CN105920107A - 一种用于治疗黄肿的药物 - Google Patents
一种用于治疗黄肿的药物 Download PDFInfo
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Abstract
本发明涉及一种用于治疗黄肿的药物，它是由以下重量配比的原料药材制备而成：羽裂藁本9份、荷梗9份、胡芦巴6份、骨牌草12份、挟剑豆9份、紫河车15份、党参12份、白术12份、茯苓15份、炙甘草6份。本发明运用：羽裂藁本苦辛凉，散风清热，活血调经；荷梗宽中理气；胡芦巴味苦气温，补肾阳，祛寒湿；骨牌草苦平，清热解毒止血；挟剑豆温中下气，益肾补元；紫河车味甘气大温，补肾益精，益气养血；党参甘温，入脾肺二经，补气健脾，白术甘苦温，健脾燥湿，益胃和中，茯苓甘淡而平，渗湿健脾，助白术使湿从小便而去，加强健脾除湿之功，炙甘草甘温益气，调和诸药。诸药合用，共奏益气养血、温补脾肾之功。临床实验证明，本发明能够安全有效治疗黄肿。
Description
技术领域
本发明涉及一种中药，具体涉及一种用于治疗黄肿的药物。
背景技术
中医黄肿属于现代医学中的“缺铁性贫血”。
缺铁性贫血是由于体内缺少铁质而影响血红蛋白合成所引起的一种常见贫血，在红细胞的产生受到限制之前，体内的铁贮存已耗尽，此时称为缺铁。这种贫血特点是骨髓，肝、脾及其他组织中缺乏可染色铁，血清铁浓度和血清转铁蛋白饱和度均降低，典型病例贫血是属于小细胞低色素型。本病是贫血中常见类型，普遍存在于世界各地，缺铁性贫血的原因：一是铁的需要量增加而摄入不足，二是铁的吸收不良，三是失血过多等，均会影响血红蛋白和红细胞生存而发生贫血。
中医学认为本病的形成多由长期慢性肠胃疾患或长期失血、妊娠失养、加之饮食失调、护理不当等所致。 1．脾胃虚弱：由于饮食不节，损伤脾胃或平素脾胃虚弱，或七情所伤，郁怒伤肝，忧思伤脾而使脾胃功能减退，影响水谷之精微的吸收致化血无源。 2．血证：由于阴虚血热，或气不摄血或脾不统血而致长期慢性失血症。 3．肾虚精不化血：一为先天禀赋不足，肾脏素虚；一为后天失养，即由于其他脏腑病变，不能将其精气输送至肾而藏之。4．虫积：如钩虫侵入人体引起脾胃受损或虫栖肠中，大量吸收人体精微导致贫血。
临床表现
①症状：贫血的发生是隐伏的。症状进展缓慢，患者常能很好地适应，并能继续从事工作。贫血的常见症状是头晕、头痛、乏力、易倦、心悸、活动后气短、眼花、耳鸣等。
②特殊表现：缺铁的特殊表现有：口角炎、舌乳突萎缩、舌炎，严重的缺铁可有匙状指甲(反甲)，食欲减退、恶心及便秘。欧洲的患者常有吞咽困难、口角炎和舌异常，称为Plummer-Vinson或Paterson-Kelly综合征，这种综合征可能与环境及基因有关。吞咽困难是由于在下咽部和食管交界处有黏膜网形成，偶可围绕管腔形成袖口样的结构，束缚着食管的开口。常需要手术破除这些网或扩张狭窄，单靠铁剂的补充无济于事。
③非贫血症状：缺铁的非贫血症状表现：儿童生长发育迟缓或行为异常，表现为烦躁、易怒、上课注意力不集中及学习成绩下降。异食癖是缺铁的特殊表现，也可能是缺铁的原因，其发生的机制不清楚。患者常控制不住地仅进食一种“食物”，如冰块、黏土、淀粉等。铁剂治疗后可消失。
④体征：除皮肤黏膜苍白、毛发干枯、口唇角化、指甲扁平、失光泽、易碎裂，约18%的患者有反甲，约10%缺铁性贫血患者脾脏轻度肿大，其原因不清楚，患者脾内未发现特殊的病理改变，在缺铁纠正后可消失。少数严重贫血患者可见视网膜出血及渗出。
此症诊断主要依靠实验室检查
①血象，呈现典型的小细胞低色素性贫血(MCV＜80fl、MCH＜27pg、MCHC＜30%)。红细胞指数改变的程度与贫血的时间和程度相关。红细胞宽度分布(RDW)在缺铁性贫血的诊断中意义很难定，正常为(13.4±1.2)%，缺铁性贫血为16.3%(或＞14.5%)特殊性仅为50%～70%。血片中可见红细胞染色浅淡，中心淡染区扩大，大小不一。网织红细胞大多正常或轻度增多。
②骨髓象，骨髓检查不一定需要，除非是需要与其他疾患的贫血相鉴别时。骨髓涂片表现增生活跃，幼红细胞明显增生。早幼红及中幼红细胞比例增高，染色质颗粒致密，细胞质少，血红蛋白形成差。粒系和巨核细胞系正常。铁粒幼细胞极少或消失。细胞外铁缺如。
③生化检查
(1)血清铁测定：血清铁降低＜8.95μmol/L(50μg/dl)，总铁结合力增高＞64.44μmol/L(360μg/dl)，故转铁蛋白饱和度降低。由于血清铁的测定波动大，影响因素较多，在判断结果时，应结合临床考虑。
(2)血清铁蛋白测定：血清铁蛋白低于14μg/L。但在伴有炎症、肿瘤及感染时可以增高，应结合临床或骨髓铁染色加以判断。缺铁性贫血患者骨髓红系细胞内及细胞外铁染色均减少或缺如。
(3)红细胞游离原卟啉(FEP)测定：FEP增高表示血红素合成有障碍，用它反映缺铁的存在，是较为敏感的方法。但在非缺铁的情况如铅中毒及铁粒幼细胞贫血时，FEP亦会增高。
药物治疗 ①口服铁剂：这是治疗本病的主要方法。最常用者为硫酸亚铁片；此外尚有乳酸亚铁，10％枸橼酸铁胺溶液，在众多的口服铁剂中以硫酸亚铁疗效较好、安全，且价格低廉。作为成人治疗每日给元素铁100～200mg即够，儿童用成人量的一半。于进食时或饭后服用，以减少对胃肠道的刺激。②注射铁剂：缺铁性贫血也可用铁注射治疗，但注射铁剂毒性反应较多，有时甚至可以发生致命的过敏反应，且注射治疗既不方便，又不经济，故凡是可以采用口服治疗的，就不应用铁注射治疗。③缺铁患者往往伴有维生素E的缺乏，因此铁剂疗效不显著者，可加用维生素E。④中药治疗黄肿可用中医中药治疗，效果比较理想。同时应注意饮食以及生活习惯。
本发明所涉及药材均可见记载于《中华本草》。
发明内容
本发明旨在提供一种用于治疗黄肿的药物，通过选择合适的药材及其配比，达到安全有效治愈黄肿的目的。
为了达到上述目的，本发明采用以下技术方案：
一种用于治疗黄肿的药物，其特征在于，它是由以下重量配比的原料药材制备而成：羽裂藁本9份、荷梗9份、胡芦巴6份、骨牌草12份、挟剑豆9份、紫河车15份、党参12份、白术12份、茯苓15份、炙甘草6份。
下面结合中药学理论说明本发明有益效果：
发明人认为，黄肿的基本病机是由各种原因引起脾胃虚弱，脾胃功能减退，胃不能腐熟，脾不能运化、吸收，导致水谷精微不足，化血无源、出现贫血。“血者水谷之精也，生化于脾”、“中焦受气取汁，变化而赤是为血”。即中焦接受水谷之气与精微物质，变化而赤，造成血液。肾主骨，生髓、藏精，血为精所化、故肾脏虚衰，则精不能化血，而致血虚。肾虚不能主水，则见浮肿，甚则有腹水、男子阳痿，女子月经停闭等脾肾两虚的证候。治疗宜益气养血、温补脾肾。
本发明运用：羽裂藁本苦辛凉，散风清热，活血调经；荷梗宽中理气；胡芦巴味苦气温，补肾阳，祛寒湿；骨牌草苦平，清热解毒止血；挟剑豆温中下气，益肾补元；紫河车味甘气大温，补肾益精，益气养血；党参甘温，入脾肺二经，补气健脾，白术甘苦温，健脾燥湿，益胃和中，茯苓甘淡而平，渗湿健脾，助白术使湿从小便而去，加强健脾除湿之功，炙甘草甘温益气，调和诸药。诸药合用，共奏益气养血、温补脾肾之功。
下面结合临床实验数据说明本发明的有益效果：
1、一般资料
发明人2012年08月-2013年08月间共收集100例黄肿患者。随机分为：治疗组50例，对照组50例。治疗组50例患者中，男38例，女12例；年龄18~76岁，平均年龄52.6岁；对照组50例患者中，男39例，女11例；年龄18~75岁，平均年龄51.8岁。两组性别、年龄、病程等资料无显著性差异，具有可比性。
诊断标准
①有引起缺铁的病史，如慢性失血（常见于月经过多、溃疡病、胃肠道肿瘤、钩虫病及痔)，吸收障碍（如萎缩性胃炎、胃肠道术后)，营养不良和铁需要量增加（如偏食、妊娠、哺乳及儿童生长期)等。
②症状包括贫血及组织缺铁的各种表现，如毛发枯干、平甲、反甲、吞咽疼痛或困难等。
③血液检查
（1）.血片有小细胞低色素性贫血的红细胞形态特点。网织红细胞计数在正常范围内，白细胞及血小板数变化不大。
（2）.血清铁低于9μmol/L（50μg/dl)，总铁结合力增高，可达71.6～89.5μmol/L（400～500μg/dl)，铁饱和度少于0.15。血清铁蛋白少于15μg/dl。
④骨髓红细胞系统增生，幼稚红细胞体积小，胞浆偏蓝。铁粒幼细胞和细胞外铁减少或缺如。
⑤除外慢性感染和肝、肾疾病所致的贫血、地中海贫血及铁粒幼细胞性贫血。
纳入标准 ①符合诊断标准；②自愿接受临床观察。
排除标准 ①血红蛋白＜60g/L；②慢性感染性疾病；③合并心、肝、肾、脾等原发性疾病者；④其他原因引起贫血者；⑤不愿接受临床观察者。
2、治疗方法
治疗组口服本发明按照具体实施例3制得的胶囊，每日3次。治疗8周。
对照组口服硫酸亚铁片，0.3g每次，3次/d；维生素E，50mg/d。治疗8周。
3、疗效标准与治疗结果
3.1疗效标准
①痊愈：临床贫血症状消失；血象：WBC，pt正常。Hb：男>130g/L，女>120g/L[或RBC男>0.45×1012/L（450万/mm3)，女>0.4×1012/L（400万/mm3)]；血浆铁>1.43μmol/L（80mg%)；骨髓细胞内外铁含量正常；
②显效：临床贫血症状消失；血象：WBC，pt正常。Hb：男>110g/L（11g%)，女>100g/L（10g%)；
③有效：临床症状改善；血象：Hb比治疗前增加30g/L（3g%)以上，但未达基本治愈标准。WBC、pt正常；
④无效：治疗后，临床症状、血象无改善。
3.2治疗统计结果见表1。
表1 两组疗效比较
| 组别 | n | 痊愈 | 显效 | 有效 | 无效 | 总有效率(%) | 明显不良反应例 |
| 治疗组 | 50 | 40 | 6 | 3 | 1 | 98% | 0 |
| 对照组 | 50 | 25 | 7 | 6 | 12 | 76% | 0 |
可见，本发明制得的药物能够安全有效治疗黄肿，治愈率高。
具体实施方式
为了更好地理解和实施本发明，下面结合具体实施例进一步说明本发明。
实施例1
称取：羽裂藁本9克、荷梗9克、胡芦巴6克、骨牌草12克、挟剑豆9克、紫河车15克、党参12克、白术12克、茯苓15克、炙甘草6克；加8倍量水，煎煮1.5小时，过滤；滤渣加6倍量水，煎煮1小时，过滤；合并滤液，浓缩至120克，即得符合正常成人一天用量的煎剂。
用于治疗黄肿。口服，每日服用一次。
实施例2
称取：羽裂藁本9克、荷梗9克、胡芦巴6克、骨牌草12克、挟剑豆9克、紫河车15克、党参12克、白术12克、茯苓15克、炙甘草6克；加10倍量水，煎煮2小时，过滤；滤渣加8倍量水，煎煮1.5小时，过滤；合并滤液，浓缩，干燥，包装，即得符合正常成人一天用量的散剂。
用于治疗黄肿。口服，每日分早晚两次服用。
实施例3
称取：羽裂藁本9克、荷梗9克、胡芦巴6克、骨牌草12克、挟剑豆9克、紫河车15克、党参12克、白术12克、茯苓15克、炙甘草6克；加6倍量水，煎煮3次，每次煎煮1小时，合并煎煮液，浓缩，干燥，装入胶囊壳，即得符合正常成人一天用量的胶囊剂。
用于治疗黄肿。口服，每日分早中晚三次服用。
Claims (4)
1.一种用于治疗黄肿的药物，其特征在于，它是由以下重量配比的原料药材制备而成：羽裂藁本9份、荷梗9份、胡芦巴6份、骨牌草12份、挟剑豆9份、紫河车15份、党参12份、白术12份、茯苓15份、炙甘草6份。
2.如权利要求1所述的用于治疗黄肿的药物，其特征在于，其制备方法为：称取：羽裂藁本9份、荷梗9份、胡芦巴6份、骨牌草12份、挟剑豆9份、紫河车15份、党参12份、白术12份、茯苓15份、炙甘草6份；加8倍量水，煎煮1.5小时，过滤；滤渣加6倍量水，煎煮1小时，过滤；合并滤液，浓缩至120份，即得煎剂；上述份均是指重量份。
3.如权利要求1所述的用于治疗黄肿的药物，其特征在于，其制备方法为：称取：羽裂藁本9份、荷梗9份、胡芦巴6份、骨牌草12份、挟剑豆9份、紫河车15份、党参12份、白术12份、茯苓15份、炙甘草6份；加10倍量水，煎煮2小时，过滤；滤渣加8倍量水，煎煮1.5小时，过滤；合并滤液，浓缩，干燥，包装，即得散剂；上述份均是指重量份。
4.如权利要求1所述的用于治疗黄肿的药物，其特征在于，其制备方法为：称取：羽裂藁本9份、荷梗9份、胡芦巴6份、骨牌草12份、挟剑豆9份、紫河车15份、党参12份、白术12份、茯苓15份、炙甘草6份；加6倍量水，煎煮3次，每次煎煮1小时，合并煎煮液，浓缩，干燥，装入胶囊壳，即得胶囊剂；上述份均是指重量份。
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