CN105582393A - Medicine for treating hepatic encephalopathy - Google Patents
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- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/185—Magnoliopsida (dicotyledons)
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Abstract
The invention relates to a medicine for treating the hepatic encephalopathy. The medicine is prepared from, by weight, 13 parts of rhizoma imperatae, 8 parts of herba artemisiae scopariae, 7 parts of semen plantaginis, 8 parts of radix aristolochiae heterophyllae, 9 parts of radix ranunculi ternati, 20 parts of Philippine violet herb and 9 parts of cortex magnoliae officinalis. Rhizoma imperatae cools blood to stop bleeding, removes heat to promote salivation and induces diuresis for treating stranguria; herba artemisiae scopariae clears away wet heat and treats jaundice; semen plantaginis reduces fever and achieves diuresis, resolves dampness and stops diarrhea, and improves eyesight and eliminates phlegm; radix aristolochiae heterophyllae dispels wind and relieves pain, and clears away heat and promotes urination; radix ranunculi ternate removes toxin, and reduces phlegm and resolves masses; Philippine violet herb clears away heat and toxic materials, and cools blood and eliminates swelling; cortex magnoliae officinalis promotes qi circulation to remove stasis, eliminates dampness and removes fullness, and calms the adverse-rising energy and relieves asthma. The medicine materials are used together for achieving the functions of nourishing yin and suppressing the excessive yang, and relieving dizziness and inducing resuscitation. It is proved through clinical experiments that the hepatic encephalopathy can be safely and effectively treated.
Description
Technical field
The present invention relates to a kind of Chinese medicine, be specifically related to a kind of medicine that is used for the treatment of hepatic encephalopathy.
Background technology
Hepatic encephalopathy (HE) claim again hepatic coma, be that serious hepatopathy causes, taking metabolic disorder as basisThe syndrome of central nervous system function imbalance is one of performance of the serious exhaustion of hepatocyte function. There is urgencyProperty and chronic encephalopathy point. Cardinal symptom feature sickens for consciousness, behavioral disorder and stupor, and subclinical orRecessive hepatic encephalopathy refers to without obviously clinical manifestation and biochemical abnormal, only can be with meticulous intelligent test and (or)The hepatic encephalopathy that electricity physiological detection just can be made diagnosis. Portal-systemic encephalopathy is the most common, generation mainMechanism is portal hypertension, has offshoot circulation to exist, thereby make a large amount of portal veins between portal vein and vena caveWalk around liver stream human circulation. Hepatic encephalopathy belongs to the models such as the traditional Chinese medical science " stupor ", " acute febrile ", " liver-syncope "Farmland.
The cause of disease
The protopathy that causes hepatic encephalopathy have severe viral hepatitis, severe poisoning hepatitis, DILD,After Acute Fatty Liver During Pregnancy, various cirrhosis, door-vena systemica bypass, primary carcinoma of liver and other moreThe whole latter stage of unrestrained hepatopathy, and the most common with liver cirrhosis patient generation hepatic encephalopathy, account for 70%. Bring out liver propertyThe factor of encephalopathic is a lot, as UGB, high-protein diet, arrange potassium diuresis in a large number, put ascites, makesWith sleeping peacefully, calm, arcotic, constipation, uremia, infection or operation wound etc. These factors substantially allTo pass through: 1. make neural toxin produce the poisonous effect that increases or improve neural toxin. 2. improve brain tissue pairThe sensitiveness of various toxicants. 3. increase the permeability of blood cerebrospinal fluid barrier and bring out encephalopathic.
Clinical manifestation
Because of the urgency difference slow and inducement of the degree of the type of hepatopathy, hepatocellular damage, onset poor to some extentDifferent. Owing to causing the underlying diseases difference of hepatic encephalopathy, its clinical manifestation is more complicated, changeable also, early stageThe variability of symptom is this sick feature. But also have the performance of its general character: be reflected as neuropsychic symptom andSign. The performance of existing former liver underlying diseases, has again its distinctive clinical manifestation, generally showing as propertyLattice, behavior, intelligence change and the disturbance of consciousness.
1. onset
Can suddenly can delay. Acute hepatoencephalopathy onset is hurried, and prodromal stage is very of short duration, can enter rapidly stupor,How after jaundice occurs, go into a coma, also have before jaundice appearance, to occur the disturbance of consciousness and be misdiagnosed as mental diseasePerson. Chronic hepatic encephalopathy onset concealment or gradually rise, originally normal being difficult for found, easily mistaken diagnosis and failing to pinpoint a disease in diagnosis.
2. personality change
Be often the symptom that this disease occurs the earliest, be mainly to belong to viscerotonia originally person shows as depression, and belong to originallyInternally-oriented personality person shows as glad multi-lingual.
3. behavior change
May only limit at first the behavior of " regardless of trivial matters ", as scrawl, disorderly watering, disorderly spits,Litter the ground with paper, cigarette end, fumble and disorderly seek, urinate and defecate everywhere, the tables and chairs in room arbitrarily disorderly drag to leave about to wait has no meaningThe action of justice.
4. sleep habit changes
Often show as the perversion of sleep, also have person for the nearly property stupor of compeling, this phenomenon has people to find and patients serumThe disorder of melatonin secretion phase is relevant, and the excitement of prompting patient central nervous system and inhibition are in disorderly shapeState, often indicates that hepatic encephalopathy is coming.
5. the smelly appearance of liver
Be due to liver failure, in body, Metabolism of Sulfur-Containing Amino Acids intermediate product is (as methyl mercaptan, ethyl mercaptanAnd dimethyl sulfide compound etc.) a kind of characteristic odor of breathing out or giving out through skin through lung. This smell has scholarClaim rotten apple taste, garlic flavour, fishlike smell etc.
6. asterixis
Be the distinctive nervous system signs of tool of hepatic encephalopathy, there is early diagnosis meaning. But regrettablyBe not that asterixis all can appear in all patients. Method is: advises patient to stretch out forearm, launches the five fingers, orWrist hyper-extended while maintaining static, patient slaps-refers to and wrist joint can occur fast flexing and stretch fortuneMoving, often can occur 1～2 time also having 5～9 persons each second of reaching each second, and often with the side position of pointingAction. Now patient can be simultaneously trembles and being total to of gait with whole upper limbs, tongue, lower jaw, jaw portion trickleJi imbalance. Or send out in one-sided, also can come across bilateral. This trembling do not have characteristic, is found in the heart yetDecline, the patient such as renal failure, lung decline. After often patient's Yu sleep and the stupor of trembling, disappear, after reviving, still can occur.
7. vision disorder
Uncommon. But recent domestic bibliographical information increases gradually, when hepatic encephalopathy occurs, patient can occurVision disorder, blind be main clinical manifestation, this vision disorder is of short duration, functional, can be along withThe intensification of hepatic encephalopathy and increasing the weight of, also can recover lost eyesight along with the recovery of hepatic encephalopathy. Its pathogenesis is not clear,It is the same with hepatic encephalopathy complicated that majority is thought, is the result of many factors comprehensive function.
8. disturbance of intelligence
Along with the progress of the state of an illness, patient's intelligence changes, show as time, concept of space unclear,Personality concept is fuzzy, pronounces indistinctly, disorder, dysgraphia, and calculating, numerical ability decline, numeralConnection error is also simple, the reliable method of Early Identification hepatic encephalopathy.
9. the disturbance of consciousness
After disturbance of intelligence, there is the obvious disturbance of consciousness, progress into stupor shape by drowsiness, lethargic sleepState, various reactions, reflection all disappear. Also have by manic state and progress into stupor person. And hepatocerebral degeneration typeHepatic encephalopathy main clinical manifestation is: hypophrenia, dyslalia, memory decline, thought slowness, mutual aidImbalance, tetanic, the spastic paraplegia (hepatic myelopathy) of trembling etc. But without the obvious disturbance of consciousness.
Medicine treatment
Because ammonia poisoning is the main cause of hepatic encephalopathy, therefore reduce the absorption of ammonia and strengthen the discharge of ammonia and beThe Main Means of medicine treatment.
1. reduce generation and the absorption of enteron aisle ammonia: lactulose (lactulose, beta galactose fructose) is oneKind synthetic disaccharide, can not be decomposed at small intestine after oral, and arriving can be by Bacillus acidi lactici, excrement intestines ball after colonThe bacteriums such as bacterium are decomposed into lactic acid, acetic acid and reduce the pH value of enteron aisle. Bacterium to urease-producing after enteron aisle acidifyingGrow unfavorable, but be conducive to the not growth of the Bacillus acidi lactici of urease-producing, the ammonia that enteric bacteria produces is reduced;In addition, acid intestinal environment can reduce the absorption of ammonia, and promotes the ammonia in blood to infiltrate enteron aisle discharge. BreastThe determined curative effect of fructose, can be used for each phase hepatic encephalopathy and compared with the treatment of minimal hepatic encephalopathy. Bad reaction masterHave abdominal distension, stomachache, feel sick, vomiting etc., in addition, its mouthfeel is sweet greasy, and small number of patients can not be accepted.Breast pears alcohol (lactitol, beta galactose sorbierite) are another kind of synthetic disaccharide, and the bacterium of per rectum is dividedSolution is acetic acid, propionic acid acidifying enteron aisle. The curative effect of breast pears alcohol is similar to lactulose, but its sugariness is low, mouthfeelGood, bad reaction is also less. Also can try out lactose for alactasia person, owing to lacking in somebody's small intestineWeary lactase, is not decomposed and absorbs at small intestine after oral lactose, is decomposed and acidifying after entering colon by bacteriumEnteron aisle, and produce gas, enterocinesia is increased and promotion defecation. Oral antibiotic can suppress enteron aisle and produce ureaThe bacterium of enzyme, reduces the generation of ammonia. Conventional antibiosis have neomycin, metronidazole, rifaximin etc. MouthfulTaking neomycin seldom absorbs. But long-term use likely causes ototoxicity and renal toxicity, should not exceed 1 month.The curative effect of metronidazole is similar to neomycin, but its gastrointestinal side effect is larger. Rifaximin is oral not to be absorbed,Rifaximin is oral not to be absorbed, and effect is identical with neomycin. Oral some not urease-producing beneficial bacterium can press downThe growth of harmful bacteria processed, reduces the generation of ammonia. Lactobacillus acidophilus's curative effect is still disputable, but makes in recent yearsWith the curative effect of enterococcus faecalis SF68 more definite. The instructions of taking of SF68 is stopped using 2 weeks for taking for 4 weeks afterwards,Can Reusability, oral beneficial bacterium is without toxicity.
2. promote the metabolism of ammonia in body: L-Orn-L-ASPARTIC ACID is the mixed of a kind of ornithine and L-aminobutanedioic acidClose preparation, can promote urea cycle (ornithine circulation) in body and reduce blood ammonia. Intravenous injection every day 20gOA can reduce blood ammonia, improve symptom, bad reaction for feel sick, vomiting. Ornithine-KGFall ammonia mechanism identical with OA, but its curative effect is not as OA. Benzoic acid is received to be combined with nitrogenous source material and is formed and horseUric acid is discharged and reduces blood ammonia from kidney, and bad reaction is taking indigestion symptom as main. Sodium phenylacetate can with paddy ammoniaAcid amides is in conjunction with forming phenylacetylglutamine through renal excretion. Both substantially need not at present clinically. Paddy ammoniaAcid is combined formation glutamine and is reduced blood ammonia with ammonia, have two kinds of potassium glutamate and sodium glutamates, can be according to bloodPotassium and blood sodium are adjusted both usage ratios. Glutamate is alkalescence, before use, can first inject vitamin C, alkaliMass formed by blood stasis person should not use. Arginine can promote urea cycle and reduce blood ammonia, and it is acid that this medicine is, and is applicable to alkaliPoisoner.
3. the nerve of GABA/BZ coreceptor antagonist Flumazenil due to can antagonism endogenous BenzodiazepineSuppress. There is the short effect of waking up for III-IV phase patient. Intravenous injection Flumazenil is rapid-action, often at several pointsWithin clock, but it is very short to hold time, intravenous injection within 4 hours conventionally; Or during continuous intravenous infusion instils. HaveClose the curative effect of Flumazenil treatment hepatic encephalopathy, although still disputable, can be obvious after selective case is usedChange rank and the NCT integration of PSE.
4. minimizing or antagonism false neurotransmitter branched-chain amino acid (BCAA) preparation are a kind of with leucine, different brightThe BCAA such as propylhomoserin, the acid of figured silk fabrics peace are main compound amino acid. Its mechanism is that competitive BCAA is main compound ammoniaBase acid. Its mechanism, for the competitive aromatic amino acid that suppresses enters brain, reduces the formation of false neurotransmitter,Its curative effect is still disputable, but for the dietetic patient that can not tolerate protein, supplementary BCAA contributes to improveIts nitrogen balance.
5. whether effective other drug: hepatic encephalopathy injured basal ganglia has the deposition of manganese, drive manganese medicineStill need and further study. VBT can be strengthened energetic supersession, and that the important mechanisms of ammonia poisoning hypothesis is ammonia is dryDisturb energetic supersession. The curative effect of VBT awaits confirming.
6. treatment by Chinese herbs: available traditional Chinese medical herbal treatment, from many aspects relief of symptoms, effect is more satisfactory.
Medicinal material involved in the present invention is all recorded in " China's book on Chinese herbal medicine " as seen.
Summary of the invention
The present invention aims to provide a kind of medicine that is used for the treatment of hepatic encephalopathy, by select suitable medicinal material andProportioning, reaches the object of safe and effective healing hepatic encephalopathy.
In order to achieve the above object, the present invention is by the following technical solutions:
A medicine that is used for the treatment of hepatic encephalopathy, is characterized in that, it is the raw material by following weight proportionMedicinal material is prepared from: 13 parts of cogongrass rhizomes, 8 parts of oriental wormwoods, 7 parts of plantain seeds, 8 parts of radix aristolochiae heterophyllaes, radix ranunculi ternati9 parts, 20 parts of Chinese violets, 9 parts of the barks of official magnolia.
Below in conjunction with theories of Chinese materia medica, beneficial effect of the present invention is described:
Inventor thinks, the disease located in liver of hepatic encephalopathy, brain have with internal organs such as liver, kidney, brain, spleen, stomachesClose. Often, because of hepatopathy protracted course of disease, heat symptoms caused by an exopathgen epidemic disease poison, injures cloudy liquid, so that endogenous deficient wind; Or because of prosperous gram of soil of wood,Liver qi invading spleen, weakness of the spleen and the stomach, poly-phlegm is raw wet, the clear key of the turbid upper illiteracy of phlegm, so that coma is failed to see. This state of an illness dangerHeavy, the domination of pathogen is weakened body resistance, and liver kidney yin exhausts. Therefore treatment is taked to educate the moon in temperature and is relieved dizziness, high fever, infantile convulsions, epilepsy, etc., the removing toxic substances of purging heat, the stasis of blood of dispelling is led stagnant,Eliminate phlegm for resuscitation.
The present invention uses: cogongrass rhizome cooling blood and hemostasis, clearing heat and promoting fluid, inducing diuresis for treating strangurtia; Oriental wormwood clearing away damp-heat, removing jaundiceSubcutaneous ulcer; Plantain seed reducing fever and causing diuresis, excreting dampness antidiarrheal, improving eyesight is eliminated the phlegm; Radix aristolochiae heterophyllae wind-expelling pain-stopping, clearing away heat and promoting diuresis;Radix ranunculi ternati removing toxic substances, reducing phlegm and resolving masses; Chinese violet is clearing heat and detoxicating, cool blood detumescence; Bark of official magnolia promoting the circulation of qi disappears long-pending, eliminating dampnessExcept full, relieving asthma. All medicines share, and reach nourishing yin and suppressing the excessive yang, the effect that relieves dizziness, high fever, infantile convulsions, epilepsy, etc. and have one's ideas straightened out.
Below in conjunction with clinical trial data declaration beneficial effect of the present invention:
1, physical data
73 routine hepatic encephalopathies are collected between year March altogether in inventor in February, 2012-2015. Be divided at random:Treatment group 37 examples, control group 36 examples. Wherein treatment group man 21 examples, female's 16 examples, 24～64 years old age,The course of disease 6 months～2 years; Control group man 23 examples, female's 13 examples, between 23～65 years old age, the course of disease 1 year～2Year. The data there was no significant differences such as two groups of sexes, age, the course of disease, have comparativity.
Diagnostic criteria
1. the basis that has serious hepatopathy and (or) the offshoot circulation of door body to form;
2. there is abalienation, the disturbance of consciousness, asterixis;
3. there is the inducement of hepatic encephalopathy;
4. the biochemical indicator of hypofunction of liver is abnormal;
5. electroencephalogram is abnormal.
1. inclusive criteria meets diagnostic criteria; 2. 18～70 years old age; 3. compliance is good; 4. signature voluntarilyInformed Consent Form.
1. exclusion standard merges other serious diseases patient; 2. suffer from severe cardiac, lung, liver, kidney trouble troublePerson; 3. spiritedness systemic disease, can not partner treatment person; 4. the patient who treats through other drug after morbidity.
2, methods for the treatment of
The powder that the oral the present invention for the treatment of group makes according to specific embodiment 2, every day 3 times. Treat 5 days.
The oral lactulose oral solution of control group, each 20ml, every day 3 times. Treat 5 days.
3, criterion of therapeutical effect and treatment results
3.1 criterion of therapeutical effect
Curative effect index for treatment after 48 hours clinical symptoms and mind turn the time clearly.
1. effective: mind turns clearly;
2. effective: symptom is obviously improved;
3. invalid: symptom is unchanged or increase the weight of.
3.2 treatment statisticses are in table 1.
Table 1 liang group curative effect comparison
Visible, the medicine that the present invention makes can safe and effective treatment hepatic encephalopathy, and cure rate is high.
Detailed description of the invention
In order to understand better and to implement the present invention, further illustrate the present invention below in conjunction with specific embodiment.
Embodiment 1
Take: 13 grams of cogongrass rhizomes, 8 grams of oriental wormwoods, 7 grams of plantain seeds, 8 grams of radix aristolochiae heterophyllaes, 9 grams of radix ranunculi ternatis,20 grams of Chinese violets, 9 grams of the barks of official magnolia; Add 8 times of water gagings, decoct 1.5 hours, filter; Filter residue adds 6 times of amountsWater, decocts 1 hour, filters; Merging filtrate, is concentrated into 120 grams, must meet one day use of normal adultThe decoction of amount.
Be used for the treatment of hepatic encephalopathy. Oral, take once every day.
Embodiment 2
Take: 13 grams of cogongrass rhizomes, 8 grams of oriental wormwoods, 7 grams of plantain seeds, 8 grams of radix aristolochiae heterophyllaes, 9 grams of radix ranunculi ternatis,20 grams of Chinese violets, 9 grams of the barks of official magnolia; Add 10 times of water gagings, decoct 2 hours, filter; Filter residue adds 8 times of amountsWater, decocts 1.5 hours, filters; Merging filtrate, concentrated, dry, packaging, must meet normal adultThe powder of one day consumption.
Be used for the treatment of hepatic encephalopathy. Oral, every bu is taken for twice sooner or later.
Embodiment 3
Take: 13 grams of cogongrass rhizomes, 8 grams of oriental wormwoods, 7 grams of plantain seeds, 8 grams of radix aristolochiae heterophyllaes, 9 grams of radix ranunculi ternatis,20 grams of Chinese violets, 9 grams of the barks of official magnolia; Add 6 times of water gagings, decoct 3 times, decoct 1 hour at every turn, merging is decoctedBoil liquid, concentrated, dry, incapsulate shell, must meet the capsule of one day consumption of normal adult.
Be used for the treatment of hepatic encephalopathy. Oral, every bu morning, noon and afternoon take for three times.
Claims (4)
1. a medicine that is used for the treatment of hepatic encephalopathy, is characterized in that, it is former by following weight proportionMaterial medicinal material is prepared from: 13 parts of cogongrass rhizomes, 8 parts of oriental wormwoods, 7 parts of plantain seeds, 8 parts of radix aristolochiae heterophyllaes, ram's horn9 parts of grass, 20 parts of Chinese violets, 9 parts of the barks of official magnolia.
2. a kind of medicine that is used for the treatment of hepatic encephalopathy as claimed in claim 1, is characterized in that its systemPreparation Method is: take: 13 parts of cogongrass rhizomes, 8 parts of oriental wormwoods, 7 parts of plantain seeds, 8 parts of radix aristolochiae heterophyllaes, ram's horn9 parts of grass, 20 parts of Chinese violets, 9 parts of the barks of official magnolia; Add 8 times of water gagings, decoct 1.5 hours, filter; Filter residueAdd 6 times of water gagings, decoct 1 hour, filter; Merging filtrate, is concentrated into 120 parts, obtains decoction; Above-mentionedPart all refers to weight portion.
3. a kind of medicine that is used for the treatment of hepatic encephalopathy as claimed in claim 1, is characterized in that its systemPreparation Method is: take: 13 parts of cogongrass rhizomes, 8 parts of oriental wormwoods, 7 parts of plantain seeds, 8 parts of radix aristolochiae heterophyllaes, ram's horn9 parts of grass, 20 parts of Chinese violets, 9 parts of the barks of official magnolia; Add 10 times of water gagings, decoct 2 hours, filter; Filter residueAdd 8 times of water gagings, decoct 1.5 hours, filter; Merging filtrate, concentrated, dry, packaging, obtains powder;Above-mentioned part all refers to weight portion.
4. a kind of medicine that is used for the treatment of hepatic encephalopathy as claimed in claim 1, is characterized in that its systemPreparation Method is: take: 13 parts of cogongrass rhizomes, 8 parts of oriental wormwoods, 7 parts of plantain seeds, 8 parts of radix aristolochiae heterophyllaes, ram's horn9 parts of grass, 20 parts of Chinese violets, 9 parts of the barks of official magnolia; Add 6 times of water gagings, decoct 3 times, decoct 1 hour at every turn,Merge decoction liquor, concentrated, dry, incapsulate shell, obtain capsule; Above-mentioned part all refers to weight portion.
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| CN201610160993.8A CN105582393A (en) | 2016-03-21 | 2016-03-21 | Medicine for treating hepatic encephalopathy |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN104940848A (en) * | 2015-07-25 | 2015-09-30 | 孙振玲 | Medicine for treating hepatic encephalopathy |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN104940848A (en) * | 2015-07-25 | 2015-09-30 | 孙振玲 | Medicine for treating hepatic encephalopathy |
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Application publication date: 20160518 |