CN105031243B - 一种调脂清肝中药制剂 - Google Patents
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Abstract
本发明公开了一种调脂清肝中药制剂,目的是治疗血脂异常和脂肪肝;本发明按照重量单位份计的配方为:制何首乌1~200g,生山楂1~75g,干荷叶1~75g,骨碎补1~25g,地骨皮1~25g,制黄精1~50g,广陈皮1~25g,紫丹参1~25g,川赤芍1~50g,炒黄芩1~50g,福泽泻1~50g。该中药制剂对血脂异常和脂肪肝及高粘血症有很好的治疗效果;服用简单,临床应用安全可靠。
Description
技术领域
本发明涉及一种调脂清肝中药制剂。
背景技术
现有的许多用于治疗血脂异常和脂肪肝的中药,普遍存在的问题是在近期与远期疗效的病变缓解率、防治有效率、临床治愈率等方面的效果均不够理想。还有少数患者用药后出现了肝功异常等不良反应。
发明内容
本发明目的是提供一种对血脂异常和脂肪肝有很好的治疗效果、且无不良反应的中药制剂。
本发明提供的一种调脂清肝中药制剂,按照重量单位份计的配方为:制何首乌1~200g,生山楂1~75g,干荷叶1~75g,骨碎补1~25g,地骨皮1~25g,制黄精1~50g,广陈皮1~25g,紫丹参1~25g,川赤芍1~50g,炒黄芩1~50g,福泽泻1~50g。
所述中药制剂能制成胶囊、片剂或水丸剂。
所述中药胶囊的制法: 将各味中药混合后粉碎成细末,过一百目筛后,采用不破坏药效的红外线、紫外线或钴60等适当方法消毒,以延长保存期;然后装入胶囊,每粒胶囊内装0.5克中药散剂。胶囊胶囊应忌摄氏40度以上高温消毒。
所述中药片剂的制法:将各味中药混合后粉碎成细末,过一百目筛后,采用钴60的方法灭菌,按2010年版《中华人民共和国药典一部》附录1制剂通则附录1D片剂的规定加入经灭菌处理的医用淀粉和药粉,压片,包糖衣,每片重量0.5克。
所述中药水丸剂的制法:将各味中药混合后粉碎成细末,过一百目筛后,采用钴60的方法灭菌,水泛为丸,每10丸重1.5克。
作为一种优选方案,制作100千克本发明调脂清肝中药制剂的具体配方为:制何首乌20g,生山楂10g,干荷叶10g,骨碎补5g,地骨皮5g,制黄精10g,广陈皮5g,紫丹参5g,川赤芍10g,炒黄芩10g,福泽泻10g。
作为一种优选方案,所述中药制剂的具体配方为:制何首乌18g,生山楂8g,干荷叶8g,骨碎补3g,地骨皮3g,制黄精8g,广陈皮3g,紫丹参3g,川赤芍8g,炒黄芩8g,福泽泻8g。
作为一种优选方案,所述中药制剂的具体配方为:制何首乌16g,生山楂6g,干荷叶6g,骨碎补2g,地骨皮2g,制黄精6g,广陈皮2g,紫丹参2g,川赤芍6g,炒黄芩6g,福泽泻6g。
本发明所用中药的药性如下:
制何首乌性温味苦、甘、涩,归肝、心、肾经。功能肝肾,益精血,乌须发,强筋骨功效。用于血虚萎黄,眩晕耳鸣,须发早白,腰膝酸软,肢体麻木,崩漏带下,久疟体虚;高血脂。主要适宜人群是脂肪肝,三高,肥胖症,失眠,脱发,少白头及亚健康人群。
生山楂酸、甘、微温。归脾、胃、肝经,消食健胃,行气散瘀,有扩张冠状动脉、舒张血管、降脂降压强心的作用。
干荷叶性平味苦涩,归心、肝、脾经。功能清热解暑,升清阳,凉血减肥。
骨碎补性温味苦。归肾、肝经。功能补肾强骨,续伤止痛。用于肾虚腰痛,耳鸣耳聋,牙齿松动,跌扑闪挫,筋骨折伤;外治斑秃,白癜风。动物实验表明骨碎补水煎剂降低骨关节病变率。心肌细胞有起搏作用。可明显预防血清胆甾醇、甘油三酯的上升,并能防止主动脉壁粥样硬化斑块的形成。可减轻卡那霉素对耳蜗的毒性作用。能抑制葡萄球菌的生长。
地骨皮性寒味甘,归肺、肝、肾经。功能凉血除蒸,清肺降火。用于阴虚潮热、骨蒸盗汗、肺热咳嗽、咯血、衄血。内热消渴。实验表明地骨皮有降血脂、降血糖和降血压作用。对伤寒杆菌、甲型副伤寒杆菌与弗氏痢疾杆菌有较强的抑制作用,但对金黄色葡萄球菌无作用;对流感亚洲甲型京科68-1病毒株有抑制其细胞病变作用;对结核杆菌为低效抑菌药物。
制黄精性平味甘,归肺,脾,肾经。功能滋肾润肺,补脾益气。药理研究发现,黄精具有降血压、抑制高血糖,以及防治动脉粥样硬化与肝脂肪浸润等药理作用。制黄精抗病原微生物,抗疲劳,抗氧化,抗病毒;抗心肌缺血;延缓衰老。治疗冠心病、高脂血症、糖尿病、慢性肝炎、白细胞减少症、免疫功能低下症。
广陈皮性温味苦、辛,归肺、脾经。功能理气健脾,燥湿化痰,利水通便。 主治脾胃不和,胸脘胀满,食少吐泻;痰湿阻肺,咳嗽痰多,胸膈满闷,头目眩晕;水肿,小便不利,大便秘结;乳痈疥癣,中鱼蟹毒、酒毒。
紫丹参性微寒味苦,归心、肝经。功能活血祛瘀,通经止痛,清心除烦,凉血消痈。药理表明紫丹参强心加强心肌收缩力、改善心脏功能。扩张血管改善微循环,抗血栓形成 改善血液流变学特性使血粘度降低。促进组织的修复与再生作用。保肝 改善肝微循环。抗菌,对体外的葡萄球菌、大肠杆菌、变性杆菌有抑制作用。
川赤芍:赤芍味苦,微寒。归肝经。具有清热凉血,散瘀之功能。用于温毒发斑,吐血衄血,目赤肿痛,肝郁胁痛,经闭痛经,瘕腹痛,跌打损伤,痈肿疮疡等症。忌与藜芦配伍同用。 性微寒味苦,归肝经。功能清热凉血,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。
炒黄芩:性寒味苦,归肺、胆、脾、大肠、小肠经。功能:清热燥湿,泻火解毒,止血,安胎。用于湿温、暑温胸闷呕恶,湿热痞满,泻痢,黄疸,肺热咳嗽,高热烦渴,血热吐衄,痈肿疮毒,胎动不安。
福泽泻性寒味甘、淡,入肾、膀胱、三焦、小肠经。 功能利水渗湿。现代医学研究,泽泻可降低血清总胆固醇及三酰甘油含量,减缓动脉粥样硬化形成;泽泻及其制剂现代还用于治疗内耳眩晕症、血脂异常、遗精、脂肪肝及糖尿病等。
本发明所述中药制剂用于临床的情况如下:采用本发明中药制剂治疗183例脂肪肝、高血脂患者,并与采用“降脂灵片”治疗的61例对照组进行临床对比观察,总共244例脂肪肝、高血脂患者,按照随机单盲法以3:1的比例分为治疗组和对照组。治疗组口服本发明中药制剂每日三次,每次2.0克;对照组每次口服降脂灵片5片,每日三次;疗程均为2个月。
临床观察:脂肪肝、高血脂患者右上腹不适、头昏等常见症状,治疗前及疗程结束时做肝脾B超、血脂、血糖等检查;结果表明,本发明中药制剂对脂肪肝、高血脂患者常见症状的疗效为显效61例,有效87例,总有效率80.87%;而对照组的总有效率为49.91%。
诊断依据:采用中华医学会肝脏病学会脂肪肝和酒精性肝病学组2010年《非酒精性肝病诊疗指南(修订版)》、《酒精性肝病诊疗指南(修订版)》症状可有乏力、消化不良、肝区隐痛、肝脾肿大等非特异性症状及肝掌体征,血清转氨酶和Y-谷氨酰转肽酶水平可有轻至中度增高(小于5倍正常值上限),通常以丙氨酸氣基转移酶(ALT)增高为主;肝脏影像学表现符合弥漫性脂肪肝的影像学诊断标准(B超和CT)。排除嗜肝病毒现症感染以及药物,中毒性肝损伤和自身免疫性肝病等。
效果评价:参考酒精性、非酒精性脂肪性肝病诊疗指南及《中药新药治疗脂肪肝的临床指导原则》制定。临床治愈:肝功能、血脂指标转为正常,肝/脾CT比值>1.0或/和B超肝脏形态及回声恢复正常,小血管显示尚清;有效:肝功能、血脂指标仍高于正常值,但较治疗前降低,CT影像学仍有异常改变,但较治疗前好转,肝/脾CT值上升或改善1个等级或/和B超肝脏后缘回声衰减减轻;无效:肝功能、血脂指标、CT或/和B超肝影像学异常与治疗前相比无改善或加重。
制备中药散剂胶囊:制作100千克本发明中药胶囊的具体配方为:制何首乌20g,生山楂10g,干荷叶10g,骨碎补5g,地骨皮5g,制黄精10g,广陈皮5g,紫丹参5g,川赤芍10g,炒黄芩10g,福泽泻10g。将各味中药混合后粉碎成细末,过一百目筛后装入胶囊,每胶囊内装0.5克中药散剂。胶囊采用不破坏药效的红外线、紫外线或钴60等适当方法消毒,以延长保存期。胶囊应忌摄氏40度以上高温消毒。
本发明中药制剂应按年龄、体重、体质强弱确定用量。用于治疗时,每日服三次,约每八小时服一次;成人每次服用量为2.0~2.5克,青少年为1.5~2.0克。每个疗程为2个月,一个疗程后一般临床症状基本消除。服药期内忌吸烟饮酒,忌食味精与动物肝脏、海产品等。
本发明中药何山调脂清肝胶囊的适用对象为脂肪肝及高脂血症疾病。患者使用后,复发率极低;本发明中药散剂胶具有增强机体免疫力、降低血脂、血压和血糖、降低血液粘稠度、清除生理病理糟粕在体内蓄积酿乱的功效;实践证明,本发明中药健肝清脂胶囊能够明显改善或消除病人的自觉症状,显著改善肝脏病变,降低高胆固醇、高甘油三脂血症,长期服用无毒副作用和明显不良反应。
典型病例1:王某,男,71岁,2015年1月1日因:“右上腹不适、头昏、高血脂11年,加重1天”就诊。患者于11年前右上腹不适、头昏同时化验血脂高,B超示脂肪肝。就诊时血压120/80mmHg,血脂化验TC9.1mmol/L,TG6.1mmol/L,B超、CT检查均为中度脂肪肝。给予保肝、调脂等治疗后效果不明显,加用本发明中药胶囊(制何首乌20g,生山楂10g,干荷叶10g,骨碎补5g,地骨皮5g,制黄精10g,广陈皮5g,紫丹参5g,川赤芍10g,炒黄芩10g,福泽泻10g),每次服用量为2.0克,每日服3次,每8小时服一次。一个疗程后观察疗效:血压为121/82mmHg,血脂化验TC5.7mmol/L,TG2.7mmol/L。右上腹不适、头昏等症状缓解,并且近三周来未再发作。B超、CT检查均为轻度脂肪肝。
本发明的有益效果:
本发明中药制剂具有调脂清肝的功效,采用本发明中药制剂口服治疗脂肪肝和血脂异常,疗效明显,显著改善肝脏病变,降低高胆固醇、高甘油三脂血症,药物使用方便,患者使用药物依从性好,安全,效价比高。
具体实施方式
下面通过实施例来进一步说明本发明,但不局限于以下实施例。
实施例1:
一种调脂清肝胶囊,由下列重量份的原料组成:制何首乌20g,生山楂10g,干荷叶10g,骨碎补5g,地骨皮5g,制黄精10g,广陈皮5g,紫丹参5g,川赤芍10g,炒黄芩10g,福泽泻10g。
将上述各药物原料混合后粉碎,过一百目筛后装入胶囊,每胶囊内装0.5克中药散剂。
(1)临床资料:治疗血脂异常伴脂肪肝患者901例,按抽签法随机分为2组,其中450例(对照组)服用降脂灵片,每次5片,每日3次,同时口服保肝药复方甘草酸苷片,每次2片,每日3次,约每八小时服一次;共服用2个月为1个疗程。451例(治疗组)服用本发明调脂清肝胶囊,每次5片,每日3次,约每八小时服一次,共服用2个月为1个疗程。
(2)疗效评定标准:A临床治愈:肝功能、血脂指标转为正常,肝/脾CT比值>1.0或/和B超肝脏形态及回声恢复正常,小血管显示尚清;
B有效:肝功能、血脂指标仍高于正常值,但较治疗前降低,CT影像学仍有异常改变,但较治疗前好转,肝/脾CT值上升或改善1个等级或/和B超肝脏后缘回声衰减减轻;
C无效:肝功能、血脂指标、CT或/和B超肝影像学异常与治疗前相比无改善或加重。
(3)治疗结果:
经过一个疗程后,对照组与治疗组依次为:治愈268例,301例;好转58例,100例;未愈124例,50例;总有效率72.40%,88.91%;治疗组的治愈率、总有效率均明显好于对照组(P<0.05 )。
实施例2:
一种调脂清肝丸,由下列重量份的原料组成: 制何首乌18g,生山楂8g,干荷叶8g,骨碎补3g,地骨皮3g,制黄精8g,广陈皮3g,紫丹参3g,川赤芍8g,炒黄芩8g,福泽泻8g。将上述各药物原料混合后粉碎,过一百目筛后采用钴60方法灭菌,水泛为丸,每10丸重1.5克。
(1)病例:治疗血脂异常患者167例,诊断依据和疗效评定标准同上。其中男91例,女76例;年龄41-79岁;病程1—16年。
(2)治疗方案:给予本实施例制备的调脂清肝丸口服,每次服用量为1.5克(10粒),每日服3次,每8小时服一次,连续服用2个月为一个疗程,用1个疗程后观察疗效。
(3)疗效评定标准:同实施例1。
(4)治疗结果:治疗1个疗程后,167例血脂异常患者临床治愈105例,有效43例,无效19例,总有效率88.62%。未发现患者发生药物不良反应。
实施例3:
一种调脂清肝片,由下列重量份的原料组成: 制何首乌16g,生山楂6g,干荷叶6g,骨碎补2g,地骨皮2g,制黄精6g,广陈皮2g,紫丹参2g,川赤芍6g,炒黄芩6g,福泽泻6g。将上述各药物原料混合后粉碎,过一百目筛后采用钴60方法灭菌,按国标药剂片剂制作要求加入0.01克经灭菌处理的医用淀粉和0.49克上述中药药粉,压片,包糖衣,每片重量0.5克。
(1)病例:197例入选脂肪肝患者
(2)治疗方案:给予本实施例制备的调脂清肝片口服,每次服用量为1.6克(4片),每日服3次,每8小时服一次,连续服用2个月为一个疗程,连用1个疗程后观察疗效。
(3)疗效评定标准:同实施例1。
(4)治疗结果:治愈106人,好转73人,未愈18人,总有效率90.86%。
临床观察表明,采用本发明治疗血脂异常和脂肪肝的调脂清肝中药制剂(包括胶囊剂、丸剂、片剂)口服治疗脂肪肝和高脂血症,疗效明显,药物使用方便,患者使用药物依从性好,安全,效价比高。
Claims (8)
1.一种调脂清肝中药制剂,其特征在于:按照重量单位份计的配方为: 制何首乌16~20g,生山楂6~10g,干荷叶6~10g,骨碎补2~5g,地骨皮2~5g,制黄精6~10g,广陈皮2~5g,紫丹参2~5g,川赤芍6~10g,炒黄芩6~10g,福泽泻6~10g。
2.根据权利要求1所述的调脂清肝中药制剂,其特征在于:所述中药制剂能制成胶囊、片剂或水丸剂。
3.根据权利要求2所述的调脂清肝中药制剂,其特征在于:所述胶囊的制法:将各味中药混合后粉碎成细末,过一百目筛后,采用不破坏药效的红外线、紫外线或钴60的方法消毒,以延长保存期;然后装入胶囊,每粒胶囊内装0.5克中药散剂。
4.根据权利要求2所述的调脂清肝中药制剂,其特征在于:所述片剂的制法:将各味中药混合后粉碎成细末,过一百目筛后,采用钴60的方法灭菌,按2010年版《中华人民共和国药典一部》附录1制剂通则附录1D片剂的规定加入经灭菌处理的医用淀粉和药粉,压片,包糖衣,每片重量0.5克。
5.根据权利要求2所述的调脂清肝中药制剂,其特征在于:所述水丸剂的制法:将各味中药混合后粉碎成细末,过一百目筛后,采用钴60的方法灭菌,水泛为丸,每10丸重1.5克。
6.根据权利要求1所述的调脂清肝中药制剂,其特征在于:所述中药制剂的具体配方为:制何首乌20g,生山楂10g,干荷叶10g,骨碎补5g,地骨皮5g,制黄精10g,广陈皮5g,紫丹参5g,川赤芍10g,炒黄芩10g,福泽泻10g。
7.根据权利要求1所述的调脂清肝中药制剂,其特征在于:所述中药制剂的具体配方为:制何首乌18g,生山楂8g,干荷叶8g,骨碎补3g,地骨皮3g,制黄精8g,广陈皮3g,紫丹参3g,川赤芍8g,炒黄芩8g,福泽泻8g。
8.根据权利要求1所述的调脂清肝中药制剂,其特征在于:所述中药制剂的具体配方为:制何首乌16g,生山楂6g,干荷叶6g,骨碎补2g,地骨皮2g,制黄精6g,广陈皮2g,紫丹参2g,川赤芍6g,炒黄芩6g,福泽泻6g。
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