Mammary gland is small Leaf hyperplasia (the I phase proliferation of mammary gland) is the initial stage hyperplasia of mammary gland, is mostly occurred at 25~35 years old, and Symptoms are lighter, belongs to mammary gland increasing Raw I phase;Adenosis of mammary glands (mammary duct ectasia, the II phase proliferation of mammary gland) is the further development of mammary gland initial stage hyperplasia, from leaflet Hyperplasia development is mainly in 30~45 years old to mammary duct ectasia, referred to as adenosis of mammary glands, and Symptoms are serious, belong to the proliferation of mammary gland II phase.Attention is easily caused, often cures relatively difficult, obstinate causes depression, leads to exacerbation of symptoms.Seriously cause Endocrine disturbance, such as the dark and gloomy serial reaction of irregular menstruation, insomnia and dreamful sleep, the colour of skin;(mammary duct ectasia merges for cystic hyperplasia Endothelial cell proliferation disease, the III phase proliferation of mammary gland) be mammary gland second phase hyperplasia further development, mostly occur at 40~55 years old, symptom table It is now very serious, the canceration rates of three phase hyperplasia 70% or more, the three phase proliferation of mammary gland often to patient bring depression and The feared state of mind.
Therefore, the drug of the research and development effectively treatment proliferation of mammary gland is very necessary.
Summary of the invention
The purpose of the present invention is to provide a kind of pharmaceutical compositions and its preparation method and application for treating the proliferation of mammary gland.
The present invention provides a kind of pharmaceutical compositions for treating the proliferation of mammary gland, it is by the bulk pharmaceutical chemicals system of following weight proportion Preparation made of standby:
5~15 parts of the root of Dahurain angelica, 1~11 part of radix bupleuri, 10~20 parts of rhizoma atractylodis macrocephalae, 1~11 part of Radix Angelicae Sinensis, 15~25 parts of calcined oyster shell, cowherb 3~13 parts of art, 10~20 parts of Poria cocos, 1~11 part of ramulus cinnamomi, 7~17 parts of seaweed, 5~15 parts of Cortex Magnoliae Officinalis, 7~17 parts of Radix Astragali, wrinkled giant hyssop 3 ~13 parts, 5~15 parts of tangerine seed, 7~17 parts of thallus laminariae, 1~9 part of radix gentianae, 1~9 part of myrrh, 1~5 part of olibanum, trigone 3~13 Part, 1~9 part of cimicifugae foetidae, 10~20 parts of water tinctorius seed, 1~7 part of leech, 10~20 parts of luffa, 3~13 parts of peach kernel, STEVIA REBAUDIANA 5 ~15 parts, 1~11 part of excrementum pteropi, 3~13 parts of Prunella vulgaris, 10~20 parts of radix scrophulariae, 1~5 part of dragon's blood, 7~17 parts of fritillaria thunbergii.
Preferably, it is the preparation being prepared by the bulk pharmaceutical chemicals of following weight proportion: 7~13 parts of the root of Dahurain angelica, radix bupleuri 3~9 Part, 12~18 parts of rhizoma atractylodis macrocephalae, 3~9 parts of Radix Angelicae Sinensis, 17~23 parts of calcined oyster shell, 5~11 parts of curcuma zedoary, 12~18 parts of Poria cocos, ramulus cinnamomi 3~9 Part, 9~15 parts of seaweed, 7~13 parts of Cortex Magnoliae Officinalis, 9~15 parts of Radix Astragali, 5~11 parts of wrinkled giant hyssop, 7~13 parts of tangerine seed, 9~15 parts of thallus laminariae, dragon 2~8 parts of gallbladder grass, 2~8 parts of myrrh, 2~4 parts of olibanum, 5~11 parts of trigone, 2~8 parts of cimicifugae foetidae, 12~18 parts of water tinctorius seed, leech 2~6 parts, it is 12~18 parts of luffa, 5~11 parts of peach kernel, 7~13 parts of STEVIA REBAUDIANA, 3~9 parts of excrementum pteropi, 5~11 parts of Prunella vulgaris, profound Join 12~18 parts, 2~4 parts of dragon's blood, 9~15 parts of fritillaria thunbergii.
It is further preferred that it is the preparation being prepared by the bulk pharmaceutical chemicals of following weight proportion: 10 parts of the root of Dahurain angelica, radix bupleuri 6 Part, 15 parts of rhizoma atractylodis macrocephalae, 6 parts of Radix Angelicae Sinensis, 20 parts of calcined oyster shell, 8 parts of curcuma zedoary, 15 parts of Poria cocos, 6 parts of ramulus cinnamomi, 12 parts of seaweed, 10 parts of Cortex Magnoliae Officinalis, 12 parts of Radix Astragali, 8 parts of wrinkled giant hyssop, 10 parts of tangerine seed, 12 parts of thallus laminariae, 5 parts of radix gentianae, 5 parts of myrrh, 3 parts of olibanum, 8 parts of trigone, 5 parts of cimicifugae foetidae, 15 parts of water tinctorius seed, 4 parts of leech, 15 parts of luffa, 8 parts of peach kernel, 10 parts of STEVIA REBAUDIANA, 6 parts of excrementum pteropi, 8 parts of Prunella vulgaris, radix scrophulariae 15 Part, 3 parts of dragon's blood, 12 parts of fritillaria thunbergii.
Wherein, it is active constituent that the preparation, which is by the medicinal powder of each bulk pharmaceutical chemicals, the water of bulk pharmaceutical chemicals or/and ethanol extract, In addition the preparation that common auxiliary material or complementary ingredient are prepared in pharmacy or health care product.
Further, the preparation is oral preparation.
Further, the oral solution, granule, capsule, paste, pill, medicinal tea, tablet or powder.
The present invention also provides the preparation methods of aforementioned pharmaceutical compositions, it includes the following steps:
(1) each bulk pharmaceutical chemicals are weighed by weight ratio;
(2) after each bulk pharmaceutical chemicals directly being crushed or are added water or/and ethyl alcohol to extract, be added in pharmacy common auxiliary material or Complementary ingredient, be prepared into common preparation to get.
The present invention also provides purposes of the aforementioned pharmaceutical compositions in the drug of the preparation treatment proliferation of mammary gland.
Wherein, the drug is to treat hyperplasia of mammary glands, adenosis of mammary glands or the drug of cystic hyperplasia.
Wherein, the drug be treatment breast pain, lump in breast, nipple discharge, menstrual disorder, feelings will it is unsmooth and/or The drug of dysphoria.Water tinctorius seed dissipates blood and disappears lump in the abdomen in we, clearing stagnation and killing pain, inducing diuresis for removing edema, Yong Yu abdominal mass and lump, goiter, benefit Monarch drug in a prescription is thought in water detumescence.Thallus laminariae, seaweed, calcined oyster shell resolving hard lump are apt to solution goiter, scrofula carbuncle swells;Prunella vulgaris mass dissipating and swelling eliminating, is used for Acute mastitis, breast illness, swollen breasts, above be ministerial drug altogether.Rhizoma Atractylodis Macrocephalae, Poria cocos, Cortex Magnoliae Officinalis, wrinkled giant hyssop, radix gentianae Li Shui are except dry, with wet in solving; Leech, luffa clearing and activating the channels and collaterals eliminate airsetting stasis;Radix bupleuri, which rises, to be lifted, priming to human upper;The root of Dahurain angelica, astragalus swell dispersing analgesic, Mitigate pain caused by the proliferation of mammary gland;Radix Angelicae Sinensis, curcuma zedoary, ramulus cinnamomi, olibanum, myrrh, trigone, peach kernel, excrementum pteropi, dragon's blood Huoxue San " The stasis of blood promotes hyperplasia position to restore;Tangerine seed, radix scrophulariae, fritillaria thunbergii detoxicating and resolving a mass, to eliminate the lump formed in the proliferation of mammary gland;Sweetleaf Chrysanthemum reconciliation flavour of a drug, above each taste medicine is adjutant altogether.Cimicifugae foetidae has liter the benefits of lifting, and makes to make medicine in the drug effect uplink side of being.
Breast pain, lump in breast, nipple discharge, menstrual disorder, feelings will can be effectively relieved in pharmaceutical composition of the present invention Change the symptom of the proliferations of mammary gland such as (feelings will unsmooth, dysphoria), it is efficient high, it can treat the I phase proliferation of mammary gland, II phase mammary gland Hyperplasia and the III phase proliferation of mammary gland provide a kind of new medicament selection for clinic.
Obviously, above content according to the present invention is not being departed from according to the ordinary technical knowledge and customary means of this field Under the premise of the above-mentioned basic fundamental thought of the present invention, the modification, replacement or change of other diversified forms can also be made.
The specific embodiment of form by the following examples remakes further specifically above content of the invention It is bright.But the range that this should not be interpreted as to the above-mentioned theme of the present invention is only limitted to example below.It is all to be based on above content of the present invention The technology realized all belongs to the scope of the present invention.
Specific embodiment
The preparation of 1 present composition of embodiment
Root of Dahurain angelica 10g, radix bupleuri 6g, rhizoma atractylodis macrocephalae 15g, Radix Angelicae Sinensis 6g, calcined oyster shell 20g, curcuma zedoary 8g, Poria cocos 15g, ramulus cinnamomi 6g, seaweed 12g, Cortex Magnoliae Officinalis 10g, Radix Astragali 12g, wrinkled giant hyssop 8g, tangerine seed 10g, thallus laminariae 12g, radix gentianae 5g, myrrh 5g, olibanum 3g, trigone 8g, cimicifugae foetidae 5g, water tinctorius seed 15g, leech 4g, luffa 15g, peach kernel 8g, STEVIA REBAUDIANA 10g, excrementum pteropi 6g, Prunella vulgaris 8g, radix scrophulariae 15g, blood Exhaust 3g, fritillaria thunbergii 12g.
Above-mentioned raw materials medicine is taken, is added water to cook 3 times, decocts 30min every time, merges decocting liquid to get decoction.
The preparation of 2 present composition of embodiment
Root of Dahurain angelica 7g, radix bupleuri 3g, rhizoma atractylodis macrocephalae 12g, Radix Angelicae Sinensis 3g, calcined oyster shell 17g, curcuma zedoary 5g, Poria cocos 12g, ramulus cinnamomi 3g, seaweed 9g, 7~13g of Cortex Magnoliae Officinalis, Radix Astragali 9g, wrinkled giant hyssop 5g, tangerine seed 7g, thallus laminariae 9g, radix gentianae 2g, myrrh 2g, olibanum 2g, trigone 5g, cimicifugae foetidae 2g, water tinctorius seed 12g, leech 2g, luffa 12g, peach kernel 5g, STEVIA REBAUDIANA 7g, excrementum pteropi 3g, Prunella vulgaris 5g, radix scrophulariae 12g, blood Exhaust 2g, fritillaria thunbergii 9g.
Above-mentioned raw materials medicine is taken, by each component crushed after being dried, sieve takes the medicinal powder of certain particle size, and bag bubble is made after mixing Medicinal tea or powder, per packed amount 2g.
The preparation of 3 present composition of embodiment
Take bulk pharmaceutical chemicals: root of Dahurain angelica 13g, radix bupleuri 9g, rhizoma atractylodis macrocephalae 18g, Radix Angelicae Sinensis 9g, calcined oyster shell 23g, curcuma zedoary 11g, Poria cocos 18g, osmanthus Branch 9g, seaweed 15g, Cortex Magnoliae Officinalis 13g, Radix Astragali 15g, wrinkled giant hyssop 11g, tangerine seed 13g, thallus laminariae 15g, radix gentianae 8g, myrrh 8g, olibanum 4g, Trigone 11g, cimicifugae foetidae 8g, water tinctorius seed 18g, leech 6g, luffa 18g, peach kernel 11g, STEVIA REBAUDIANA 13g, excrementum pteropi 9g, Prunella vulgaris 11g, radix scrophulariae 18g, dragon's blood 4g, fritillaria thunbergii 15g.
Above-mentioned raw materials medicine is taken, is added water to cook 3 times, decocts 30min every time, merges decocting liquid, is concentrated, stands, takes supernatant, It is concentrated again, appropriate amount of auxiliary materials is added, prepares paste, oral solution or syrup.
The preparation of 4 present composition of embodiment
Take bulk pharmaceutical chemicals: root of Dahurain angelica 5g, radix bupleuri 1g, rhizoma atractylodis macrocephalae 10g, Radix Angelicae Sinensis 1g, calcined oyster shell 15g, curcuma zedoary 3g, Poria cocos 10g, ramulus cinnamomi 1g, it seaweed 7g, Cortex Magnoliae Officinalis 5g, Radix Astragali 7g, wrinkled giant hyssop 3g, tangerine seed 5g, thallus laminariae 7g, radix gentianae 1g, myrrh 1g, olibanum 1g, trigone 3g, rises Numb 1g, water tinctorius seed 10g, leech 1g, luffa 10g, peach kernel 3g, STEVIA REBAUDIANA 5g, excrementum pteropi 1g, Prunella vulgaris 3g, radix scrophulariae 10g, Dragon's blood 1g, fritillaria thunbergii 7g.
Above-mentioned raw materials medicine is taken, is first extracted 2 times with 75% alcohol reflux, alcohol extract is collected, the dregs of a decoction add water decoction 2 times, close And decocting liquid mixes after alcohol extract is recycled ethyl alcohol with decocting liquid, is concentrated, and appropriate amount of auxiliary materials is added and prepares granule, tablet or glue Wafer.
The preparation of 5 present composition of embodiment
Take bulk pharmaceutical chemicals root of Dahurain angelica 15g, radix bupleuri 11g, rhizoma atractylodis macrocephalae 20g, Radix Angelicae Sinensis 11g, calcined oyster shell 25g, curcuma zedoary 13g, Poria cocos 20g, Ramulus cinnamomi 11g, seaweed 17g, Cortex Magnoliae Officinalis 15g, Radix Astragali 17g, wrinkled giant hyssop 13g, tangerine seed 15g, thallus laminariae 17g, radix gentianae 9g, myrrh 9g, olibanum 5g, trigone 13g, cimicifugae foetidae 9g, water tinctorius seed 20g, leech 7g, luffa 20g, peach kernel 13g, STEVIA REBAUDIANA 15g, excrementum pteropi 11g, summer Withered grass 13g, radix scrophulariae 20g, dragon's blood 5g, fritillaria thunbergii 17g.
Above-mentioned raw materials medicine is taken, is added water to cook 3 times, decocting liquid is merged, concentration is added appropriate amount of auxiliary materials and prepares buccal tablet.
Beneficial effects of the present invention are proved below by way of specific pharmacodynamics test.
Therapeutic effect of the pharmaceutical composition of the present invention of test example 1 to the proliferation of mammary gland
Accept standard for medical treatment: accepting for medical treatment through diagnosis is the I phase proliferation of mammary gland, the II phase proliferation of mammary gland, III phase proliferation of mammary gland patient 238 Example.The symptom that patient is likely to occur includes breast pain, lump in breast, nipple discharge, menstrual disorder, (feelings will is or not the change of feelings will Freely, dysphoria).
Treatment method: the decoction prepared using the embodiment of the present invention 1, daily 2 times, each 20ml concentrate, every 1ml Concentrate is equivalent to 1.6g raw medicinal herbs, and treatment time 15-30 days.
Treatment results:
Table 1
Table 2
Table 3
Table 4
Table 5
The experiment results show that pharmaceutical composition of the present invention can be effectively relieved breast pain, lump in breast, nipple discharge, Menstrual disorder, feelings will change the symptom of the proliferations of mammary gland such as (feelings will unsmooth, dysphoria), efficient high, can treat I phase mammary gland Hyperplasia, the II phase proliferation of mammary gland and the III phase proliferation of mammary gland, potential applicability in clinical practice are good.

Claims (12)

1. a kind of pharmaceutical composition for treating the proliferation of mammary gland, it is characterised in that: it is prepared by the bulk pharmaceutical chemicals of following weight proportion Made of preparation:
5~15 parts of the root of Dahurain angelica, 1~11 part of radix bupleuri, 10~20 parts of rhizoma atractylodis macrocephalae, 1~11 part of Radix Angelicae Sinensis, 15~25 parts of calcined oyster shell, curcuma zedoary 3~ 13 parts, 10~20 parts of Poria cocos, 1~11 part of ramulus cinnamomi, 7~17 parts of seaweed, 5~15 parts of Cortex Magnoliae Officinalis, 7~17 parts of Radix Astragali, wrinkled giant hyssop 3~13 Part, 1~9 part of radix gentianae, 1~9 part of myrrh, 1~5 part of olibanum, 3~13 parts of trigone, rises 5~15 parts of tangerine seed, 7~17 parts of thallus laminariae Numb 1~9 part, 10~20 parts of fructus polygoni orientalis, 1~7 part of leech, 10~20 parts of luffa, 3~13 parts of peach kernel, STEVIA REBAUDIANA 5~15 Part, 1~11 part of excrementum pteropi, 3~13 parts of Prunella vulgaris, 10~20 parts of radix scrophulariae, 1~5 part of dragon's blood, 7~17 parts of fritillaria thunbergii.
2. pharmaceutical composition according to claim 1, it is characterised in that: it is prepared by the bulk pharmaceutical chemicals of following weight proportion Made of preparation:
7~13 parts of the root of Dahurain angelica, 3~9 parts of radix bupleuri, 12~18 parts of rhizoma atractylodis macrocephalae, 3~9 parts of Radix Angelicae Sinensis, 17~23 parts of calcined oyster shell, curcuma zedoary 5~11 Part, 12~18 parts of Poria cocos, 3~9 parts of ramulus cinnamomi, 9~15 parts of seaweed, 7~13 parts of Cortex Magnoliae Officinalis, 9~15 parts of Radix Astragali, 5~11 parts of wrinkled giant hyssop, tangerine 7~13 parts of core, 9~15 parts of thallus laminariae, 2~8 parts of radix gentianae, 2~8 parts of myrrh, 2~4 parts of olibanum, 5~11 parts of trigone, cimicifugae foetidae 2~8 Part, 12~18 parts of fructus polygoni orientalis, 2~6 parts of leech, 12~18 parts of luffa, 5~11 parts of peach kernel, 7~13 parts of STEVIA REBAUDIANA, five spirits 3~9 parts of rouge, 5~11 parts of Prunella vulgaris, 12~18 parts of radix scrophulariae, 2~4 parts of dragon's blood, 9~15 parts of fritillaria thunbergii.
3. pharmaceutical composition according to claim 2, it is characterised in that: it is prepared by the bulk pharmaceutical chemicals of following weight proportion Made of preparation: 10 parts of the root of Dahurain angelica, 6 parts of radix bupleuri, 15 parts of rhizoma atractylodis macrocephalae, 6 parts of Radix Angelicae Sinensis, 20 parts of calcined oyster shell, 8 parts of curcuma zedoary, 15 parts of Poria cocos, osmanthus Branch 6 parts, 12 parts of seaweed, 10 parts of Cortex Magnoliae Officinalis, 12 parts of Radix Astragali, 8 parts of wrinkled giant hyssop, 10 parts of tangerine seed, 12 parts of thallus laminariae, 5 parts of radix gentianae, 5 parts of myrrh, 3 parts of olibanum, 8 parts of trigone, 5 parts of cimicifugae foetidae, 15 parts of fructus polygoni orientalis, 4 parts of leech, 15 parts of luffa, 8 parts of peach kernel, 10 parts of STEVIA REBAUDIANA, five 6 parts of clever rouge, 8 parts of Prunella vulgaris, 15 parts of radix scrophulariae, 3 parts of dragon's blood, 12 parts of fritillaria thunbergii.
4. pharmaceutical composition according to any one of claims 1 to 3, it is characterised in that: it is by the medicine of each bulk pharmaceutical chemicals Powder, the water of bulk pharmaceutical chemicals or/and ethanol extract are active constituent, in addition common auxiliary material or the preparation of complementary ingredient in pharmacy Made of preparation.
5. pharmaceutical composition according to any one of claims 1 to 3, it is characterised in that: the preparation is oral preparation.
6. pharmaceutical composition according to claim 4, it is characterised in that: the preparation is oral preparation.
7. pharmaceutical composition according to claim 5, it is characterised in that: the oral preparation is oral solution, granule, glue Wafer, paste, pill, tablet, medicinal tea or powder.
8. pharmaceutical composition according to claim 6, it is characterised in that: the oral preparation is oral solution, granule, glue Wafer, paste, pill, tablet, medicinal tea or powder.
9. the preparation method of claim 1~8 any one described pharmaceutical composition, it is characterised in that: it includes the following steps:
(1) each bulk pharmaceutical chemicals are weighed by weight ratio;
(2) after each bulk pharmaceutical chemicals directly crush or add water or/and ethyl alcohol extract, common auxiliary material or auxiliary in pharmacy is added Property ingredient, is prepared into common preparation.
10. purposes of the claim 1~8 any one described pharmaceutical composition in the drug of the preparation treatment proliferation of mammary gland.
11. purposes according to claim 10, it is characterised in that: the drug is treatment hyperplasia of mammary glands, mammary gland gland Disease or the drug of cystic hyperplasia.
12. purposes described in 0 or 11 according to claim 1, it is characterised in that: the drug is that treatment breast pain, breast are swollen Block, nipple discharge, menstrual disorder, feelings will is unsmooth and/or the drug of dysphoria.
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