CN106421694B - External traditional Chinese medicine preparation for treating dysmenorrhea - Google Patents
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Abstract
The invention belongs to the technical field of traditional Chinese medicines, and particularly relates to an external traditional Chinese medicine preparation for treating primary dysmenorrhea caused by nerve, endocrine and immune network imbalance and uterine local microcirculation disturbance. The external traditional Chinese medicine preparation comprises the following raw materials in parts by weight: 10-20 parts of cinnamon, 5-10 parts of dried ginger, 5-10 parts of asarum, 10-20 parts of rhizoma corydalis, 5-10 parts of trogopterus dung, 5-10 parts of cattail pollen, 5-10 parts of rhizoma cyperi, 5-10 parts of scorpion and 2-5 parts of pangolin. The traditional Chinese medicine can be used for treating primary dysmenorrhea by combining with drug-separated moxibustion therapy, and has strong pertinence and remarkable effect.
Description
Technical Field
The invention belongs to the technical field of traditional Chinese medicines, and particularly relates to an external traditional Chinese medicine preparation for treating primary dysmenorrhea caused by nerve, endocrine and immune network imbalance and uterine local microcirculation disturbance.
Background
Primary Dysmenorrhea (PD) refers to the symptoms of lower abdominal pain, tenesmus, and soreness of waist before and after menstruation or during menstruation. Through a plurality of epidemiological surveys, more than half of women in sexual maturity stages have dysmenorrheal phenomenon in different periods, and pain is caused when menstruation comes. Not only can cause the patient to have depressed and anxious mood, but also can not even carry out normal daily work and rest, and seriously influences the health and the life of the female. Therefore, research on prevention and treatment of primary dysmenorrhea is urgent and needs to be solved urgently.
The exact cause of primary dysmenorrhea is not completely clear at present, and modern medicine considers that the pathological mechanism of primary dysmenorrhea is closely related to Prostaglandins (PGs). PGF in endometrium and menstrual blood of dysmenorrhea patients2α、PGE2The content of PGF is obviously increased compared with normal women2αThe high content can cause the over-strong contraction of uterine smooth muscle and the contraction of blood vessels, so as to cause uterine ischemia and hypoxia state to cause dysmenorrheal; PG (Picture experts group)E2Plays an important role in the development of pain, and tissues can be locally released when being damaged and inflamedPGE2Pain is caused by inflammatory pain-causing substances such as histamine and leukotriene, increased prostaglandin enters blood circulation, and cardiovascular and digestive tract symptoms may also be caused. In addition, other metabolic endocrine factors such as Nitric Oxide (NO), Endothelin (ET), oxytocin (0T), Estrogen (ESG), progestin (P) and the like also play a role in the mechanism of PD development. It has also been found that PD is treated by cutting off nerve conduction from the proximal uterus and its appendages to the spine (i.e. pre-sacral sympathectomy) and that norepinephrine causes spasmodic contraction of uterine smooth muscle and blood vessels, resulting in dysmenorrhea, suggesting that nerves and neurotransmitters are involved in primary dysmenorrhea. Meanwhile, researches show that the levels of T lymphocyte CD3+ and CD4+ in the blood serum of the rats with dysmenorrhea are obviously lower than those of a normal control group, and the immune function is obviously low. In addition to the above factors, some scholars use color doppler ultrasound to detect uterine artery blood flow parameters, and the results show that the blood flow resistance of patients with dysmenorrhea is higher than that of healthy people, the uterine artery blood flow resistance is large, and the local blood flow of uterus is reduced, which causes microcirculation disturbance. In summary, it is currently believed that the occurrence of primary dysmenorrhea is mainly related to two factors: first, imbalance of neural, endocrine, immune networks; second, partial microcirculation disturbance of uterus.
In the aspect of treating primary dysmenorrhea, non-steroidal anti-inflammatory drugs and contraceptives are mostly adopted in modern medicine at present, intervention treatment is carried out by taking pain relieving, sedation and hormone secretion inhibition as main means, although the modern medicine has the advantages of rapidness and high efficiency, the effect is not lasting, long-term administration is required, and various adverse reactions and toxic and side effects can be brought to a body after long-term administration. Therefore, there is a need to research a drug for treating dysmenorrhea with strong pertinence and significant effect.
Disclosure of Invention
The invention aims at the problems and provides an external traditional Chinese medicine preparation for treating dysmenorrhea. The traditional Chinese medicine can be used for treating primary dysmenorrhea by combining with moxibustion therapy, and has remarkable effect.
In order to achieve the purpose, the external traditional Chinese medicine preparation for treating dysmenorrhea provided by the invention comprises the following raw material components in parts by weight: 10-20 parts of cinnamon, 5-10 parts of dried ginger, 5-10 parts of asarum, 10-20 parts of rhizoma corydalis, 5-10 parts of trogopterus dung, 5-10 parts of cattail pollen, 5-10 parts of rhizoma cyperi, 5-10 parts of scorpion and 2-5 parts of pangolin.
The preparation is powder.
The external preparation is powder for drug-separated moxibustion.
In order to realize the purpose, the invention also provides a preparation method of the external traditional Chinese medicine preparation.
Pulverizing decoction pieces of the required raw materials (sieving with No. 7-8 sieve of 120-150 meshes), and mixing; adding yellow wine to get dry paste (10 ml per 10g Chinese medicinal powder); making into medicinal cake with diameter of 3-5cm and thickness of 1-1.5 cm.
The medicinal raw materials selected by the invention have the following pharmacodynamic analysis.
Cortex Cinnamomi has effects of tonifying fire, supporting yang, guiding fire to its original origin, dispelling cold, relieving pain, promoting blood circulation and dredging channels. Modern pharmacological research shows that cinnamon has the effects of resisting platelet aggregation and blood coagulation, simultaneously has the inhibition effect on animal pain response caused by various stimulations, and has certain influence on endocrine function because the cinnamon has obvious promotion effect on adrenal cortex function.
The dried ginger has the effects of warming the middle-jiao and dispelling cold, restoring yang and promoting blood circulation, and eliminating dampness and phlegm. Modern pharmacological research suggests that rhizoma Zingiberis has antithrombotic effect, and can significantly prolong thromboplastin time of experimental animals. Meanwhile, the ether extract and the water extract of the dried ginger have the analgesic effect, and the times of the body writhing reaction of the mice caused by acetic acid can be reduced.
Modern pharmacological research shows that the asarum has the analgesic effect, and meanwhile, the asarum can improve the metabolic function of an organism, and the racemized higenamine separated from the asarum has β -receptor agonist-like wide pharmacological effect and has the effects of strengthening heart, dilating blood vessels, relaxing smooth muscles and the like.
Rhizoma corydalis has the effects of promoting blood circulation, removing blood stasis, regulating qi and relieving pain. Modern pharmacology indicates that rhizoma corydalis has obvious analgesic effect and has relaxation effect on muscles. Corydalis B extracted from rhizoma corydalis has effect in exciting pituitary adrenal system, and regulating endocrine system.
Oletum Trogopterori has effects in promoting blood circulation and removing blood stasis; pollen Typhae has hemostatic, blood stasis dispelling, and stranguria relieving effects. Modern pharmacological research suggests that both have platelet aggregation resisting and anticoagulation effects, and research shows that trogopterus dung has the effect of relieving smooth muscle spasm.
The rhizoma cyperi has the effects of soothing liver-qi stagnation, regulating qi, relieving epigastric distention, regulating menstruation and relieving pain. Research shows that the volatile oil of nutgrass galingale rhizome has the functions of easing pain, relaxing smooth muscles of intestines, relieving spasm of smooth muscles of bronchus, relaxing smooth muscles of uterus, reducing muscle tension and weakening contractility.
Scorpion can extinguish wind, relieve spasm, activate meridians, alleviate pain, counteract toxic pathogen and dissipate nodulation. Studies suggest that scorpion has analgesic effect.
Squama Manis has effects of promoting blood circulation, resolving hard mass, dredging channels, promoting lactation, resolving carbuncle, and dissipating hard mass. Research shows that the water decoction of pangolin scales has the functions of obviously prolonging the blood coagulation time of mice and reducing the blood viscosity of the mice.
The prescription has the characteristics that: wherein cinnamon, dried ginger and asarum are good at warming yang, dispelling cold and relieving pain and are the monarch drugs; rhizoma corydalis, trogopterus dung and cattail pollen are taken as ministerial drugs for removing blood stasis and relieving pain; rhizoma cyperi is used as adjuvant for promoting the circulation of qi and relieving pain; scorpion, scorpion and pangolin scales, which are guiding drugs, dredge the channels and collaterals and relieve pain.
The prescription adopted in the invention is a formula of a decoction for removing blood stasis in lower abdomen: fructus Foeniculi with the functions of dispelling cold and relieving pain, and herba asari with pungent and warm natured effects and better fragrance and penetration effect; trogopterus dung has good effects of promoting blood circulation, removing blood stasis and relieving pain, is an essential medicine for treating various pains caused by blood stasis, is used together with cattail pollen for assisting the effect, and is pungent in flavor, capable of activating qi stagnation in blood and qi stagnation in qi and blood, specially used for treating various pains in the upper and lower parts of the whole body, and has enough effects of removing blood stasis and relieving pain, so that the rhizoma ligustici wallichii, the angelica, the red paeony root and the myrrh which have weaker blood circulation-activating force in the middle and the above formula are used; the rhizoma cyperi is the essential drug for soothing the liver and relieving the depression, promoting the circulation of qi and relieving pain, and the rhizoma cyperi is added to the drug for taking the qi as the commander of blood and removing the pain caused by blood stasis when the qi circulates; squama Manis is good at moving and fleeing, reaches viscera and meridians, and has effects of promoting blood circulation, removing blood stasis, eliminating mass, and dredging channels and collaterals; scorpio has effects in dredging collaterals and relieving pain. The whole formula has the effects of warming channels, dispelling cold, promoting blood circulation and relieving pain.
The invention has the beneficial effects.
In the invention, the drug-separated moxibustion is an important component of the external treatment method of the traditional Chinese medicine, is a characteristic medicine and an important medical and health resource in China, and has profound clinical deposit and long-term popularization value in application by the advantages and characteristics of simple, convenient, cheap, effective, quick, non-traumatic and non-pain disease prevention and treatment. The medicine-separated moxibustion is a therapy which is formed by taking the basic theory of traditional Chinese medicine as guidance and combining moxibustion and traditional Chinese medicine to excite channels and collaterals and acupuncture points to play a comprehensive treatment role, thereby playing a role of combining medicines, acupuncture points and moxibustion. On one hand, acupuncture and drug actions directly stimulate acupuncture points on the channels and collaterals to produce certain curative effects; on the other hand, the medicine moxibustion is applied on the acupuncture points, the medicine is kept for a long time at the acupuncture points, so that the medicine can circulate along the meridians to dredge the channel qi, and the medicine reaches the disease sites, thereby having the effects of warming the meridians and expelling cold, regulating qi and blood, and balancing yin and yang. PD occurrence may be related to multiple system dysfunction of the body, and the treatment of dysmenorrhea by drug-mediated moxibustion focuses on regulating the body function as a whole, so regulating the neuro-endocrine-immune network and improving uterine microcirculation are important components of the therapeutic approach of primary dysmenorrhea by drug-mediated moxibustion.
In the invention, effective medicines are screened to form an effective prescription on the basis of a large amount of clinical medicines, a medicine cake for external administration is developed, and clinical comparative observation of the medicine for treating primary dysmenorrhea is carried out in two years, so that the prescription is proved to have the effects of warming channels, dispelling cold, promoting blood circulation and relieving pain. The drug-separated moxibustion is superior to the simple moxibustion method in the aspects of VAS scoring of abdominal pain of patients with primary dysmenorrhea and improvement of traditional Chinese medicine symptoms of dysmenorrhea, can relieve symptoms of dysmenorrhea in a short time, and has definite curative effect.
40 cases of primary dysmenorrhea (congealing cold and blood stasis) patients are randomly divided into two groups, the treatment group is treated by drug-separated moxibustion, the control group is treated by simple moxibustion, and moxibustion is applied 7 times per menstrual cycle for 3 consecutive menstrual cycles. Changes in the VAS score and the traditional chinese medical syndrome score for abdominal pain after 3 months of treatment over the period were observed and differences between the two groups were compared. The result shows that the difference of VAS scores of abdominal pain before and after treatment of the drug-separated moxibustion group and the simple moxibustion group has statistical significance (P is less than 0.05), and the curative effect of the drug-separated moxibustion group is superior to that of the simple moxibustion group (P is less than 0.05); in the aspect of traditional Chinese medicine syndrome curative effect, the effective rates of the drug-separated moxibustion group and the simple moxibustion group are respectively 95% and 80%, and the curative effect of the drug-separated moxibustion group is superior to that of the control group. The external traditional Chinese medicine has better treatment effect in clinical treatment of primary dysmenorrhea.
Detailed Description
The present invention will be further described with reference to the following examples.
Example 1.
The external traditional Chinese medicine preparation for treating dysmenorrhea comprises the following raw material components in parts by weight: 20 parts of cinnamon, 10 parts of dried ginger, 10 parts of asarum, 18 parts of rhizoma corydalis, 8 parts of trogopterus dung, 10 parts of cattail pollen, 10 parts of rhizoma cyperi, 7 parts of scorpion and 4 parts of pangolin.
The external traditional Chinese medicine preparation is prepared into a drug-separated moxibustion medicine cake for treating primary dysmenorrhea, and the preparation method specifically comprises the following steps: weighing the raw material medicine decoction pieces according to the weight part ratio, crushing the decoction pieces to the granularity of 120-mesh and 150-mesh, and uniformly mixing. Taking 10g of the pulverized medicinal powder, blending with 10ml of yellow wine, and preparing a medicinal cake specification by using a medicinal cake mold, wherein the medicinal cake specification is as follows: diameter of 3cm, thickness of 1cm, sealing, and keeping.
The application method of the drug-separated moxibustion medicine cake for treating primary dysmenorrhea comprises the following steps: the medicated cakes are placed on SHENQUE acupoint and GUANYUAN acupoint respectively, and the moxa cone is placed on the two medicated cakes and ignited. Moxibustion is started 5 days before menstruation, and is continuously applied for 7 days in each menstrual cycle, which is a treatment course and is continuously applied for 3 menstrual cycles, namely 3 treatment courses.
1. Clinical data.
1.1 general data.
40 subjects who met the inclusion criteria were from outpatients of hospitals affiliated to Liaoning university of traditional Chinese medicine, Liaoning university and Liaoning university of traditional Chinese medicine, respectively. The subjects were randomly divided into 20 cases each of the drug-separated moxibustion group (treatment group) and the simple moxibustion group (control group). The comparative difference of the two groups of patients in terms of age and disease course has no statistical significance (P >0.05) and is comparable.
1.2 inclusion criteria.
(1) The diagnosis standard of primary dysmenorrhea (congealing cold and blood stasis syndrome) is met; (2) the age is more than or equal to 18 years and less than or equal to 35 years; (3) menstrual cycle regularity (28 ± 7) d; (4) signing an informed consent; (5) the VAS score is more than or equal to 3 points; (6) CMSS score > 10.
1.3 exclusion criteria.
(1) The western medicine diagnosis belongs to secondary dysmenorrhea, and the examination proves that the patients with secondary dysmenorrhea are caused by pelvic inflammation, endometriosis, hysteromyoma, ovarian lesion and the like; (2) combined with primary diseases such as cardiovascular and cerebrovascular diseases, liver, kidney and hemopoietic system which seriously endanger life and mental patients, and other diseases which are not suitable for moxibustion; (3) lactating women and pregnant or recently pregnancies; (4) those with allergic constitution, or those known to be allergic to the medicinal component; (5) taking analgesic, sedative and hormone medicine within 1 month before treatment; (6) are participating in other clinical trials; (7) medical staff attending the clinical study.
2. Methods of treatment.
2.1 moxibustion group (treatment group) with separated medicines.
2.1.1 the medicine composition (dysmenorrhea powder): a cake was prepared as in example 1.
2.1.2 moxa-cones were produced.
The moxa cones were made by hand according to the national general higher education Chinese medicine fine-knitted teaching material "acupuncture and moxibustion", with a diameter of about 2cm and a height of about 2.5 cm.
2.1.3 operating method.
(1) Point selection: the patient takes the supine position and fully exposes the umbilicus and lower abdomen. Shenque acupoint: in the middle of the abdomen, in the center of the umbilicus. Guanyuan acupoint: on the lower abdomen, on the midline of the abdomen, 3 cun below the umbilicus. The acupuncture point location is carried out according to the national standard of the people's republic of China (GB 12346-90).
(2) Sterilizing with 75% ethanol on navel and Guanyuan acupoint.
(3) The medicated cake is placed on SHENQUE acupoint and GUANYUAN acupoint respectively.
(4) A moxa cone was placed on top of the two cakes and moxibustion was performed for 6 strong approximately 20 minutes.
(5) Moxibustion application time: moxibustion is applied to each acupoint for 20 minutes, 1 time/day, and 7 times in total.
2.1.4 the timing and course of moxibustion.
Moxibustion is applied 5 days before menstruation, and is continuously applied for 7 days in each menstrual cycle and for 3 months in each menstrual cycle.
2.2 moxibustion only group (control group).
2.2.1 methods of operation.
(1) Point selection: the same medicated moxibustion group.
(2) Mild moxibustion is performed by igniting one end of a moxa roll, aiming at the acupoint to be moxibustion, and performing moxibustion at a distance of about 2-3 cm from the skin, so that the local part of a patient is warm and hot without burning pain, and the moxibustion is performed for 20 minutes every acupoint until the skin is reddish and moist.
(3) Moxibustion application time: the same medicated moxibustion group.
2.2.2 moxibustion application time and course of treatment are as follows: the same medicated moxibustion group.
3, the treatment effect.
3.1 Observation index.
3.1.1 Abdominal pain VAS score.
The pain degree of dysmenorrheal and abdominal pain is evaluated by adopting a Visual Analogue Scale (VAS) which is commonly used internationally, and the change of VAS scores in the treatment group and the control group before and after the treatment and between the groups is compared.
3.1.2 evaluation of the curative effect of the traditional Chinese medicine syndrome.
The changes of the Chinese medicine syndrome score before and after treatment and between the treatment groups and the control group are compared.
The therapeutic effect judgment standard is drawn up according to nimodipine method and clinical research guiding principle of new Chinese medicine.
(1) And (3) healing: the abdominal pain disappears under the menstrual period, and n is more than or equal to 95 percent.
(2) The effect is shown: the abdominal pain during the menstrual period is obviously relieved, and n is more than or equal to 70% and less than 95%.
(3) The method has the following advantages: the abdominal pain is relieved during the menstrual period, and n is more than or equal to 30% and less than 70%.
(4) And (4) invalidation: the abdominal pain under menstrual period is not obviously improved, and n is less than 30 percent.
The curative effect index (n) is (the integral of the traditional Chinese medicine syndrome before treatment-the integral of the traditional Chinese medicine syndrome after 3 months of treatment) or the integral of the traditional Chinese medicine syndrome before treatment multiplied by 100 percent.
3.1.3 adverse reaction observation.
Adverse reactions, which may be associated with therapeutic agents, are well documented.
3.2 statistical methods.
Statistical processing is carried out by using SPSS19.0 statistical software, and the detection result is expressed by mean +/-standard deviation; the significance of the difference between the two groups was tested by t-test. P < 0.05 is a statistically significant sign of the difference. The grade data were analyzed by Ridit.
4 treatment results.
4.1 comparison of pain VAS scores before and after treatment in the two groups, see Table 1.
Table 1 two groups of patients were compared before and after pain VAS scores.
Note that P is < 0.01 before treatment compared with the present group, and △ P is < 0.05 after treatment compared with the control group, the results in Table 1 show that the VAS scores of both groups after treatment are significantly reduced compared with those before treatment (P < 0.05), and the treatment group is lower than that of the control group (P < 0.05).
4.2 the curative effect of the traditional Chinese medicine syndrome before and after two groups of treatment is judged.
In 20 cases of the treatment group, 2 cases are cured, 12 cases with obvious effect, 5 cases with effect and 1 case with no effect, and the total effective rate is 95 percent; in 20 cases of the control group, 2 cases are cured, 6 cases are obviously effective, 8 cases are effective, 4 cases are ineffective, and the total effective rate is 80%. Ridit analysis showed that the treatment was superior to the control in efficacy, as shown in Table 2.
Table 2 compares the therapeutic effects of the two groups of patients.
The tests show that the external traditional Chinese medicine has obvious curative effect on treating primary dysmenorrhea caused by nerve, endocrine, immune network imbalance and partial uterine microcirculation disturbance, and the curative effect is superior to that of a pure moxibustion treatment control group. And (4) conclusion: the external traditional Chinese medicine has better treatment effect in clinical treatment of primary dysmenorrhea. No adverse reaction appeared during observation.
Example 2.
17 parts of cinnamon, 5 parts of dried ginger, 5 parts of asarum, 20 parts of rhizoma corydalis, 5 parts of trogopterus dung, 5 parts of cattail pollen, 7 parts of rhizoma cyperi, 10 parts of scorpion and 2 parts of pangolin.
Example 3.
10 parts of cinnamon, 7 parts of dried ginger, 8 parts of asarum, 10 parts of rhizoma corydalis, 10 parts of trogopterus dung, 9 parts of cattail pollen, 5 parts of rhizoma cyperi, 5 parts of scorpion and 5 parts of pangolin.
Claims (3)
1. The external traditional Chinese medicine preparation for treating dysmenorrhea is characterized by comprising the following raw material components in parts by weight: 20 parts of cinnamon, 10 parts of dried ginger, 10 parts of asarum, 10 parts of rhizoma cyperi, 18 parts of rhizoma corydalis, 8 parts of trogopterus dung, 10 parts of cattail pollen, 7 parts of scorpion and 4 parts of pangolin.
2. The external traditional Chinese medicine preparation for treating dysmenorrhea is characterized by comprising the following raw material components in parts by weight: 17 parts of cinnamon, 5 parts of dried ginger, 5 parts of asarum, 7 parts of rhizoma cyperi, 20 parts of rhizoma corydalis, 5 parts of trogopterus dung, 5 parts of cattail pollen, 10 parts of scorpion and 2 parts of pangolin.
3. The external traditional Chinese medicine preparation for treating dysmenorrhea is characterized by comprising the following raw material components in parts by weight: 10 parts of cinnamon, 7 parts of dried ginger, 8 parts of asarum, 5 parts of rhizoma cyperi, 10 parts of rhizoma corydalis, 10 parts of trogopterus dung, 9 parts of cattail pollen, 5 parts of scorpion and 5 parts of pangolin.
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| CN107050123B (en) * | 2017-05-10 | 2020-08-11 | 吉安长江生物药业有限公司 | Body surface external application liniment for relieving dysmenorrhea |
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| CN103933292A (en) * | 2014-04-24 | 2014-07-23 | 陈筠 | Dysmenorrhea treating patch |
| CN103990099A (en) * | 2014-06-13 | 2014-08-20 | 山东省医学科学院基础医学研究所 | Traditional Chinese medicine composition for treating dysmenorrhea |
| CN104107299A (en) * | 2014-06-28 | 2014-10-22 | 蚌埠火鹤制药有限公司 | Traditional Chinese medicine mixture for treating dysmenorrhoea |
| CN104983989A (en) * | 2015-06-25 | 2015-10-21 | 广州中医药大学 | Traditional Chinese medicine drug for treating dysmenorrheal and gel paste and preparation method thereof |
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| CN103933292A (en) * | 2014-04-24 | 2014-07-23 | 陈筠 | Dysmenorrhea treating patch |
| CN103990099A (en) * | 2014-06-13 | 2014-08-20 | 山东省医学科学院基础医学研究所 | Traditional Chinese medicine composition for treating dysmenorrhea |
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