CN106177363A - 能够延缓慢性肾功能衰竭的中药 - Google Patents

能够延缓慢性肾功能衰竭的中药 Download PDF

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CN106177363A
CN106177363A CN201610781581.6A CN201610781581A CN106177363A CN 106177363 A CN106177363 A CN 106177363A CN 201610781581 A CN201610781581 A CN 201610781581A CN 106177363 A CN106177363 A CN 106177363A
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radix
rhizoma
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刘新瑞
李玉春
邱婧
王世岩
刘万成
王显成
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Jilin Academy of Traditional Chinese Medicine
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Jilin Academy of Traditional Chinese Medicine
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Abstract

能够延缓慢性肾功能衰竭的中药属于中药技术领域。现有技术缺少一种治疗西医所称的慢性肾功能衰竭的中药。本发明其特征在于，组分及配比为：黄芪15～25克，肉桂2～5克，萆薢9～15克，淮山药15～25克，杜仲10～15克，益母草10～25克，牛膝6～15克，大黄5～15克，土茯苓9～15克，甘草3～10克；取黄芪、肉桂、淮山药、大黄粉碎成细粉，过筛，混匀，得混合粉料；其余组分加水煎煮3～5次，首次煎煮时间为2～3小时，之后各次煎煮时间相同，均为0.5～1.5小时，将各次煎煮液合并，过滤后得滤液，将所述滤液浓缩得稠膏状滤液；将所述混合粉料加入所述稠膏状滤液中，混匀，干燥，粉碎成细粉，装入胶囊，即得。用于治疗慢性肾功能衰竭。

Description

能够延缓慢性肾功能衰竭的中药
技术领域
[0001 ]本发明涉及一种能够延缓慢性肾功能衰竭的中药，用于治疗慢性肾功能衰竭，属于中药技术领域。
技术背景
[0002] CRF(chronic renal failure，慢性肾功能衰竭)是各种慢性肾脏疾病或累及肾脏的系统性疾病发展到一定阶段后，引起慢性进行性肾功能减退，并产生各种临床症状和代谢紊乱的一种综合征，是各种慢性肾脏病发展的最终结局，严重危害人的健康。CRF具有发病率高、病程迀延、知晓率低和医疗费用高等特点。CRF最终发展为ESRD(终末期肾衰竭)，进入昂贵的替代治疗阶段。而ESRD的年发病率估计未来10年仍将以每年4.1%的百分比上升。在住院病人中，患泌尿系统疾病的老年病人占3.4〜6.3%，是老年住院病人的第8位死因，且近年来呈上升趋势。美国健康研究院的数据表明，ESRD占接受医疗患者群的I %，但其医疗费用却占整个医疗预算的7%;美国透析支出由20世纪80年代的2000亿美元升至90年代约4500亿美元，预计2016年将达到万余亿美元。鉴于CRF的严重健康危害和经济负担，研制疗效确切的能够延缓CRF进展的药物具有极其重要意义。
[0003]目前，从CRF的发现初期进展到ESRD阶段，现代医学尚无有效措施延缓这一过程，血管紧张素转换酶抑制剂(ACEI)及血管紧张素受体拮抗剂(ARB)的应用虽被证实对肾脏具有一定的保护作用，但其作用单一，且因应用时机的局限性，仍不适合应用于大部分CRF患者。而进入透析期后，费用昂贵的透析或肾移植等肾脏替代治疗虽能维持生命，但患者不仅要承受巨大的经济负担，也饱受身体和心理上的折磨。对于ESRD无论是腹膜透析还是血液透析均存在副作用，也不能改善肾组织的病理损害。肾移植因肾源缺乏、费用昂贵以及术后排斥反应，也使多数患者难以承受和接受。
[0004]由于CRF的病机复杂，症状多变，应该进行全面整体的治疗。已有大量的临床资料显示，中医中药在缓解CRF患者症状、提高生活质量、保护残余肾功能、延缓早中期肾功能衰竭的进展、推迟进入替代治疗阶段等方面具有较好疗效和化学药无可替代的独特优势。
发明内容
[0005]本发明的目的就是要提供一种用于治疗CRF的中药，为此，我们发明了一种能够延缓慢性肾功能衰竭的中药，本发明能够明显改善CRF患者的临床症状、延缓肾功能衰竭的进展、减少透析次数、提高生活质量，且安全无毒、质量可控。
[0006]本发明之能够延缓慢性肾功能衰竭的中药其特征在于，组分及配比为:黄芪15〜25克，肉桂2〜5克，萆蘚9〜15克，淮山药15〜25克，杜仲10〜15克，益母草10〜25克，牛膝6〜15克，大黄5〜15克，土茯苓9〜15克，甘草3〜10克;取黄芪、肉桂、淮山药、大黄粉碎成细粉，过筛，混匀，得混合粉料;其余组分加水煎煮3〜5次，首次煎煮时间为2〜3小时，之后各次煎煮时间相同，均为0.5〜1.5小时，将各次煎煮液合并，过滤后得滤液，将所述滤液浓缩得稠膏状滤液;将所述混合粉料加入所述稠膏状滤液中，混匀，干燥，粉碎成细粉，装入胶囊，即得。
[0007]本发明选定的组分分别具有以下药物功效:
[0008]黄芪:味甘、微温，归脾、肺经，能够益气健脾、升阳举陷、利尿消肿；
[0009]肉桂:味辛、甘、大热，归肾、脾、心、肝经，能够补火助阳、散寒止痛、温通经脉、引火归原；
[0010]萆蘚:味苦、平，归肾、胃经，能够利湿化浊；
[0011]淮山药:味甘、平，归脾、肺、肾经，能够补脾肺肾、益气固本；
[0012]杜仲:味甘、温，归肝、肾经，能够补肝肾、强筋骨；
[0013]益母草:味辛、苦，归心、膀胱经，能够利水消肿、清热解毒；
[0014]牛膝:味苦、甘、酸、平，归肾、肝经，能够补肝肾、利水通淋、引药下行；
[0015]大黄:味苦、寒，归脾、胃、大肠、肝经，能够泻下攻积、清热泻火、祛瘀解毒；
[0016] 土茯苓:味甘、淡，归肝、胃经，能够利湿去热、解毒；
[0017]甘草:味甘、平，归脾、胃、肾经，能够补脾益气、清热解毒、调和诸药。
[0018]在所述各组分的药物功效基础上，所述各组分具有以下君药、臣药、佐药、使药配伍机理:
[0019]黄芪健脾补气、利水消肿，肉桂补肾壮阳、固精暖脾，萆蘚利湿化浊，三者相伍，补肾助阳、益气健脾、利水化浊，共为君药；
[0020]淮山药补脾益气、益肾固本，杜仲补肾扶正，益母草解毒行水，三者助君药利水消月中，解毒化浊，共为臣药；
[0021]牛膝引药下行，大黄泻下导滞、降浊解毒，土茯苓利湿解毒，三者助君臣降逆下行、清浊解毒，共为佐药；
[0022]甘草调和诸药，为使药。
[0023]全方共奏补肾健脾、降逆化浊之效。
[0024]本发明体现了中医中药对CRF认识的深化，以传统中医学理论为指导，辨证施治。本发明用于脾肾阳(气)虚、浊毒内蕴型慢性肾功能衰竭，适用于各种原因引起的慢性肾功能衰竭，为此，已开展临床试验10余年，能够明显改善患者的临床症状、延缓肾功能的进展、减少透析次数、提高生活质量，经过上千例患者的疗效统计，在降低血肌酐及尿素氮等尿毒物质方面总有效率达77.63%。且本发明为纯中药制剂，无毒副作用，临床应用过程中未出现不良反应。本发明为口服制剂，无创伤，无痛苦，价格低廉，可减轻患者负担。
具体实施方式
[0025]下面结合代表性医案进一步说明本发明。
[0026]医案一:
[0027]患者某男，56岁。该患者因全身浮肿6个月，加重伴乏力2天就诊。症见:全身浮肿，乏力，腹胀，畏寒，恶心，尿黄，便干，舌暗红，苔黄腻，脉滑缓无力。理化检查一一尿常规示:尿蛋白3+，潜血3+;肾功示:尿素氮13.6mmol/L，血肌酐366ymol/L。中医诊断为:肾衰(脾肾两虚、湿浊内蕴)；西医诊断为:慢性肾功能衰竭(失代偿期)；治以补肾健脾、化湿降浊。处方:黄芪20克、肉桂3克、荜蘚10克、淮山药15克、杜仲10克、益母草15克、牛膝8克、大黄10克、土茯苓15克、甘草6克，另加车前子10克、大腹皮15克;取黄芪、肉桂、淮山药、大黄粉碎成细粉，过筛，混匀，得混合粉料;其余组分加水煎煮3次，煎煮时间依次为3小时、I小时、I小时，将3次煎煮液合并，过滤后得滤液，将所述滤液浓缩得稠膏状滤液，将所述混合粉料加入所述稠膏状滤液中，混匀，干燥，粉碎成细粉，装入胶囊，即得。二诊，浮肿明显改善，腹胀减轻，恶心减轻，乏力，便略溏，舌暗红，苔黄腻，脉滑无力。复查尿常规:尿蛋白2+，潜血I+;复查肾功:尿素氮10.6mmol/L，血肌酐286ymol/L。继续服用前方。三诊，患者浮肿明显改善，眼睑及下肢中度浮肿，乏力减轻，未见恶心，饮食增加，大便干，舌淡红，苔薄黄腻，脉滑弱。复查尿常规:尿蛋白1+，潜血I+;复查肾功:尿素氮9.3mmol/L，血肌酐202ymol/L。继续服用前方。四诊，患者浮肿明显改善，眼睑及下肢轻度浮肿，乏力好转，未见恶心，舌淡红，苔薄黄腻，脉滑弱。复查尿常规:尿蛋白I+;复查肾功:尿素氮7.5mmol/L，血肌酐168ymol/L。继续服用前方。五诊，患者浮肿明显改善，下肢轻度浮肿，无乏力，无心烦，大便正常，舌淡红，苔薄白，脉滑。复查尿常规:尿蛋白I + ;复查肾功:尿素氮6.3mmol/L，血肌酐148ymol/L。前方去大腹皮，继续巩固治疗。
[0028]医案二:
[0029]患者某男，35岁。自述肾炎病史3年，刻诊:面色恍白，颜面、下肢浮肿，神疲乏力，纳呆，腰背酸痛，膝软，畏寒肢冷，尿少，24小时尿量800ml，大便正常。舌淡嫩，有齿痕，苔白腻，脉沉细。血压145/80mmHg。理化检查——尿常规:蛋白3+，红细胞3〜5/高倍视野;肾功:尿素氮19.3mmol/L，血肌酐367ymol/L;血常规:血红蛋白96g/L。中医诊断:肾衰(脾肾两虚、湿池内蕴)；西医诊断为:慢性肾小球肾炎、慢性肾功能衰竭(失代偿期)。治以健脾补肾、化湿降浊。处方:黄芪20克、肉桂5克、荜蘚15克、淮山药20克、杜仲10克、益母草15克、牛膝15克、大黄10克、土茯苓15克、甘草10克，另加夏枯草10克、茯苓15克、陈皮15克;取黄芪、肉桂、淮山药、大黄粉碎成细粉，过筛，混匀，得混合粉料;其余组分加水煎煮4次，煎煮时间依次为2小时、I小时、I小时、I小时，将4次煎煮液合并，过滤后得滤液，将所述滤液浓缩得稠膏状滤液，将所述混合粉料加入所述稠膏状滤液中，混匀，干燥，粉碎成细粉，装入胶囊，即得。二诊，自诉服药3天后，尿量增加，浮肿逐渐减轻，两周时基本消退，目前颜面、下肢已无水肿，面色好转，腰痛明显减轻，饮食增加，体力增强，畏寒肢冷缓解，二便正常。复查尿常规:尿蛋白2+，血红蛋白103g/L;复查肾功:尿素氮15.6mmol/L，血肌酐298ymol/L。上方去陈皮，继续服用。三诊，患者无浮肿，精神状态佳，无明显乏力感，饮食较好，轻度畏寒，尿量、大便正常，舌淡，苔薄白，脉沉细。复查尿常规:尿蛋白2+，潜血I+;复查肾功:尿素氮11.3mmol/L，血肌酐253μmol/L。继续服用上方，嘱低盐、低蛋白饮食，防止外感，勿过劳。四诊，患者疗效巩固，病情进一步改善，自觉如健康人一样，有力气，饮食、睡眠佳，无腰酸膝软，无肢冷畏寒，舌淡胖，苔薄白，脉沉细。复查尿常规:尿蛋白2+;复查肾功:尿素氮9.5mmol/L，血肌酐201ymol/L。继续服用上方。五诊，患者无明显自觉症状，饮食、睡眠、二便正常，舌淡红，苔薄白，脉沉细。复查尿常规:尿蛋白2+;复查肾功:尿素氮9.3mmo I/L，血肌酐208μπιο I /L。继续巩固治疗。
[0030] 医案三:
[0031]患者某男，65岁。就诊主诉:间断腰酸痛、倦怠3年。现症:腰酸痛，畏凉，头晕，下肢酸软，倦怠乏力，腹胀，恶心，食少纳呆，夜尿4〜5次，大便正常。舌质淡红，苔白腻，脉沉。血压正常。中医辨证为肾衰(脾肾两虚、湿浊内蕴)，治疗以健脾益肾、化湿降浊为主。处方:黄芪25克、肉桂3克、荜蘚15克、淮山药20克、杜仲15克、益母草10克、牛膝10克、大黄10克、土茯苓15克、甘草10克，另加益智仁15克、半夏10克;取黄苗、肉桂、淮山药、大黄粉碎成细粉，过筛，混匀，得混合粉料;其余组分加水煎煮5次，煎煮时间依次为2.5小时、0.5小时、0.5小时、
0.5小时、0.5小时，将5次煎煮液合并，过滤后得滤液，将所述滤液浓缩得稠膏状滤液，将所述混合粉料加入所述稠膏状滤液中，混匀，干燥，粉碎成细粉，装入胶囊，即得。二诊:腰酸痛、畏凉减轻，下肢酸软、恶心、腹胀减轻，无头晕，轻度倦怠乏力，夜尿3次，舌质淡红，苔白腻，脉沉。继续服用上方。三诊，患者腰略酸痛，轻度倦怠乏力，饮食增加，无畏凉肢冷，无下肢酸软、恶心症状，质淡红，苔白腻，脉沉。复查肾功:血肌酐210ymol/L。继续服用上方。四诊，患者轻度腰酸痛、畏寒、倦怠乏力，无头晕、腹胀、恶心，饮食增加，夜尿2〜3次，大便正常。舌质淡红，苔白腻，脉沉。复查肾功:血肌酐167ymol/L。继续巩固治疗。

Claims (4)

1.一种能够延缓慢性肾功能衰竭的中药，其特征在于，组分及配比为:黄芪15〜25克，肉桂2〜5克，萆蘚9〜15克，淮山药15〜25克，杜仲10〜15克，益母草10〜25克，牛膝6〜15克，大黄5〜15克，土茯苓9〜15克，甘草3〜10克;取黄芪、肉桂、淮山药、大黄粉碎成细粉，过筛，混匀，得混合粉料;其余组分加水煎煮3〜5次，首次煎煮时间为2〜3小时，之后各次煎煮时间相同，均为0.5〜1.5小时，将各次煎煮液合并，过滤后得滤液，将所述滤液浓缩得稠膏状滤液;将所述混合粉料加入所述稠膏状滤液中，混匀，干燥，粉碎成细粉，装入胶囊，即得。
2.根据权利要求1所述的能够延缓慢性肾功能衰竭的中药，其特征在于，组分及配比为:黄芪20克、肉桂3克、荜蘚10克、淮山药15克、杜仲10克、益母草15克、牛膝8克、大黄10克、土茯苓15克、甘草6克，另加车前子10克、大腹皮15克。
3.根据权利要求1所述的能够延缓慢性肾功能衰竭的中药，其特征在于，组分及配比为:黄芪20克、肉桂5克、荜蘚15克、淮山药20克、杜仲10克、益母草15克、牛膝15克、大黄10克、土茯苓15克、甘草10克，另加夏枯草10克、茯苓15克、陈皮15克。
4.根据权利要求1所述的能够延缓慢性肾功能衰竭的中药，其特征在于，组分及配比为:黄芪25克、肉桂3克、荜蘚15克、淮山药20克、杜仲15克、益母草10克、牛膝10克、大黄10克、土茯苓15克、甘草10克，另加益智仁15克、半夏10克。
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* Cited by examiner, † Cited by third party
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