CN105412315A - 一种治疗扁桃体及淋巴结炎症的中药组合物膏剂 - Google Patents
一种治疗扁桃体及淋巴结炎症的中药组合物膏剂 Download PDFInfo
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Abstract
公开了一种中药组合物膏剂，其活性成分由生川乌5～9份、黄柏8～12份组成，该组合物具有清热软坚、活血通络、抗菌消炎的功效。临床用于扁桃体炎、急慢性淋巴结炎的治疗，具有较好的疗效。
Description
技术领域
本发明属于中医药领域，涉及一种治疗扁桃体及淋巴结炎症的中药组合物膏剂。
背景技术
扁桃腺炎是比较常见的一种炎症，发病率较高，一般人群中70％比例出现患者。发的原因不外是感冒、过度疲劳、季节变化及体质不好。扁桃体炎可分为急性扁桃体炎和慢性扁桃体炎。患急性传染病(如猩红热、麻疹、流感、白喉等)后，可引起慢性扁桃体炎，鼻腔有鼻窦感染也可伴发本病。病源菌以链球菌及葡萄球菌等最常见。临床表现为经常咽部不适，异物感，发干、痒，刺激性咳嗽，口臭等症状。扁桃体炎务必要引起重视并及时治疗，扁桃体炎常合并慢性咽炎、急性喉炎、慢性中耳炎等慢性疾病，甚至还可诱发风湿性关节炎、风湿性瓣膜心脏病、心内膜炎、心肌炎、急性肾炎等严重疾病。目前治疗扁桃体炎无非是药物治疗和手术治疗，对于严重、急性的扁桃体炎，常通过手术治疗，但急性炎症期及患急性病、上呼吸道感染和有流行病的患者、造血系统疾病、凝血机能减退、高血压、心脏病、肺结核等患者不宜手术。药物治疗常用药物为阿奇霉素，作为抗生素，阿奇霉素服药后可出现腹痛、腹泻(稀便)、上腹部不适(疼痛或痉挛)、恶心、呕吐等胃肠道反应，还可出现轻至中度腹胀、头昏、头痛及发热、皮疹、关节痛等过敏反应。少数患者可出现一过性中性粒细胞减少、血清氨基转移酶升高。
淋巴结是机体对抗感染、肿瘤，诱导产生获得性免疫应答的主要淋巴器官，在自身免疫性疾病、肿瘤转移等疾病过程中，也发挥重要作用。淋巴结炎是一种感染性疾病，组织学上可以看到一些炎症的表现。淋巴结炎分为急性、慢性以及结核性淋巴结炎。当致病菌从损伤破裂的皮肤或者黏膜侵入、或从其他感染性病灶如疖肿、足癣等处侵入，经组织的淋巴间隙进入淋巴管内，继续扩散到局部淋巴结，就可以导致急性淋巴结炎。急性淋巴结炎的致病菌多为金黄色葡萄球菌或者溶血性链球菌。主要表现为淋巴结肿大、疼痛、红肿以及局部的皮肤温度高于周围正常组织。通过及时治疗，肿大的淋巴结大部分均能消退，少数情况由于疤痕和组织增生，可以遗留小硬结，炎症不复发则一般不会增大。慢性淋巴结炎则多数有明显的感染灶，常表现为局限性的淋巴结肿大，肿大的淋巴结有疼痛及压痛，一般直径不超过2～3cm，抗炎治疗后会缩小。淋巴结炎的治疗通常也是选用抗生素如青霉素、链霉素等进行消炎治疗。
祖国传统医学中有许多药材可以用于扁桃体炎和淋巴结炎治疗的药材，合理选用药材，通过传统工艺制剂，可以达到靶向和快速给药的效果，本发明提供了一种中药组合物膏剂，可用于扁桃体炎和淋巴结炎的治疗。
技术内容
本发明的目的是提供一种中药组合物膏剂，该组合物具有清热软坚、活血通络、抗菌消炎的功效。临床用于扁桃体炎、急慢性淋巴结炎的治疗，具有较好的疗效。
本发明治疗骨扁桃体炎、急慢性淋巴结炎的中药组合物膏剂，其活性成分主要由如下中药材制成：生川乌、黄柏。
本发明治疗骨扁桃体炎、急慢性淋巴结炎的中药组合物膏剂，其活性成分由如下重量份中药配制而成：生川乌5～9份、黄柏8～12份。
本发明治疗骨扁桃体炎、急慢性淋巴结炎的中药组合物膏剂，其制备方法包括如下过程：
(a)将生川乌、黄柏洗净晾干，按照处方量称取后混合粉碎成粗粉，放置备用。
(b)将混合粉碎后的生川乌、黄柏粗粉置入有盖的容器中，加入药料3～5倍重量的冷水进行浸泡，浸泡时间12～20小时，浸泡完成后将药液升温至75～85℃，保持该温度1.5-2小时，然后将药液加热煮沸，再用小火保持微沸腾状态煎煮1～3小时，过滤，取其煎液，然后在药渣中加入开水，在微沸腾状态下再煎煮两次，每次加水量为药料重量的2～3倍，每次煎煮时间为1～2小时，合并煎煮三次的煎液，静置沉淀。使用四层纱布过滤三次，将完成的过滤的煎液在搅动下用小火浓缩为稠膏。
(c)将规定配比重量的麻油加入步骤(b)制得的稠膏中，升温50～60℃，搅拌混合30～60分钟，使其均匀，得到原料药膏，最后将药膏灌入软塑料包装管内即可，每管含药膏10克。
本发明治疗骨扁桃体炎、急慢性淋巴结炎的中药组合物膏剂，其使用方法：治疗扁桃体炎，采用舌下给药，每次1～2克，含服20～30分钟，漱口即可。治疗淋巴结炎，采用病灶给药，清理结节溃烂伤口，消毒，轻轻将软塑料管药膏挤出，涂抹在患病部位即可。视病情严重程度，每日1～3次给药。
本发明治疗骨扁桃体炎、急慢性淋巴结炎的中药组合物膏剂，其药用选材充分考虑了药材的配伍禁忌和组合原理，结合了中医对于扁桃体炎、急慢性淋巴结炎的辩证考量，通过多年的临床验证，也逐步确证了组合物之间的优良的配比范围。
本发明中药组合物，采用膏剂对于扁桃体炎，也是通过舌下给药，利用舌下粘膜吸收膏剂方便快捷的优点，直接将药物通过毛细血管送到病灶部位。对与淋巴结炎的治疗，则充分发挥了靶向给药的优点，直接在病灶处给药，避免内服给药带来的全身毒性。起效快，疗效确切。
本发明中药组合物剂型还可以根据药剂学方法制成外用膏剂、贴剂，内用口服汤剂、片剂、丸剂、散剂、胶囊剂、口服溶液等剂型。
本发明中药组合物膏剂，所用药材的药理基础为：生川乌，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。治疗风寒湿痹、关节疼痛等病症。黄柏，清热。燥湿，泻火，解毒。治热痢，泄泻，消渴，黄疸，痿蹙，梦遗，淋浊，痔疮，便血，亦白带下，骨蒸劳热，目赤肿痛，口舌生疮，疮疡肿毒。黄柏具有多种抗菌抗炎活性，具体如下。1.抗菌作用：体外试验对金黄色葡萄球菌、肺炎球菌、白喉杆菌、草绿色链球菌、痢疾杆菌(宋内氏除外)、溶血性链球菌、脑膜炎球菌、霍乱弧菌、炭疽杆菌均有效或有较强的抑制作用；对枯草杆菌、百日咳杆菌、破伤风杆菌亦有抑制作用；对H37Rv、鸟型结核杆菌无直接抑制作用，但可使菌数减少，但浓度达1％时呈现抑菌作用。在用豚鼠接种人型结核菌(H37Rv)作实验治疗时，口服或注射的疗效均很差。对接种牛型结核菌的豚鼠，黄柏提取物的盐酸结晶物肌肉注射时，有一定疗效。黄柏对结核病人的临床症状及X线检查有好转，且优于黄连。在试管中，黄柏煎剂或浸剂对常见的致病性真菌有不同程度的抑菌作用。其水煎剂不能杀死钩端螺旋体(剂量需较黄连大I倍)。在体外对阴道滴虫也有弱的作用。据报道，黄柏酸碱法提取物制成1∶1黄柏液，用灌肠法可治疗菌痢，一般2-4天可痊愈。黄柏理疗液用直流电导入治疗慢性前列腺炎，总有效率达97.3％。2.抗真菌作用：关黄柏和川黄柏的乙醚浸提物对新型隐球菌和红色发癣菌具有较强的抑菌作用，其作用比制霉菌素强，但对白色念珠菌的抑制作用比制霉菌享弱。
本发明治疗骨扁桃体炎、急慢性淋巴结炎的中药组合物膏剂，所选用的中药材不是简单的功效累加，是在具有药理学配伍基础及实际临床用药经验，形成具有确切功效的临床验方，各组分作用相辅相成，药性相互衬托，相互融合。
主要参考文献：[1]郭江.扁桃体炎的中医治疗[J].医学美学美容，2013，5；[2]王颖，李兆坤，邵红喜.中医药治疗扁桃体炎的研究进展[J].中国中医急症，2000，19(6)：1017；[3]朱智泉，靳晓平.中西医结合治疗舌扁桃体炎疗效观察[J].成都中医药大学学报，2000，23(4)：50；[4]章春娣.扁桃体炎辩证治疗[J].浙江中医药大学学报，2008，32(3)：374；[5]董继业.小儿急性肠系膜淋巴结炎的中药治疗[J].中华中医药杂志，2007，22(11)：816；[6]陈晓琳.急性淋巴结炎的诊断和治疗[J].中国实用乡村医生杂志，2007，14：3.
临床疗效
1.样本信息
样本选择均为多年来接诊患者，共计90例。其中男46例，女44例；男女比例无明显统计学差异。年龄分布在7～64岁之间；其中扁桃体炎患者44例，急性淋巴结炎患者27例，慢性淋巴结炎患者19例。
2.治疗方法
治疗扁桃体炎，采用舌下给药，每次1～2克，含服20～30分钟，漱口清除。
治疗淋巴结炎，采用病灶给药，清理结节溃烂伤口，消毒，轻轻将软塑料管药膏挤出，涂抹在患病部位，厚度0.3～0.5毫米即可。
根据情严重程度，每日1～3次给药。
3.临床结果
数年来使用该组合物膏剂治疗扁桃体炎、急慢性淋巴结炎的有效率不低于85％。证实该组合物膏剂成分、组合及剂型设计合理，具有较好的功效。
4.典型病例
(1)袁某某，女，34岁，患两耳后结块7天，局部皮肤稍红肿，结块推之稍能移动，疼痛阵作，舌苔白腻略显淡黄，脉沉迟略滑。为典型急性淋巴结炎症，治疗采用活血止痛、消肿溃坚、清热解毒。遂用生川乌、黄柏调剂膏药，嘱咐其涂抹患处，每日2次，7日后复查，已愈，症状消失，恢复健康。
(2)李某，女，12岁。2012年7月12日来诊：初起发热、咳嗽、口渴，3天后颌下右下方出现结块，如杏仁大小，局部皮肤出现泛红，结块摸起来比较疼痛，有移动的能力。大概10天后，结块处皮肤红肿穿溃，流出浓汁。15日后，患者腋窝、腹股沟、耳后、锁骨等多处出现结块，肿痛穿溃，浓汁淋漓，难以收口。之前去医院治疗使用阿奇霉素分散片，出现过敏症状，症状愈甚，家人无助带其来我处试试。诊断为风毒所致淋巴结炎症，遂用生川乌、黄柏，配制膏剂，用于祛风解毒、软坚散结法治疗。清创口消毒，涂抹膏剂，每日更换一次，连续使用7日后，脓血停止，伤口收口。复5日，结块化小，逐步流散消失。药不更方，继续治疗5日，彻底痊愈，患者千恩万谢。
(3)刘某，男，45岁，初诊：2012年7月9日，咽喉开始肿痛，伴有高烧，以为感冒，服用板蓝根、感冒颗粒，三天后症状没有减轻，出现咳嗽、咽喉肿痛、声音沙哑、痰多、口干舌苦、吞咽困难。遂来我处求医，观察发现患者扁桃体肿大，粘膜充血，舌苔薄，脉细弱。治疗宜和解少阳，解毒力咽。方用生川乌、黄柏秘制膏剂治疗连续治疗3天，痊愈。
(4)吴某，男，9岁，初诊：2011年5月6日，患者发烧3天，体温38.9℃，咽喉疼痛，不欲饮食。咳嗽、黄痰、鼻塞流涕、声音嘶哑。经查，发现患者咽喉部位粘膜红肿，扁桃体肿大，充血明显，出现分泌物，舌苔薄白，脉浮数。证实为外感风热，导致急性扁桃体发炎。治疗宜疏风清热，利咽消肿。方用生川乌、黄柏秘制膏剂治疗连续治疗3天，咳嗽、黄痰、鼻塞流涕症状消失，声音复回清脆，咽喉和扁桃体部位肿痛消失。
具体实施例
以下结合具体实施实例对本发明的原理和特征进行描述，所举实例只用于解释本发明，并不限定本发明的内容。凡在本发明的精神和原则内，所作的任何修改、替换、改进等，均应包含在本发明的保护范围之内。
实施实例一
(a)将生川乌、黄柏洗净晾干，按照处方量称取生川乌500克、黄柏1200克，混合粉碎成粗粉，放置备用。
(b)将混合粉碎后的生川乌、黄柏粗粉置入有盖的容器中，加入6千克冷水进行浸泡，浸泡时间12小时，浸泡完成后将药液升温至80℃，保持该温度2小时，然后将药液加热煮沸，再用小火保持微沸腾状态煎煮3小时，过滤，取其煎液，然后在药渣中加入开水，在微沸腾状态下再煎煮两次，每次加水量3.5千克，每次煎煮时间为1.5小时，合并煎煮三次的煎液，精制沉淀。使用四层纱布过滤三次，将完成的过滤的煎液在搅动下用小火浓缩为稠膏。
(c)将850克麻油加入步骤(b)制得的稠膏中，升温50℃，搅拌混合30～60分钟，使其均匀，得到原料药膏，最后将药膏灌入软塑料包装管内即可，每管含药膏30克。
实施实例二
(a)将生川乌、黄柏洗净晾干，按照处方量称取生川乌900克、黄柏800克混合粉碎成粗粉，放置备用。
(b)将混合粉碎后的生川乌、黄柏粗粉置入有盖的容器中，加入7千克冷水冷水进行浸泡，浸泡时间20小时，浸泡完成后将药液升温至85℃，保持该温度1.5小时，然后将药液加热煮沸，再用小火保持微沸腾状态煎煮3小时，过滤，取其煎液，然后在药渣中加入开水，在微沸腾状态下再煎煮两次，每次加水3.5千克，每次煎煮时间为2小时，合并煎煮三次的煎液，精制沉淀。使用四层纱布过滤三次，将完成的过滤的煎液在搅动下用小火浓缩为稠膏。
(c)将850克麻油加入步骤(b)制得的稠膏中，升温60℃，搅拌混合60分钟，使其均匀，得到原料药膏，最后将药膏灌入软塑料包装管内即可，每管含药膏30克。
注意事项：1忌辛辣、油腻及刺激性食物。2体虚者慎用；感冒期间暂停服用。3注意药后出现过敏反应，一旦发现栗粒样丘疹，应立即停药。
Claims (3)
1.一种治疗扁桃体炎、急慢性淋巴结炎的中药组合物膏剂，其技术特征在于该膏剂的活性成分由生川乌、黄柏组成。
2.如权利要求1所述治疗骨扁桃体炎、急慢性淋巴结炎的中药组合物膏剂，其活性成分的重量份配比为：生川乌5～9份、黄柏8～12份。
3.如权利要求1所述治疗骨扁桃体炎、急慢性淋巴结炎的中药组合物膏剂。其制备方法包括如下过程：
(a)将生川乌、黄柏洗净晾干，按照处方量称取后混合粉碎成粗粉，放置备用。
(b)将混合粉碎后的生川乌、黄柏粗粉置入有盖的容器中，加入药料3～5倍重量的冷水进行浸泡，浸泡时间12～20小时，浸泡完成后将药液升温至75～85℃，保持该温度1.5-2小时，然后将药液加热煮沸，再用小火保持微沸腾状态煎煮1～3小时，过滤，取其煎液，然后在药渣中加入开水，在微沸腾状态下再煎煮两次，每次加水量为药料重量的2～3倍，每次煎煮时间为1～2小时，合并煎煮三次的煎液，静置沉淀。使用四层纱布过滤三次，将完成的过滤的煎液在搅动下用小火浓缩为稠膏。
(c)将规定配比重量的麻油加入步骤(b)制得的稠膏中，升温50～60℃，搅拌混合30～60分钟，使其均匀，得到原料药膏，最后将药膏灌入软塑料包装管内即可。
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