CN105943816A - 一种治疗妇女卵巢早衰的中药组合物及其制备方法 - Google Patents
一种治疗妇女卵巢早衰的中药组合物及其制备方法 Download PDFInfo
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- Medicines Containing Plant Substances (AREA)
Abstract
本发明提供一种治疗妇女卵巢早衰的中药组合物,内服药物:赤芍10~20份,鸡血藤10~20份,山茱萸10~20份,益母草10~20份,柴胡10~20份,紫草10~20份,熟地10~20份,女贞子10~20份,旱莲草10~20份,五味子10~20份,覆盆子10~20份,菟丝子10~20份,淫羊藿10~20份,丹皮10~20份,葛根10~20份,车前子10~20份,知母10~20份;外用药物:紫草10~20份,苦参10~20份,蛇床子10~20份,土茯苓10~20份,白芨10~20份,艾叶10~20份,青黛10~20份,夏枯草10~20份,冰片10~20份,小米草10~20份。诸药合用共奏补肾养阴活血,调养冲任功效。
Description
技术领域
本发明涉及含有来源于植物组份的医用配制品,特别涉及一种治疗妇女肝火型带下的中药组合物及其制备方法。
背景技术
卵巢早衰(POF)是指卵巢功能衰竭所导致的40岁之前即闭经的现象。特点是原发或继发闭经伴随血促性腺激素水平升高和雌激素水平降低,并伴有不同程度的一系列低雌激素症状如:潮热多汗、面部潮红、性欲低下等。妇女的平均自然绝经年龄为50~52岁,绝经年龄存在着种族和地区分布的差异,但其绝对值相差不大。Coulam等总结1858例妇女的自然闭经情况,小于40岁的POF发生率为1%,小于30岁的POF发生率为1‰。原发闭经中POF占10%~28%,继发闭经中POF占4%~18%。徐苓等发现北京地区妇女POF发生率为1.8%。由此可见,POF在临床上并不少见。
卵巢早衰(POF)以月经改变、雌激素缺乏、FSH水平升高、雌激素水平下降为临床特点。西医诊断标准为40岁以前出现至少4个月以上闭经,并有2次或以上血清FSH>40U/L(2次检查间隔1个月以上),雌二醇水平<73.2pmol/L。中医诊断标准为40岁以前断经,月经稀少,渐至闭经或忽然停经,烘热汗出,潮热面红,五心烦热,头晕耳鸣,腰膝酸软或后足跟疼,溲赤便干,形体消瘦,阴道干涩。B超示子宫偏小或两侧卵巢偏小,未发现卵泡或连续监测仅见极少数的未能发育的小卵泡,血清E2水平低下,FSH明显升高,舌红或有裂纹、苔少,脉细数或带弦。
卵巢早衰占妇女总人数的1%~3.8%,是妇科内分泌领域的常见病。由于此类患者表现为早发或原发闭经、雌激素低下所致的围绝经期症状及不孕,故属中医闭经、早发绝经、绝经前后诸证、不孕等范畴。由于肾虚冲任功能早衰,经血的生成障碍致胞宫胞脉(血海)空虚,无血可下而早发绝经。《傅青主女科》云:“经水早断,似乎肾水衰涸”。因妇女以血为主,且“阴常不足,阳常有余”,故治疗应重在补肾养阴,活血调经。补肾养阴方方中熟地滋肾阴,益精髓为君药。卵巢早衰从病因到病程到临床表现都有明显的异质性,要进行正确的病因诊断,辨证与辨病相结合,采取相应的治疗对策,以改善健康或延缓性腺衰老。
现代研究认为,补肾调冲中药有增强体质,调节性腺轴及免疫功能,甚或延缓性腺衰老作用。临床表明,补肾养阴方临床应用安全、有效,治疗卵巢早衰疗效肯定,不良反应少,在保护、恢复卵巢功能方面有一定的作用,其疗效等同于单纯西药治疗,并且毒副作用较小,价格便宜。
目前最好的治疗方式是采用中医调理治疗的方法。中医治疗可以有效的解决了疾病的表面症状,又能够彻底的解决致病的根本因素。患者还可以根据具体情况适当的选择物理疗法。但是,患者要注意千万不能随便用药,要在专家的指导下进行。对于物理疗法,也有限度,不能过度,过度反而不利于病情,有损患者的健康。
发明内容
本发明所要解决的技术问题在于,雌孕激素替代治疗对于年轻的POF患者来说是非常重要的,即可以缓解低雌激素症状及泌尿生殖道萎缩(为赠卵胚胎移植作准备),又可以预防远期并发症(骨质疏松、老年性痴呆症等)、结肠癌的风险降低37%。但长期HRT也有一定的风险,如子宫内膜癌和乳腺癌的发生。中医讲究对症下药,个体差异明显,要在专家的指导下进行。对于物理疗法,也有限度,不能过度,过度反而不利于病情,有损患者的健康。本发明在传统医学的基础上结合多年临床经验,采用现代加工方法精心研制而成。本发明对原料药品的各有效成分科学配伍,能直达病灶,且见效快、副作用小、能有效解除患者的痛苦,达到祛除疾病的目的。
为解决上述技术难题,本发明提供一种治疗妇女卵巢早衰的中药组合物,由内服药物和外用药物组成,所述内服药物可以包括以下重量份的原料药:赤芍10~20份,鸡血藤10~20份,山茱萸10~20份,益母草10~20份,柴胡10~20份,紫草10~20份,熟地10~20份,女贞子10~20份,旱莲草10~20份,五味子10~20份,覆盆子10~20份,菟丝子10~20份,淫羊藿10~20份,丹皮10~20份,葛根10~20份,车前子10~20份,知母10~20份;
所述外用药物可以包括以下重量份数的原料药:紫草10~20份,苦参10~20份,蛇床子10~20份,土茯苓10~20份,白芨10~20份,艾叶10~20份,青黛10~20份,夏枯草10~20份,冰片10~20份,小米草10~20份。
所述治疗妇女卵巢早衰的中药组合物,其所述内服药物还可以包括以下重量份的原料药:赤芍10~15份,鸡血藤10~15份,山茱萸10~15份,益母草10~15份,柴胡10~15份,紫草10~15份,熟地10~15份,女贞子10~15份,旱莲草10~15份,五味子10~20份,覆盆子10~20份,菟丝子10~20份,淫羊藿10~20份,丹皮10~20份,葛根10~20份,车前子10~20份,知母10~20份;
所述外用药物还可以包括以下重量份数的原料药:紫草10~15份,苦参10~15份,蛇床子10~15份,土茯苓10~15份,白芨10~15份,艾叶10~20份,青黛10~20份,夏枯草10~20份,冰片10~20份,小米草10~20份。
所述治疗妇女卵巢早衰的中药组合物,其所述内服药物也可以包括以下重量份的原料药:赤芍10~20份,鸡血藤10~20份,山茱萸10~20份,益母草10~20份,柴胡10~20份,紫草10~20份,熟地10~20份,女贞子10~20份,旱莲草10~20份,五味子10~15份,覆盆子10~15份,菟丝子10~15份,淫羊藿10~15份,丹皮10~15份,葛根10~15份,车前子10~15份,知母10~15份;
所述外用药物也可以包括以下重量份数的原料药:紫草10~20份,苦参10~20份,蛇床子10~20份,土茯苓10~20份,白芨10~20份,艾叶10~15份,青黛10~15份,夏枯草10~15份,冰片10~15份,小米草10~15份。
为解决上述技术问题,本发明还提供一种治疗妇女卵巢早衰的中药组合物的制备方法,其所述内服药物为胶囊剂的制备步骤包括:
a、取原料药放入乙醇中浸泡,热提取2次,为组分1;
b、药渣加水提取2次,浓缩过滤,为组分2;
c、将上述两种组分合并,浓缩,干燥成粉末装入胶囊。
所述步骤a中,可以取原料药加入5-10倍量的乙醇中浸泡1-2小时,加热提取2次,每次1-2小时,合并提取液,静置后去上清液,然后100-120目滤过,再经截流分子量为5000-10000的超滤柱超滤,超滤液减压浓缩相对密度为80℃时1.36的浸膏,静置备用,成为组分1。
所述步骤b中,可以取上述乙醇提取过的原料药的药渣加10倍量水,加热回流提取2次,每次1~2小时,将2次提取液合并静置,成为组分2。
所述步骤c中,可以将组分1和组分2的合并,然后放入减压浓缩罐内,减压回收乙醇,浓缩至药液浓度为0.6g生药/mL,抽滤至滤液的相对密度为20℃时1.06;上述滤液经体积为10L的大孔吸附树脂柱吸附后,用10倍树脂柱体积的去离子水或蒸馏水洗脱,再用5倍树脂柱体积的95%乙醇洗脱,收集乙醇洗脱液,去除溶剂,得到药粉干燥后装入胶囊。
为解决上述技术问题,本发明也提供一种治疗妇女卵巢早衰的中药组合物的制备方法,所述外用药物为栓剂的制备步骤包括:
a.取白芨、青黛、冰片用蒸馏法汽化成结晶,粉碎过细筛待用,作为组分1;
b.将其余原料用乙醇萃取,浓缩,作为组分2;
c.将组分1、组分2混合后加基质调和,定型制成栓剂,杀菌装袋。
所述步骤a中,可以先将原料药白芨、青黛、冰片用水蒸气法蒸馏,得到结晶物,然后粉碎,过100-120目筛,作为组分1备用;所述步骤b中,可以再将其余原料药切碎,将其浸泡置于有盖不锈钢桶内,加70%乙醇液,质量为粗颗粒的0.8-1倍,搅拌均匀,湿润密闭放置1小时以上,使充分膨胀;将渗漉筒底部滤板用纱布袋包裹铺平后再将湿润膨胀后的药物样品拌松弄散,然后用不锈钢勺盛粉,均匀的装入渗漉筒,装10-12厘米厚,用T型棒压匀,再按上述操作,一层一层的装入,适当加压,药粉填装不得超过渗漉筒的2/3高处;药粉面上盖不锈钢孔板压牢,打开渗漉筒下面的放料阀,并放一容器,然后缓缓加入70%乙醇液;待排出药粉粉粒之间的空气,并有乙醇流出约20L左右,关闭放料阀,盖上漉筒、浸渍24小时,然后开放料阀进行渗漉,控制渗漉速度一般为1000g药材每分钟流出2~3ml,滤液放入贮液缸内,并将排空时的乙醇液倒入贮液缸;将渗滤液合并静置,作为组分2;组分1组分2混合成药膏;选取基质50℃~60℃加热融化,加入上述得到的药膏冷却定型制成类弹头状栓剂,紫外线杀毒。
所述治疗妇女卵巢早衰外用栓剂的制备方法,其所述栓剂所用的基质可以选自:半合成脂肪酸甘油酯、泊洛沙姆、聚乙二醇、羊毛脂中的一种或多种;所述基质在温度50℃~60℃条件下加热融化,加入所述制备方法制得的药物膏体,水浴搅拌均匀,混合成粘稠的液体,灌注在塑料定型管内,插入棉栓,冷却定型制成子弹头状栓剂;所述棉栓为尾部带有棉线的棉栓。。
本发明采用药栓和棉栓一体工艺,弥补了普通栓剂的不足,普通栓剂不能有效送达到阴道的深处。由于阴道的自净作用,当有异物存在时,会增加液体分泌,在短时间内将药物排除体外,既降低了疗效,又延长了疗程,增加费用又污染内衣裤。而本发明克服这一技术难题,制成的栓剂可充分发挥药物疗效,具有安全性好,可行性好的优点,能直达病灶,达到祛病目的。
本发明补肾养阴,活血调经。补肾养阴方中熟地滋肾阴,益精髓为君药。山茱萸、何首乌、菟丝子补益肝肾,养精血。紫草、赤芍活血化淤,行血养肝血,调冲任。淫羊藿补益肝肾。女贞子、旱莲草为二至丸,功效补肾养肝益精。柴胡、知母滋阴清热泻火。葛根清热生津,据现代药理研究葛根具有雌激素样作用,对于妇女生殖内分泌具有调节作用。诸药合用共奏补肾养阴活血,调养冲任功效。补肾调经中药具有延缓性腺功能减退作用,又有促进卵巢功能恢复作用,同时补肾中药对女性性腺轴功能有一定的调节作用,通过动物实验研究发现补肾药有促进卵巢LH/HCG受体增加现象。中药还可能有促进FSH受体产生的作用,滋补肝肾、益精养血中药具有促卵泡发育的作用。
具体实施方式
卵巢早衰(POF)以月经改变、雌激素缺乏、FSH水平升高、雌激素水平下降为临床特点。西医诊断标准为40岁以前出现至少4个月以上闭经,并有2次或以上血清FSH>40U/L(2次检查间隔1个月以上),雌二醇水平<73.2pmol/L。中医诊断标准为40岁以前断经,月经稀少,渐至闭经或忽然停经,烘热汗出,潮热面红,五心烦热,头晕耳鸣,腰膝酸软或后足跟疼,溲赤便干,形体消瘦,阴道干涩。B超示子宫偏小或两侧卵巢偏小,未发现卵泡或连续监测仅见极少数的未能发育的小卵泡,血清E2水平低下,FSH明显升高,舌红或有裂纹、苔少,脉细数或带弦。
卵巢早衰占妇女总人数的1%~3.8%,是妇科内分泌领域的常见病。由于此类患者表现为早发或原发闭经、雌激素低下所致的围绝经期症状及不孕,故属中医闭经、早发绝经、绝经前后诸证、不孕等范畴。由于肾虚冲任功能早衰,经血的生成障碍致胞宫胞脉(血海)空虚,无血可下而早发绝经。《傅青主女科》云:“经水早断,似乎肾水衰涸”。因妇女以血为主,且“阴常不足,阳常有余”,故治疗应重在补肾养阴,活血调经。补肾养阴方方中熟地滋肾阴,益精髓为君药。卵巢早衰从病因到病程到临床表现都有明显的异质性,要进行正确的病因诊断,辨证与辨病相结合,采取相应的治疗对策,以改善健康或延缓性腺衰老。
1.闭经分为原发闭经和继发闭经,继发闭经发生在40岁之前。通过对大样本的POF患者的调查发现闭经之前并没有特征性的月经异常的先兆。有的人是在规律的月经后突然闭经,有的是停避孕药或分娩以后闭经,有的则在闭经之前表现为月经周期及经期的紊乱。
2.不孕部分患者因不孕就诊而发现卵巢早衰。不孕是卵巢早衰患者就诊和苦恼的主要原因。有原发不孕和继发不孕,所以建议有卵巢早衰家族史者应尽早计划怀孕。
3.低雌激素症状原发闭经者低雌激素症状(潮热和/或性交困难等)少见(22.2%),如果有也大多与既往用过雌激素替代治疗有关,继发闭经者低雌激素症状常见(85.6%)。这与低雌激素症状是由雌激素撤退引起的理论相一致。这些低雌激素症状还包括萎缩性阴道炎和尿频、尿痛等萎缩性尿道炎。
4.伴发的自身免疫性疾病的表现如Addison病、甲状腺疾病、糖尿病、红斑狼疮、类风湿性关节炎、白癜风和克隆病等。另外还有肾上腺功能不全的隐匿症状,如近期体重的减轻、食欲减退、不明确的腹部疼痛、衰弱、皮肤色素沉着加重和嗜盐。
本发明补肾养阴,活血调经。补肾养阴方中熟地滋肾阴,益精髓为君药。山茱萸、何首乌、菟丝子补益肝肾,养精血。紫草、赤芍活血化淤,行血养肝血,调冲任。淫羊藿补益肝肾。女贞子、旱莲草为二至丸,功效补肾养肝益精。柴胡、知母滋阴清热泻火。葛根清热生津,据现代药理研究葛根具有雌激素样作用,对于妇女生殖内分泌具有调节作用。诸药合用共奏补肾养阴活血,调养冲任功效。补肾调经中药具有延缓性腺功能减退作用,又有促进卵巢功能恢复作用,同时补肾中药对女性性腺轴功能有一定的调节作用,通过动物实验研究发现补肾药有促进卵巢LH/HCG受体增加现象。中药还可能有促进FSH受体产生的作用,滋补肝肾、益精养血中药具有促卵泡发育的作用。
鸡血藤苦、甘,温。归肝、肾经。主治:活血舒筋;养血调经。主手足麻木;肢体瘫痪;风湿痹痛;妇女有经不调;痛经;闭经。功用:补血,活血,通络。用于月经不调,血虚萎黄,麻木瘫痪,风湿痹痛。《饮片新参》:去瘀血,生新血,流利经脉。治暑痧,风血痹症。《现代实用中药》:为强壮性之补血药,适用于贫血性之神经麻痹症,如肢体及腰膝酸痛,麻木不仁等。又用于妇女月经不调,月经闭止等,有活血镇痛之效。
山茱萸,主治心下邪气寒热,温中,逐寒温痹,去三虫,久服轻身有强阴益精、安五脏、通九窍、止小便淋沥之功;久服明目、强力长年。山茱萸,又名山芋肉、药枣、实枣儿、枣皮、肉枣等,为我国常用名贵中药材,应用历史悠久。它以其补力平和、壮阳而不助火,滋阴而不腻膈,收敛而不留邪等特殊功效被历代医学所喜用。张仲景以山茱萸为君创制了“金匮肾气丸”。据化学分析,山茱萸含有生理活性较强的山茱萸甙、酒石酸、没食子酸、苹果酸、树酯、鞣质和多种维生素等有效成分,具有增强免疫、抗炎、抗菌等药理作用,是中医临床中常用的一味药。
柴胡性味归经:性微寒、味苦、辛、归肝经、胆经,具疏肝利胆、疏气解郁、散火之功效。功能:透表泄热,疏肝解郁,升举阳气。主治:治感冒发热、寒热虚劳发热。小儿痘疹余热,面黄肌瘦腹部膨大,[3]疟疾,肝郁气滞,胸肋胀痛,脱肛,子宫脱落,月经不调。《本草正》:″柴胡,用此者用其凉散,平肝之热。其性凉,故解寒热往来,肌表潮热,肝胆火炎,胸胁痛结,兼治疮疡,血室受热;其性散,故主伤寒邪热未解,温病热盛,少阳头痛,肝经郁证。
女贞子,味甘苦、性凉,归肝肾经,具有滋补肝肾、益阴养血之功。现代医学研究证明,女贞子内含熊果酸、甘露醇、葡萄糖、脂肪油等,有强心、利尿和保肝作用,能使因化疗引起的白细胞下降数量升高,并对金黄色葡萄球菌、大肠杆菌有抑制作用。女贞子中含有齐墩果酸女贞子酸、女贞苷、熊果酸、硬脂酸、油酸、甘露醇、白桦脂醇、磷脂以及糖类如女贞子多糖、阿拉伯糖、葡萄糖等,还含有15种氨基酸,11种微量元素及挥发油等。研究认为女贞子有降血糖及降血脂并有抗动脉粥样硬化作用,还有抗菌、抗病毒作用,女贞子煎剂对金黄色葡萄球菌、福氏痢疾杆菌、伤寒杆菌、绿脓杆菌和大肠杆菌均有抑制作用。对B型腺病毒有中等度抑制作用。升高白细胞:女贞子及其成分制剂对血细胞均有一定影响,它对因化疗所致白细胞下降有升高作用。含女贞子的复方也有升白细胞作用。抗血栓作用:齐墩果酸可加快血小板细胞的流动性,减弱了血小板之间的碰撞,使之不易粘连和聚集,更不易在血管内膜沉积,减缓或防止血栓形成,又可降低脂质内膜的沉积,为防治老年人的血栓性疾病提供了部分实验依据。抗衰老提高免疫力:女贞子煎剂可使小鼠免疫器官胸腺、脾脏重量增加;明显提高小鼠血清溶血素抗体活性,对小鼠脾淋巴细胞产生白介素-2的影响具有双向调节作用。女贞子具有显著的免疫增强作用,清除自由基从而抗衰老。应用女贞子防治:心血管疾病、冠心病、高脂血症、糖尿病、血小板减少症、白细胞减少症,慢性肾炎、慢性支气管炎、顽固性失眠、慢性苯中毒、肿瘤、营养不良、免疫功能低下症、脂溢性皮炎
丹皮,中药名。为毛茛科植物牡丹干燥根皮。产于安徽、山东等地。秋季采挖根部,除去细根,剥取根皮,晒干。生用或炒用。《本草纲目》:“滋阴降火,解斑毒,利咽喉,通小便血滞。后人乃专以黄蘖治相火,不知丹皮之功更胜也。赤花者利,白花者补,人亦罕悟,宜分别之。”现代研究,所含牡丹酚及其以外的糖苷类成分均有抗炎作用;牡丹皮的甲醇提取物有抑制血小板作用;牡丹酚有镇静、降温、解热、镇痛、解痉等中枢抑制作用及抗动脉粥样硬化、利尿、抗溃疡等作用。
车前子甘;淡;性微寒。归经:归肺经;肝经;肾经;膀胱经。功能:清热利尿;渗湿止泻;明目;祛痰。主治:主小便不利;淋浊带下;水肿胀满;暑湿泻痢;目赤障翳;痰热咳喘。《本草经集注》:主虚劳。《药性沦》:能去风毒,肝中风热,毒风冲眼目,赤痛障翳,脑痛泪出,去心胸烦热。《日华子本草》:通小便淋涩,壮阳。治脱精,心烦。下气。
丹参苦,微寒。归心、肝经。祛瘀止痛,活血通经,清心除烦。用于月经不调,经闭痛经,症瘕积聚,胸腹刺痛,热痹疼痛,疮疡肿痛,心烦不眠。用于胸肋胁痛,风湿痹痛,症瘕结块,疮疡肿痛,跌仆伤痛,月经不调,经闭痛经,产后瘀痛等。治疗胸肋疼痛、症瘕结块,以及月经不调、经闭经痛具有良效。《纲目》载:丹参,按《妇人明理论》云,四物汤治妇人病,不问产前产后,经水多少,皆可通用,惟一味丹参散,主治与之相同。盖丹参能破宿血,补新血,安生胎,落死胎,止崩中滞下,调经脉。
覆盆子植物可入药,有多种药物价值,其果实有补肾壮阳的作用。覆盆子油属于不饱和脂肪酸,可促进前列腺分泌苛尔蒙。功效:补肝益肾,固精缩尿,明目。以大鼠、兔的阴道涂片及内膜切片作治疗指标,覆盆子似有雌激素样作用。抑菌作用100%煎剂用平板打洞法,对葡萄球菌有抑制作用,对霍乱弧菌也有抑制作用。雌激素样作用大鼠、兔的阴道涂片及内膜切片等指标表明,覆盆子似有雌激素样作用。
益母草味辛苦、凉。活血、祛淤、调经、消水。治疗妇女月经不调,胎漏难产,胞衣不下,产后血晕,瘀血腹痛,崩中漏下,尿血、泻血,痈肿疮疡。益母草碱性皮下注射有中枢抑制作用,MLD为0.4-0.6g/kg。兔静脉注射益母草碱1mg/kg,可见尿量显著增加。益母草碱在较高浓度时能使兔血悬液发生溶血作用。益母草碱水浸液用试管稀释法1∶13-1∶10,对许兰氏毛菌,羊毛样小孢子菌、红色表皮癣菌、星状奴卡氏菌均有抑制作用。益母草煎剂用平板纸片法,对大肠杆菌、志贺氏痢疾杆菌有抑制作用。益母草能去淤生新,活血调经,含有硒、锰等多种微量元素,能抗氧化、防衰老,具有相当不错的益颜美容、抗衰防老功效。
葛根,中药名。为豆科植物野葛的干燥根,习称野葛。秋、冬二季采挖,趁鲜切成厚片或小块;干燥。甘、辛,凉。有解肌退热,透疹,生津止渴,升阳止泻之功。常用于表证发热,项背强痛,麻疹不透,热病口渴,阴虚消渴,热泻热痢,脾虚泄泻。
知母中国各地都有栽培,抗旱抗寒能力强,干旱少雨的荒山、荒漠、荒地中都能生长,是绿化山区和荒原的首选品种,全年各季节都能播种,主要是春播或夏播。该种干燥根状茎为著名中药,性苦寒,有滋阴降火、润燥滑肠、利大小便之效。属清热下火药,主治:温热病、高热烦渴、咳嗽气喘、燥咳、便秘、骨蒸潮热、虚烦不眠、消渴淋浊。有“毛知母”与“知母肉”之分。最主要产区在河北。
菟丝子:中药菟丝子为双子叶植物药旋花科植物菟丝子、南方菟丝子、金灯藤等的种子,能补肾益精、养肝明目、固胎止泄之功效。滋补肝肾、固精缩尿,安胎,明目,止泻。用于阳痿遗精、尿有余沥、遗尿尿频、腰膝酸软、目昏耳鸣、肾虚胎漏、胎动不安、脾肾胎漏、胎动不安、脾肾虚泻;外治白癜风。将原药筛去泥屑,拣去杂质,晒干。
熟地为玄参科植物地黄(学名:Rehmannia glutinosa)的块根,又名熟地黄或伏地,经加工炮制而成。通常以酒、砂仁、陈皮为辅料经反复蒸晒,至内外色黑油润,质地柔软粘腻。切片用,或炒炭用。熟地又名熟地黄或伏地,属玄参科植物,是一种上好中药材,具有补血滋阴功效,可用于血虚萎黄,眩晕,心悸失眠,月经不调,崩漏等症,亦可用于肾阴不足的潮热骨蒸、盗汗、遗精、消渴等症,是虚证类非处方药药品六味地黄丸主要成分之一。
五味子为木兰科植物五味子Schisandra chinensis(Turcz.)Baill.或华中五味子Schisandra sphenanthera Rehd.et Wils.的干燥成熟果实。前者习称“北五味子”,后者习称“南五味子”。秋季果实成熟时采摘,晒干或蒸后晒干,除去果梗及杂质。唐等《新修本草》载“五味皮肉甘酸,核中辛苦,都有咸味”,故有五味子之名。五味子分为南、北二种。古医书称它荎蕏、玄及、会及,最早列于神农本草经上品中药,能滋补强壮之力,药用价值极高,有强身健体之效,与琼珍灵芝合用治疗失眠。
墨旱莲草为中医常用的养肝益肾、凉血止血药物。对肝肾阴虚所致的头昏目眩、牙齿松动、腰背酸痛、下肢痿软诸症以及血热所致的多种出血证有良好疗效。旱莲草含有挥发油、鞣质、皂甙、旱莲草素及维生素A等化学成分。动物试验有止血效果,体外试验对金黄色葡萄球菌有抑制作用。
淫羊藿为小檗科植物淫羊藿、箭叶淫羊藿、巫山淫羊藿、朝鲜淫羊藿等多种淫羊藿的茎叶。味性归经:辛、甘,温。归肝、肾经主治功能:补肾阳,强筋骨,祛风湿。淫羊藿具有延缓衰老、降血压,降血糖,降血脂。改善脑缺血缺氧、降低血液黏度、抑制体外血栓形成、刺激骨髓DNA的合成、增加外周血白细胞及骨髓造血干细胞的数量、提高免疫力、促进骨骼生长、预防骨质疏松、抗炎,抗病毒,抗肿瘤、对抗抗癌药物的副作用。
中药何首乌有生首乌与制首乌之分,直接切片入药为生首乌,用黑豆煮汁拌蒸后晒干入药为制首乌。二者的功用有所不同:生首乌功能解毒、消痈、润肠通便,常用于治疗瘰疬疮痈、风疹瘙痒、肠燥便秘;制首乌功能补肝肾、益精血、乌须发、强筋骨,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、久疟体虚等。本发明所采用的制首乌是补肾益肾的佳品。
赤芍,中药名。为毛茛科植物赤芍或川赤芍的干燥根。春、秋二季采挖,除去根茎、须根及泥沙,晒干。苦,微寒。归肝经。有清热凉血,活血祛瘀的功效。赤芍是著名野生地道中药材,
外用:
土茯苓甘淡,平。归经:肝经;胃经;脾经。功能:解毒,除湿,利关节。主治:治梅毒,淋浊,筋骨挛痛,脚气,疗疔疮,痈肿,瘰疬,梅毒及汞中毒所致的肢体拘挛,筋骨疼痛。《本草正义》:土茯苓,利湿去热,能入络,搜剔湿热之蕴毒。其解d水银、轻粉毒者,彼以升提收毒上行,而此以渗利下导为务,故专治杨梅毒疮,深入百络,关节疼痛,甚至腐烂,又毒火上行,咽喉痛溃,一切恶症。
蛇床子性辛、苦,温;有小毒。归肾经。主治温肾壮阳,燥湿,祛风,杀虫。用于阳痿,宫冷,寒湿带下,湿痹腰痛;外治外阴湿疹,妇人阴痒;滴虫性阴道炎,是妇科外用良药。《本草经疏》载:蛇床子,味苦平;《别录》辛甘无毒;今详其气味,当必兼温燥,阳也。故主妇人阴中肿痛,男子阴痿湿痒,除痹气,利关节,恶疮。《别录》温中下气,令妇人子服热,男子阴强,令人有子。盖以舌能除湿,温能散寒,辛能润肾,甘能益脾,故能除妇人男子一切虚寒湿所生病。寒湿既除,则病去,性能益阳,故能已疾,而又有补益也。
苦参性苦,寒。归心、肝、胃、大肠、膀胱经清热燥湿,杀虫,利尿。用于热痢,便血,黄疸尿闭,赤白带下,阴肿阴痒,湿疹,湿疮,皮肤瘙痒,疥癣麻风;外治霉菌性阴道炎,常与黄柏结合使用,是治疗阴道炎的外用妇科良药。
艾叶辛、苦,温,无毒;归肝、脾、肾经。散寒止痛,温经止血。用于少腹冷痛,经寒不调,宫冷不孕,吐血,衄血,崩漏经多,妊娠下血;外治皮肤瘙痒,脱皮。理气血,逐寒湿;温经,止血,安胎。治心腹冷痛,泄泻转筋,久痢,吐衄,下血,月经不调,崩漏,带下,胎动不安,痈疡,疥癣。《别录》:主灸百病。可作煎,止下痢,吐血,下部匿疮,妇人漏血。利阴气,生肌肉,辟风寒,使人有子。陶弘景:捣叶以灸百病,亦止伤血。
青黛性味:咸,寒。归经:入肝经、肺经、胃经。功能:清热,凉血消斑,解毒,清肝泻火,定惊。主治:治温病热盛,斑疹,吐血、咯血,小儿惊痫,疮肿,丹毒,蛇虫咬伤。《本草经疏》:“青黛,解毒除热,固其所长,古方多有用之于诸血证者,使非血分实热,而病生于阴虚内热,阳无所附,火气因虚上炎,发为吐衄咯唾等证,用之非宜。血得寒则凝,凝则寒热交作,胸膈或痛,愈增其病矣。”《本经逢原》:“青黛,泻肝胆,散郁火,治温毒发斑及产后热痢下重,《千金》蓝青丸用之,天行寒热头痛,水研服之。与蓝同类,而止血拔毒杀虫之功,似胜于蓝。又治噎膈之疾,取其化虫之力也。和溺白、冰片,吹片,吹口疳最效。”
冰片味辛、苦,微寒;归心、肝、肺经;清香宣散,具有开窍醒神,清热散毒,明目退翳的功效,主治热病高热神昏,中风痰厥惊痫,暑湿蒙蔽清窍,喉痹耳聋,口疮齿肿,疮痈疳痔,目赤肿痛,翳膜遮睛。通诸窍,散郁火,去翳明目,消肿止痛,清热散毒,散火解毒。治乳腺结块,中风口噤,热病神昏,惊痫痰迷,气闭耳聋,喉痹,口疮,中耳炎,痈肿,痔疮,目亦翳膜,蛲虫病。《别录》:″妇人难产,取龙脑研末少许,以新汲水调服。″《唐本草》:″主心腹邪气,风湿积聚,耳聋。明目,去目赤肤翳。″《海药本草》:″主内外障眼,三虫,治五痔,明目,镇心,秘精。″
白芨性苦、甘、涩,微寒。归肺、肝、胃经。功能主治收敛止血,消肿生肌。用于咳血吐血,外伤出血,疮疡肿毒,皮肤皲裂;肺结核咳血,溃疡病出血。《神农本草经》:“主痈肿、恶疮、败疽,伤阴死肌,胃中邪气”;《本草纲目》:“气味(根)苦、平、无毒。
紫草性味:苦,寒,归经:入心包络、肝经。功能主治:凉血,活血,清热,解毒。治温热斑疹,湿热黄疸,紫癜,吐、衄、尿血,淋浊,热结便秘,烧伤,湿疹,丹毒,痈疡。《本经》:″主心腹邪气,五疸,补中益气,利九窍,通水道。″
小米草,学名:Euphrasia pectinata Ten,为一年生草本植物,全草具药用价值。小米草提取物为小米草的全草的地上部分,具有去眼袋、消疲劳的功效。味苦;性微寒,归经,归膀胱经,功能主治清热解毒;利尿。主热病口渴;头痛;肺热咳嗽;咽喉肿痛;热淋;小便不利;口疮;痈肿。
夏枯草辛、苦,寒。归肝、胆经。功效:清热泻火,明目,散结消肿。目赤肿痛、头痛眩晕、目珠夜痛。本品苦寒主入肝经,善泻肝火以明目。用治肝火上炎,目赤肿痛,可配桑叶、菊花、决明子等药用。本品清肝明目之中,略兼养肝,配当归、枸杞子,可用于肝阴不足,目珠疼痛,至夜尤甚者;亦可配香附、甘草用,如夏枯草散(《张氏医通》)。瘰疬、瘿瘤。本品味辛能散结,苦寒能泄热,常配贝母、香附等药用以治肝郁化火,痰火凝聚之瘰疬,如夏枯草汤(《外科正宗》);用治瘿瘤,则常配昆布、玄参等用,如夏枯草膏(《医宗金鉴》)。
本发明内服丸剂的制备步骤为:取赤芍1500g,鸡血藤1500g,山茱萸1500g,益母草1500g,柴胡1500g,紫草1500g,熟地1500g,女贞子1500g,旱莲草1500g,五味子1500g,覆盆子1500g,菟丝子1500g,淫羊藿1500g,丹皮1500g,葛根1500g,车前子1500g,知母1500g,加水浸泡30分钟至1小时,加热煮沸30~40分钟,过滤,滤液备用;滤渣加水,第二次加热,煮沸30~40分钟,过滤,滤液备用;滤渣再加水,第三次加热煮沸30~40分钟,过滤;将三次滤液合在一起,加热浓缩至膏状,用烘箱干燥后,成细粉,掺蜂蜜搓成丸剂。
本发明内服胶囊剂的制作过程为:取赤芍1200g,鸡血藤1100g,山茱萸1100g,益母草1200g,柴胡1100g,紫草1100g,熟地1200g,女贞子1200g,旱莲草1200g,五味子1200g,覆盆子1200g,菟丝子1200g,淫羊藿1200g,丹皮1100g,葛根1200g,车前子1200g,知母1100g,将原料晾晒,切成粗粒,然后浸泡于乙醇中2小时。然后加热提取2次,每次1-2小时,合并提取液,静置后去上清液,然后100-120目滤过,再经截流分子量为5000-10000的超滤柱超滤,超滤液减压浓缩相对密度为80℃时1.36的浸膏,静置备用,成为组分1。再将上述乙醇提取过的原料药的药渣加10倍量水,加热回流提取2次,每次1~2小时,将2次提取液合并静置,成为组分2。将组分1和组分2的合并,然后放入减压浓缩罐内,减压回收乙醇,浓缩至药液浓度为0.6g生药/mL,抽滤至滤液的相对密度为20℃时1.06;上述滤液经体积为10L的大孔吸附树脂柱吸附后,用10倍树脂柱体积的去离子水或蒸馏水洗脱,再用5倍树脂柱体积的95%乙醇洗脱,收集乙醇洗脱液,去除溶剂,得到药粉干燥后装入胶囊。
本发明栓剂的制备方法:将白芨1000g、青黛1000g、冰片1000g用蒸馏法汽化成结晶,然后粉碎,过100-120目筛,作为组分1备用;再将其余原料药紫草1000g,苦参1000g,蛇床子1000g,土茯苓1000g,艾叶1000g,夏枯草1000g,小米草1000g切碎,将其浸泡置于有盖不锈钢桶内,加70%乙醇液,质量为粗颗粒的0.8-1倍,搅拌均匀,湿润密闭放置1小时以上,使充分膨胀;将渗漉筒底部滤板用纱布袋包裹铺平后再将湿润膨胀后的药物样品拌松弄散,然后用不锈钢勺盛粉,均匀的装入渗漉筒,装10-12厘米厚,用T型棒压匀,再按上述操作,一层一层的装入,适当加压,药粉填装不得超过渗漉筒的2/3高处;药粉面上盖不锈钢孔板压牢,打开渗漉筒下面的放料阀,并放一容器,然后缓缓加入70%乙醇液;待排出药粉粉粒之间的空气,并有乙醇流出约20L左右,关闭放料阀,盖上漉筒、浸渍24小时,然后开放料阀进行渗漉,控制渗漉速度一般为1000g药材每分钟流出2~3ml,滤液放入贮液缸内,并将排空时的乙醇液倒入贮液缸;将渗滤液合并静置,作为组分2;组分1组分2混合成药膏;选取基质50℃~60℃加热融化,加入上述得到的药膏冷却定型制成类弹头状栓剂,紫外线杀毒。所述栓剂所用的基质选自:半合成脂肪酸甘油酯、泊洛沙姆、聚乙二醇、羊毛脂中的一种或多种;所述基质在温度50℃~60℃条件下加热融化,加入所述制备方法制得的药物膏体,水浴搅拌均匀,混合成粘稠的液体,灌注在塑料定型管内,插入棉栓,冷却定型制成子弹头状栓剂;所述棉栓为尾部带有棉线的棉栓。
所述栓剂的具体用法如下:将本发明药物栓剂除去塑料外壳,取出药栓,拉出尾部棉线,将药栓纳入阴道底部,每晚一次,棉线留在体外,次日晨起拉出棉栓,连续用药7天为一疗程。
毒理学试验:
试验例1:本发明急性毒性试验
一、试验材料:
动物:昆明种小鼠,体重21-24g,雌雄各半,山东大学生物试验室育种。药物:本发明内服胶囊剂。
二、方法:
1、LD50计算:采用改良寇氏法,将小鼠随机分成5组,每组10只,雌雄各半,将栓剂溶解,配成最大浓度,按小鼠最大允许容量给药,所给剂量按生药量依次为18,14.4,11.5,9.2,7.4(g.kg-1),在动物禁食(不禁水)18小时后,一日内分两次给药(间隔半小时),每次0.5ml,治疗动物死亡情况。
2、最大耐受剂量测定(MTD值):取小鼠20只,雌雄各10只。将栓剂加蒸馏水溶解,配成最高浓度,按动物的最大耐受量,以注射灌喂器能抽动为准。在动物禁食(不禁水)18小时后,一日内分两次给药(间隔半小时),每次0.5ml(每ml含生药0.36g),总药量为18g生药/kg.d,相当临床成人50Kg体重用量的300倍。给药后连续治疗7天。
三、试验结果:
在LD50计算中当用最大允许浓度和最大允许容量给予小鼠时(18g/Kg.d),未见小鼠死亡,即未测出LD50,只可求最大耐受剂量,在7天治疗期中,动物其食欲、活动、毛色、精神状态等皆正常,发育正常,未见有死亡。即选用相当于临床剂量的300倍药量,并无不良反应发生,表明急性毒性极小,MTD>18g/Kg.d。
试验例2:本发明急性皮肤刺激试验报告
1、实验目的:检测本发明栓剂对实验动物皮肤的刺激/腐蚀作用和强度
2、材料和方法:
2.1.受试物:名称:本发明栓剂(实施例3方法制得)
2.2.实验动物:壹级大耳白种家兔,10只,雌性,体重2.1-2.3kg;由青岛大学医学院生物系实验动物中心提供;
2.3.试验方法:
选用皮肤完好的健康家兔10只,于试验前24小时将其背部脊柱两侧被毛剪掉,去毛面积左、右各约4cm×4cm。试验时取受试物0.2ml涂于2.5cm×2.5cm的二层纱布上,敷贴于一侧去毛皮肤表面,油纸覆盖,胶布固定。另一侧皮肤作为空白对照。封闭4小时后,去除覆盖物,并用温水清洗去残留受试物,于去除受试物后的1、24和48小时治疗涂抹部位皮肤反应,并评分。
3、实验结果:实验动物皮肤未出现任何红斑,红肿,发炎现象。
4、小结:根据《消毒技术规范》(1999)中皮肤刺激反应评分标准判定,本发明软膏剂对动物皮肤刺激强度属无刺激性。
实施例3:阴道粘膜刺激试验结果
1.试验方法:
实验动物检疫3天后,选用18只上述健康家兔,随机分为三组,每组各6只,分别为:空白对照、赋形剂对照、本发明栓剂组(按应用液5倍浓度)。分别用适当大小的灭菌棉条浸以灭菌生理盐水和受试物置于赋形剂对照组和受试物组动物阴道内,与阴道粘膜接触6小时,24小时后处死动物。取出局部阴道组织,治疗病变情况。
2、试验结果:阴道粘膜刺激试验结果
实施例4:皮肤过敏试验结果
用本发明栓剂,进行诱导和激发接触试验,在24小时和48小时后治疗试验小鼠,均不见皮肤有红斑及水肿等现象,与阴性对照组无差异。结果表明,该栓剂对皮肤反应强度近于零,即无皮肤变态反应。
实施例5:长期毒性实验资料
1、实验方法
将豚鼠随机份成4组,每组15只。在豚鼠背部脊柱两侧将脱毛剂均匀涂上,使其脱毛范围约40平方厘米。洗净脱毛剂,治疗24小时后每组豚鼠分别涂本发明栓剂溶液0.2、0.4和0.8ml,分别含生药92、184和368mg,另一组涂溶媒0.8ml每日二次,连续30天,治疗豚鼠的一般情况,实验结束后处死动物进行血液学、血液生化及病理学检查。
2、结果
上述三组用药豚鼠躯干去毛区,未见局部皮肤有水肿、充血、红斑、出血点及溃疡。用药组与对照组动物毛发色泽、摄食、四肢活动等对照组无明显差异,血液生化检查,用药组与对照组均在正常范围。病理组织学检查,实验各组心、肝、肾及局部皮肤均未见明显病变。提示,本发明中药栓剂长期用药对局部皮肤及全身重要脏器均未见明显的毒性作用。
试验结果表明:本发明中药栓剂实验安全。该药对乙型链球菌、金黄色葡萄球菌、大肠杆菌的最小抑制浓度为1∶150,淋球菌为1∶150,白色念珠菌为1∶300,对1∶20稀释度时的杀灭时间为5分钟,1∶50时为10分钟,1∶100时为20分钟,1∶200时为40分钟,1∶400时为8小时。
临床试验:
自2014年1月-2015年11月,我们自拟补肾养阴方治疗卵巢早衰40例,疗效较好,报告如下。
1临床资料
共80例,均为40岁以前继发闭经、FSH升高者。年龄17~39岁,平均(33.3±6.8)岁;闭经1~11年,平均(3.6±3.7)年。闭经之前有月经稀发,或不规则出血,或频发或月经量少,或突然闭经。其中3例初潮1~3年即闭经,有2例有服中药雷公藤史,1例患白癜风服西药(具体不详);2~5年后闭经,有6例有慢性盆腔炎史。有3例其母在40岁以前闭经。有3例继发性不孕,1例原发性不孕。均有潮热、出汗、焦虑、抑郁、失眠或记忆力减退,或阴道干涩,性交痛或尿频尿急等症状。80例随机分为中药组与西药组。
西医诊断标准为40岁以前出现至少4个月以上闭经,并有2次或以上血清FSH>40U/L(2次检查间隔1个月以上),雌二醇水平<73.2pmol/L。
中医诊断标准为40岁以前断经,月经稀少,渐至闭经或忽然停经,烘热汗出,潮热面红,五心烦热,头晕耳鸣,腰膝酸软或后足跟疼,溲赤便干,形体消瘦,阴道干涩。B超示子宫偏小或两侧卵巢偏小,未发现卵泡或连续监测仅见极少数的未能发育的小卵泡,血清E2水平低下,FSH明显升高,舌红或有裂纹、苔少,脉细数或带弦。
2治疗方法
中药组用补肾养阴方。药用熟地12g、赤芍13g、紫草12g、山茱萸11g、五味子11g、柴胡12g、女贞子13g、旱莲草12g、制首乌12g、仙茅13g、淫羊藿12g、菟丝子12g、知母12g,葛根15g,丹皮12g。每日1剂,日服2次,3个月为一疗程。
西药组用倍美力,每次0.625mg,每日1次,连服22天;第18天加服安宫黄体酮,每日1次,每次10mg,月经来潮第5天或月经未来潮则停药第7天再继续服药。连服3个月为一疗程。
两组均治疗1个疗程后统计结果。
3观察方法
治疗前后临床症状及月经周期、经量的变化,血清性激素的变化,超声示子宫卵巢的体积,子宫内膜厚度变化。血FSH、E2由本院免疫室检验,采用荧光酶联免疫法,试剂由法国生物梅里埃公司出品,彩超为日本Nani17。统计计数资料用x2检验,计量资料用t检验。
4疗效标准
显效:临床症状及体征消失,内分泌检查血清激素正常,月经来潮且连续2次以上正常行经,排卵功能恢复或妊娠。好转:主要症状及体征明显减轻,月经恢复来潮,但周期不正常,内分泌检查血清激素好转或接近正常。无效:症状、体征及内分泌检查无明显改善。
5治疗结果
两组疗效比较:两组疗效比较无显著性差异(P>0.05)。见表1。
表1两组疗效比较例(%)
组别 | n | 显效 | 有效 | 无效 | 总有效率 |
中药组 | 40 | 26 | 3 | 11 | 72.5% |
西药组 | 40 | 22 | 5 | 13 | 67.5% |
两组血清性激素变化:血清E2明显升高,FSH明显降低,两组治疗前后比较有显著性差异(P<0.05);
两组治疗后比较无显著性差异。
表2两组血清性激素指标比较(-x±s)
两组用药后不良反应比较:中药组的不良反应低于西药组,两组比较有显著性差异,(P<0.05),见表3。
表3两组用药后不良反应比较例
组别 | 恶心 | 头痛 | 乳胀痛 | 水肿 | 腹胀 | 白带多 |
中药组 | 2 | 1 | 0 | 0 | 1 | 2 |
西药组 | 7 | 6 | 2 | 3 | 2 | 4 |
两组症状改善比较:两组症状消失率比较有显著性差异(P<0.05),见表4。
表4两组症状改善比较例(%)
卵巢早衰占妇女总人数的1%~3.8%,是妇科内分泌领域的常见病。由于此类患者表现为早发或原发闭经、雌激素低下所致的围绝经期症状及不孕,故属中医闭经、早发绝经、绝经前后诸证、不孕等范畴。由于肾虚冲任功能早衰,经血的生成障碍致胞宫胞脉(血海)空虚,无血可下而早发绝经。《傅青主女科》云:“经水早断,似乎肾水衰涸”。因妇女以血为主,且“阴常不足,阳常有余”,故治疗应重在补肾养阴,活血调经。补肾养阴方方中熟地滋肾阴,益精髓为君药。山茱萸、何首乌、菟丝子补益肝肾,养精血。紫草、生蒲黄活血化淤,行血养肝血,调冲任。淫羊藿补益肝肾。女贞子、旱莲草为二至丸,功效补肾养肝益精。银柴胡、知母滋阴清热泻火。葛根清热生津,据现代药理研究葛根具有雌激素样作用,对于妇女生殖内分泌具有调节作用。诸药合用共奏补肾养阴活血,调养冲任功效。补肾调经中药具有延缓性腺功能减退作用,又有促进卵巢功能恢复作用,同时补肾中药对女性性腺轴功能有一定的调节作用,通过动物实验研究发现补肾药有促进卵巢LH/HCG受体增加现象。中药还可能有促进FSH受体产生的作用,滋补肝肾、益精养血中药具有促卵泡发育的作用。用补肾药在去势小鼠身上有雌激素样反应,故认为中药可调节人类卵泡发育和排卵。
卵巢早衰从病因到病程到临床表现都有明显的异质性,要进行正确的病因诊断,辨证与辨病相结合,采取相应的治疗对策,以改善健康或延缓性腺衰老。现代研究认为,补肾调冲中药有增强体质,调节性腺轴及免疫功能,甚或延缓性腺衰老作用。临床表明,补肾养阴方临床应用安全、有效,治疗卵巢早衰疗效肯定,不良反应少,在保护、恢复卵巢功能方面有一定的作用,其疗效等同于单纯西药治疗,并且毒副作用较小,价格便宜。
Claims (10)
1.一种治疗妇女卵巢早衰的中药组合物,其特征在于,由内服药物和外用药物组成,所述内服药物包括以下重量份的原料药:赤芍10~20份,鸡血藤10~20份,山茱萸10~20份,益母草10~20份,柴胡10~20份,紫草10~20份,熟地10~20份,女贞子10~20份,旱莲草10~20份,五味子10~20份,覆盆子10~20份,菟丝子10~20份,淫羊藿10~20份,丹皮10~20份,葛根10~20份,车前子10~20份,知母10~20份;
所述外用药物包括以下重量份数的原料药:紫草10~20份,苦参10~20份,蛇床子10~20份,土茯苓10~20份,白芨10~20份,艾叶10~20份,青黛10~20份,夏枯草10~20份,冰片10~20份,小米草10~20份。
2.根据权利要求1所述治疗妇女卵巢早衰的中药组合物,其特征在于,所述内服药物还包括以下重量份的原料药:赤芍10~15份,鸡血藤10~15份,山茱萸10~15份,益母草10~15份,柴胡10~15份,紫草10~15份,熟地10~15份,女贞子10~15份,旱莲草10~15份,五味子10~20份,覆盆子10~20份,菟丝子10~20份,淫羊藿10~20份,丹皮10~20份,葛根10~20份,车前子10~20份,知母10~20份;
所述外用药物还包括以下重量份数的原料药:紫草10~15份,苦参10~15份,蛇床子10~15份,土茯苓10~15份,白芨10~15份,艾叶10~20份,青黛10~20份,夏枯草10~20份,冰片10~20份,小米草10~20份。
3.根据权利要求1所述治疗妇女卵巢早衰的中药组合物,其特征在于,所述内服药物也包括以下重量份的原料药:赤芍10~20份,鸡血藤10~20份,山茱萸10~20份,益母草10~20份,柴胡10~20份,紫草10~20份,熟地10~20份,女贞子10~20份,旱莲草10~20份,五味子10~15份,覆盆子10~15份,菟丝子10~15份,淫羊藿10~15份,丹皮10~15份,葛根10~15份,车前子10~15份,知母10~15份;
所述外用药物也包括以下重量份数的原料药:紫草10~20份,苦参10~20份,蛇床子10~20份,土茯苓10~20份,白芨10~20份,艾叶10~15份,青黛10~15份,夏枯草10~15份,冰片10~15份,小米草10~15份。
4.一种如权利要求1~3中任一项所述治疗妇女卵巢早衰的中药组合物的制备方法,其特征在于,所述内服药物为胶囊剂的制备步骤包括:
a、取原料药放入乙醇中浸泡,热提取2次,为组分1;
b、药渣加水提取2次,浓缩过滤,为组分2;
c、将上述两种组分合并,浓缩,干燥成粉末装入胶囊。
5.根据权利要求4所述治疗妇女卵巢早衰的胶囊剂的制备方法,其特征在于,所述步骤a中,取原料药加入5-10倍量的乙醇中浸泡1-2小时,加热提取2次,每次1-2小时,合并提取液,静置后去上清液,然后100-120目滤过,再经截流分子量为5000-10000的超滤柱超滤,超滤液减压浓缩相对密度为80℃时1.36的浸膏,静置备用,成为组分1。
6.根据权利要求4所述治疗妇女卵巢早衰的胶囊剂的制备方法,其特征在于,所述步骤b中,上述乙醇提取过的原料药的药渣加10倍量水,加热回流提取2次,每次1~2小时,将2次提取液合并静置,成为组分2。
7.根据权利要求4所述治疗妇女卵巢早衰的胶囊剂的制备方法,其特征在于,所述步骤c中,将组分1和组分2的合并,然后放入减压浓缩罐内,减压回收乙醇,浓缩至药液浓度为0.6g生药/mL,抽滤至滤液的相对密度为20℃时1.06;上述滤液经体积为10L的大孔吸附树脂柱吸附后,用10倍树脂柱体积的去离子水或蒸馏水洗脱,再用5倍树脂柱体积的95%乙醇洗脱,收集乙醇洗脱液,去除溶剂,得到药粉干燥后装入胶囊。
8.一种如权利要求1~3中任一项所述治疗妇女卵巢早衰的中药组合物的制备方法,其特征在于,所述外用药物为栓剂的制备步骤包括:
a.取白芨、青黛、冰片用蒸馏法汽化成结晶,粉碎过细筛待用,作为组分1;
b.将其余原料用乙醇萃取,浓缩,作为组分2;
c.将组分1、组分2混合后加基质调和,定型制成栓剂,杀菌装袋。
9.根据权利要求8所述治疗妇女卵巢早衰的中药组合物的外用药物的栓剂的制备方法,其特征在于,所述步骤a中,先将原料药白芨、青黛、冰片用水蒸气法蒸馏,得到结晶物,然后粉碎,过100-120目筛,作为组分1备用;所述步骤b中,再将其余原料药切碎,将其浸泡置于有盖不锈钢桶内,加70%乙醇液,质量为粗颗粒的0.8-1倍,搅拌均匀,湿润密闭放置1小时以上,使充分膨胀;将渗漉筒底部滤板用纱布袋包裹铺平后再将湿润膨胀后的药物样品拌松弄散,然后用不锈钢勺盛粉,均匀的装入渗漉筒,装10-12厘米厚,用T型棒压匀,再按上述操作,一层一层的装入,适当加压,药粉填装不得超过渗漉筒的2/3高处;药粉面上盖不锈钢孔板压牢,打开渗漉筒下面的放料阀,并放一容器,然后缓缓加入70%乙醇液;待排出药粉粉粒之间的空气,并有乙醇流出约20L左右,关闭放料阀,盖上漉筒、浸渍24小时,然后开放料阀进行渗漉,控制渗漉速度一般为1000g药材每分钟流出2~3ml,滤液放入贮液缸内,并将排空时的乙醇液倒入贮液缸;将渗滤液合并静置,作为组分2;组分1组分2混合成药膏;选取基质50℃~60℃加热融化,加入上述得到的药膏冷却定型制成类弹头状栓剂,紫外线杀毒。
10.根据权利要求8中所述治疗妇女卵巢早衰外用栓剂的制备方法,其特征在于,所述栓剂所用的基质选自:半合成脂肪酸甘油酯、泊洛沙姆、聚乙二醇、羊毛脂中的一种或多种;所述基质在温度50℃~60℃条件下加热融化,加入所述制备方法制得的药物膏体,水浴搅拌均匀,混合成粘稠的液体,灌注在塑料定型管内,插入棉栓,冷却定型制成子弹头状栓剂;所述棉栓为尾部带有棉线的棉栓。
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